In this paper, Fuzzy expert system has been carried out to recognize medical coverage frauds. The point is to recognize extortion asserts precisely inside a brief timeframe. Extortion in medical coverage is truly exceptional and exorbitant for the two policyholders and insurance agencies in all ...
However, increasing adoption of health insurance, growing burden of chronic diseases and healthcare frauds are some of the prominent factors proliferating the healthcare payer services market growth. Healthcare payer services refer to the range of administrative and operational activities performed by ...
Also, if you prefer not to use your health insurance for psychotherapy, this is one avenue to pursue. Online communication – Young people today are heavy in technology use. They mostly prefer using webinars, their emails, and text messaging greatly easing the communication process. Also, the ...
Others (Insurance Frauds & Narcotic Security) By End User Hospitals & Clinics Long term care centers and home care settings Ambulatory Surgical Centers Others (diagnostic centers, physicians and physician organizations, and private healthcare service providers) ...
As observed by the CSO respondents, the governance of civil society engagement in the RCC might have brought counteractive effects for post-transition governance. “CBO frauds in the election process” of CCM (R31-GF) for “the Western democracy” as well as “interference by the UNAIDS” (R41...
Healthcare payers in this market are expected to expand rapidly during the forecast period, supported by the implementation of stringent regulatory requirements, an in-house lack of experienced individuals for claims processing, and growing healthcare costs and related frauds. Payers have also helped ...
The healthcare payer services market is mainly driven by the increasing health insurance enrolments, rising incidences of healthcare frauds, federal mandates, and rising cases of chronic diseases. However, the risk of data breaches, a loss of managerial control, cultural and language barriers, and...
“I cannot imagine what others, that do not have the experience working for a health insurance company, do about issues such as this. I think people throw up their hands, pay the bills and end up in financial and medical disasters because they cannot afford the unexpected costs. The confusi...
Insurance Companies and Government, of course, try to control fraud, but their third party, after the fact status to the treatments makes them less able and less effective in controlling medical fraud. Hospitals, clinics, pharmaceutical companies, and other healthcare providers in general have stepp...
One of the key areas which could support pricing decisions is the detection of fraud; healthcare frauds cost billions of dollars in revenue [69]. In this regard, traditional data mining techniques offer insights into detecting and reducing healthcare fraud. Quantum computing could provide higher ...