Claims Management
Showing 1 - 8 of 8 results-
FraudHacker - Anomaly detection system for medical insurance claims data
- Published on: November, 2017
- Daniel Hannah
- Code Available
Centre for Medicare and Medicaid Services (CMS) is a governing body in United States that administers the nation's major healthcare program. To detect ...
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CMS Medicare Fraud Detection
- Published on: September, 2018
- Tao Jin
- Code Available
Healthcare is a major industry in the U.S. with both private and government run programs. Healthcare fraud is a main problem that causes substantial m ...
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Healthcare provider fraud detection analysis
- Published on: October, 2020
- Rohan Kumar Soni
- Code Available
Healthcare fraud is an organized crime which involves peers of providers, physicians, beneficiaries acting together to make fraud claims. Provider fra ...
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Evidence-based Reimbursements
- Published on: October, 2017
- CitiusTech
This predictive analytics based solution uses pre-post event analysis, pareto analysis, RFM analysis and geographical profiling to demonstrates how cl ...
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PREDICTING CONFIDENCE SCORE FOR CLAIM TO BE AUTOMATICALLY PROCESSED FOR FRAUD, WASTE AND ABUSE
- Published on: July, 2019
- CitiusTech
The model predicts the confidence score for claim to be automatically processed for being Fraud, Waste and Abuse (FWA). The confidence score allows de ...
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SUOD - Accelerating Large Scale Unsupervised Heterogeneous Outlier Detection
- Published on: March, 2021
- Wen Wang, Yunlong Wang, Jimeng Sun, Zheng Li, Jianing Yang, Changlin Wan, Leman Akoglu, Cheng Cheng, Yue Zhao,...
- Code Available
SUOD (Scalable Unsupervised Outlier Detection) is an acceleration framework for large-scale unsupervised heterogeneous outlier detector training and p ...
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HealthCare Claims : Application for Android
- Published on: October, 2020
- Green-io
- Code Available
HealthCare Claims is an AI driven FRAUD DETECTOR Android Application created to protect the payer by identifying inconsistencies and potential rule-br ...
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Sequence embeddings to identify fraudulent cases in healthcare insurance
- Published on: May, 2019
- I. Fursov, A. Zaytsev, R. Khasyanov, E. Burnaev, M. Spindler
- Code Available
Fraud leads to substantial costs and losses for companies and clients in the insurance industries hence fraud detection is a key function in these ind ...