Unsupervised Healthcare Fraud Detection

Listing Websites about Unsupervised Healthcare Fraud Detection

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Healthcare Fraud Data Mining Methods: A Look Back and …

(3 days ago) WEBEkin et al. (2018) 22 provided a comprehensive discussion of statistical methods in healthcare fraud, including sampling, over-payment estimation methods, and data-mining methods such as supervised, unsupervised, and outlier detection methods from the …

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

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Unsupervised Machine Learning for Explainable Health …

(4 days ago) WEBOur proposed approach for fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing reasoning and …

https://www.nber.org/papers/w30946

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Unsupervised Machine Learning for Explainable …

(6 days ago) WEB2 Shekhar, Leder-Luis, Akoglu: Unsupervised ML for Explainable Health Care Fraud Detection 1. Introduction Fraud in health care is hard to detect. Insurers face …

https://arxiv.org/pdf/2211.02927.pdf

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Using Data Mining to Detect Health Care Fraud and …

(3 days ago) WEBData mining is the core of the KDD process. Data mining can help third-party payers such as health insurance organizations to extract useful knowledge from …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796421/

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Data mining application to healthcare fraud detection: a …

(1 days ago) WEBData mining application to healthcare fraud detection: a two-step unsupervised clustering method for outlier detection with administrative databases …

https://pubmed.ncbi.nlm.nih.gov/32664923/

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Healthcare insurance fraud detection using data mining

(2 days ago) WEBIn this study, a fraud detection methodology is presented that utilizes association rule mining augmented with unsupervised learning techniques to detect …

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4

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Unsupervised Machine Learning for Explainable …

(8 days ago) WEB2 Shekhar, Leder-Luis, Akoglu: Unsupervised ML for Explainable Medicare Fraud Detection These issues are compounded in the federal health care programs, where …

https://arxiv.org/pdf/2211.02927v2.pdf

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WMTDBC: An unsupervised multivariate analysis model …

(7 days ago) WEBSeveral models have been developed by researchers to make the healthcare fraud detection system automated using supervised, semi-supervised and …

https://www.sciencedirect.com/science/article/pii/S0957417422022771

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Unsupervised Machine Learning for Explainable Health …

(2 days ago) WEBOur proposed approach for Medicare fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing …

https://arxiv.org/abs/2211.02927

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UNSUPERVISED MACHINE LEARNING FOR EXPLAINABLE …

(6 days ago) WEB2 Shekhar, Leder-Luis, Akoglu: Unsupervised ML for Explainable Health Care Fraud Detection 1. Introduction Fraud in health care is hard to detect. Insurers …

https://www.nber.org/system/files/working_papers/w30946/w30946.pdf

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Data mining application to healthcare fraud detection: a two-step

(3 days ago) WEBData mining application to healthcare fraud detection: a two-step unsupervised clustering method for outlier detection with administrative databases

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362640/

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GitHub - suhitasva/Capstone_Project: Healthcare Fraud Detection

(5 days ago) WEBThe Department of Justice (DOJ) recovered over $3 billion from False Claims cases in the 2019 fiscal year, with $2.6 billion coming from healthcare fraud schemes. DOJ also …

https://github.com/suhitasva/Capstone_Project

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Unsupervised Machine Learning for Explainable Health Care Fraud …

(9 days ago) WEBOur proposed approach for fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing reasoning …

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4356230

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Fraud Detection applying Unsupervised Learning techniques

(Just Now) WEBAlso known as outlier detection, anomaly detection is a data mining process used to determine types of anomalies found in a data set and to determine …

https://medium.com/southworks/fraud-detection-applying-unsupervised-learning-techniques-4ae6f71b266f

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Supervised Learning Methods for Fraud Detection in Healthcare …

(2 days ago) WEBData-mining techniques can be categorized into supervised methods and unsupervised methods. (2008) A survey on statistical methods for health care fraud …

https://link.springer.com/chapter/10.1007/978-3-642-40017-9_12

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Unsupervised Anomaly Detection of Healthcare Providers Using …

(3 days ago) WEBWith rising healthcare costs, healthcare fraud is a major contributor to these increasing healthcare costs. This study evaluates previous anomaly detection machine learning …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134221/

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Fraud, Waste and Abuse (FWA) - HCP

(8 days ago) WEBFraud, Waste and Abuse (Cont’d.) One of the primary differences between healthcare fraud, waste and abuse (FWA) is knowledge and intent. FRAUD is a person’s or entity’s …

https://www.healthcarepartnersny.com/wp-content/uploads/2020/08/FWA-Provider-Training_Aug-2020.pdf

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Medical Equipment Suppliers Convicted of Health Care Fraud

(6 days ago) WEBThe Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this …

https://www.justice.gov/opa/pr/medical-equipment-suppliers-convicted-health-care-fraud

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Medical Fraud and Abuse Detection System Based on Machine …

(3 days ago) WEBAbstract. It is estimated that approximately 10% of healthcare system expenditures are wasted due to medical fraud and abuse. In the medical area, the …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579458/

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Corporate Fraud Handbook - Wiley Online Library

(9 days ago) WEBFor general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, …

https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781119351962.fmatter

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Suit says Life Source Services fraudulently sent patients to hospice

(8 days ago) WEB0:26. An Oradell-based hospice company allegedly defrauded the federal and state governments by putting nursing home residents who weren’t dying into hospice …

https://www.northjersey.com/story/news/health/2023/01/03/nurse-alleges-life-source-services-oradell-sent-patients-to-hospice-for-profit/69767967007/

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