Healthcare Data Fraud Detection

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Healthcare Fraud Data Mining Methods: A Look Back and …

(3 days ago) WEBFraud detection in the literature encompasses data mining (rule-based to advanced statistical methods), over-sampling, and extrapolation techniques. The literature concerning overpayment and sampling estimation are important steps in fraud …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/

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Data mining application to healthcare fraud detection: a …

(2 days ago) WEBThe healthcare sector is an interesting target for fraudsters. The availability of a great amount of data makes it possible to tackle this issue with the adoption of data …

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-020-01143-9

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Healthcare Fraud Data Mining Methods: A Look Back and …

(1 days ago) WEBHealthcare fraud is an expensive, white-collar crime in the United States, and it is not a victimless crime. Costs associated with fraud are passed on to the population …

https://pubmed.ncbi.nlm.nih.gov/35440932/

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Big Data fraud detection using multiple medicare data …

(6 days ago) WEBA survey on the state of healthcare upcoding fraud analysis and detection. Health Serv Outcomes Res Methodol. 2017;17(1):31–55. Article Google Scholar …

https://journalofbigdata.springeropen.com/articles/10.1186/s40537-018-0138-3

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Graph Analysis for Detecting Fraud, Waste, and Abuse in …

(Just Now) WEBDetection of fraud, waste, and abuse (FWA) is an important yet challenging problem. In this article, we describe a system to detect suspicious activities in large …

https://onlinelibrary.wiley.com/doi/10.1609/aimag.v37i2.2630

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How to detect healthcare fraud? “A systematic review”

(7 days ago) WEBdetection. Most physicians are detected to act on Abuse and a small portion of more than 2% of doctors take part in fraud practices that harm the healthcare …

https://www.sciencedirect.com/science/article/pii/S0213911121002661

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Fraud Detection in Healthcare - Towards Data Science

(3 days ago) WEBIn summary, view 1 of the dashboard aims at educating an analyst or viewer of the data and overall healthcare situation in the US. After becoming familiar with the data, in the second view, I wish to …

https://towardsdatascience.com/fraud-detection-in-healthcare-1801bf19d36c

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How AI Is Playing a Role in Healthcare Fraud Prevention

(9 days ago) WEBJan. 22, 2020. AI will be a valuable tool for preventing healthcare fraud as more data makes its way into the industry, but it isn't foolproof. Kayla Matthews, Industry Voice. …

https://www.hcinnovationgroup.com/analytics-ai/article/21122363/how-ai-is-playing-a-role-in-healthcare-fraud-prevention

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Healthcare insurance fraud detection using data mining

(8 days ago) WEBMethodolgy In this study, a fraud detection methodology is presented that utilizes association rule mining aug-mented with unsupervised learning techniques to detect …

https://link.springer.com/content/pdf/10.1186/s12911-024-02512-4.pdf

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Data-Centric AI for Healthcare Fraud Detection - Springer

(8 days ago) WEBAutomated methods for detecting fraudulent healthcare providers have the potential to save billions of dollars in healthcare costs and improve the overall quality of patient …

https://link.springer.com/content/pdf/10.1007/s42979-023-01809-x.pdf

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An Intelligent Approach to Healthcare Fraud Prevention

(9 days ago) WEBGiven that healthcare’s most widely used technology providers, such as Epic and Cerner, serve thousands of hospitals and payers and maintain healthcare data on …

https://guidehouse.com/insights/healthcare/2023/intelligent-approach-to-healthcare-fraud-prevention

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Data Analysis on Fraud Detection in American Healthcare

(3 days ago) WEBHealthcare fraud is a white-collar crime where medical facilities submit fabricated claims, resulting in more than $100 billion in loss per year. Fraud claims …

https://nycdatascience.com/blog/student-works/healthcare-fraud-detection/

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MediSecure data breach: why is health data so lucrative for hackers?

(1 days ago) WEBPublished: May 20, 2024 1:23am EDT. Electronic prescriptions offer convenience for patients. PH888/Shutterstock. We don’t know much about the nature of …

https://theconversation.com/medisecure-data-breach-why-is-health-data-so-lucrative-for-hackers-230301

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The Benefits of AI in Healthcare IBM

(7 days ago) WEBAI and ML technologies can sift through enormous volumes of health data—from health records and clinical studies to genetic information—and analyze it …

https://www.ibm.com/think/insights/ai-healthcare-benefits

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HEALTHCARE PROVIDER FRAUD DETECTION ANALYSIS Kaggle

(5 days ago) WEBSyntaxError: Unexpected token < in JSON at position 4. Refresh. HEALTHCARE PROVIDER FRAUD DETECTION ANALYSIS.

https://www.kaggle.com/datasets/rohitrox/healthcare-provider-fraud-detection-analysis

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Providers urge HHS to clarify Change data breach reporting …

(7 days ago) WEBPublished May 21, 2024. Emily Olsen Reporter. Providers are urging the HHS to publicly confirm that Change Healthcare parent company UnitedHealth Group could …

https://www.healthcaredive.com/news/change-healthcare-cyberattack-data-breach-reporting-hhs-ocr-ama/716696/

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Unraveling Healthcare Fraud: Exploring ROI and Deterrence …

(2 days ago) WEBIn the ongoing battle against healthcare fraud, understanding the effectiveness of anti-fraud efforts is paramount. This Q&A, featuring Questrom Assistant …

https://insights.bu.edu/unraveling-healthcare-fraud-exploring-roi-and-deterrence-challenges/

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NCSBN Issues Fraud Detection Guidance for Employers and

(7 days ago) WEBFollow. Chicago, May 23, 2024 (GLOBE NEWSWIRE) -- NCSBN has developed a statement, “ Fraud Detection Guidance for Employers and Educators ,” to …

https://www.globenewswire.com/news-release/2024/05/23/2887569/0/en/NCSBN-Issues-Fraud-Detection-Guidance-for-Employers-and-Educators.html

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Healthcare Fraud Data Mining Methods: A Look Back and Look …

(9 days ago) WEBAbstract Healthcare fraud is an expensive, white-collar crime in the United States, and it is not a victimless crime. Costs associated with fraud are passed on to the population in …

https://perspectives.ahima.org/page/healthcare-fraud-data-mining-methods-a-look-back-and-look-ahead

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Healthcare company WebTPA discloses breach affecting 2.5

(6 days ago) WEBImage Credits: Dave Whitney / Getty Images. A Texas-based company that provides health insurance and benefit plans disclosed a data breach affecting almost …

https://techcrunch.com/2024/05/17/healthcare-company-webtpa-discloses-breach-affecting-2-5-million-people/

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Cyberattack disrupts operations at major US health care network

(6 days ago) WEBCNN —. A cyberattack has disrupted “clinical operations” at major health care nonprofit Ascension, forcing it to take steps to minimize any impact to patient care, …

https://www.cnn.com/2024/05/08/tech/cyberattack-disrupts-healthcare-network/index.html

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Data-Centric AI for Healthcare Fraud Detection SN Computer …

(Just Now) WEBAbstract. Automated methods for detecting fraudulent healthcare providers have the potential to save billions of dollars in healthcare costs and improve the overall …

https://link.springer.com/article/10.1007/s42979-023-01809-x

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AI Anomaly Detection: Applications and Challenges in 2024

(1 days ago) WEBAdditionally, AI-powered fraud detection systems continuously evolve by updating their models with new data, staying ahead of emerging fraud tactics and …

https://www.techmagic.co/blog/ai-anomaly-detection/

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Australian government investigating 'large-scale ransomware' data

(1 days ago) WEBThe ABC can confirm e-script provider MediSecure is the health organisation at the centre of the large-scale ransomware data breach announced by the …

https://www.abc.net.au/news/2024-05-16/health-organisation-part-of-large-scale-ransomware-data-breach/103856582

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Julio Pernía Aznar: Revolutionising Car Insurance Cash Settlements …

(9 days ago) WEBThe implementation of AI in fraud detection has led to impressive results. For example, the insurance industry has seen a significant reduction in fraudulent …

https://insurtechdigital.com/articles/insurance-cash-settlements-ready-for-an-ai-overhaul

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A Comprehensive Fraud Detection for Credit Card Transactions in

(Just Now) WEBCredit card fraud costs card issuers billions of dollars each year. Therefore, an effective Fraud Detection System (FDS) is crucial to minimize losses for banks and …

https://link.springer.com/article/10.1007/s42979-024-02898-y

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Infection Control Basics Infection Control CDC

(4 days ago) WEBInfection prevention, control and response resources for outbreak investigations, the infection control assessment and response (ICAR) tool and more. …

https://www.cdc.gov/infection-control/about/index.html

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