Seliya, "A survey on the state of healthcare upcoding fraud analysis and detection," Health Services and Outcomes Research Methodology, vol. 17, no. 1, pp. 31-55, 2017.Bauder R, Khoshgoftaar TM, Seliya N. A survey on the state of healthcare upcoding fraud analysis and detection. ...
Health Catalyst is a powerful healthcare analytics solutions provider. It has a comprehensive community health record and offers data insights to help in decision-making. They transform data into standard forms and offer reports with an easy-to-use user interface. These plus points compelled us to...
Identifying specific claim line details that underpin the fraud is also challenging, given that such billing discrepancies often pertain to the overall behavior of the provider. Therefore, in our study we employ the unsupervised methods in combination with rule-based approach for detection to mitigate...
the responsibility to establish fraudulent intent falls to investigators or experts. Identifying specific claim line details that underpin the fraud is also challenging, given that such billing discrepancies often pertain to the overall behavior of the provider. Therefore, in our study we employ the un...
Whether it’s patient admission to an ER, adding new hospital suppliers, or a new in-network provider for a payer, the ability to accurately gather the right information in real-time is critical to cost avoidance, improvedcare delivery outcomes, and alignment across all concerned parties. ...
Payer, provider, and claims data can be enriched and advanced analytics techniques, including artificial intelligence, can be applied for use cases such as patient care and disease prevention, evidence-based decision making in pre-authorization, analysis, detection, and claim fraud prevention, and opt...
Financial analytics(financial fraud detection, financial risk management, etc.). Performance monitoring of the healthcare staff. Pharma data analytics (production cycle optimization, clinical trials data analysis). Healthcare data visualization Real-time self-service operational dashboards (hospital admission...
In July,2024, IBM (US), a leading provider of healthcare analytics solutions, announced a partnership to develop a new AI-powered platform for clinical decision support. The European Commission launched a new initiative aimed at promoting the adoption of digital health technologies across Europe. ...
We send you a link from the assessment provider (Skills Arena) via email & you do the test directly with them. We assess your grammar & numerical reasoning. Candidates for more senior roles also do a psychometric test (Hogan Assessment) administered by Syzygy + interview with assessor. Contrac...
Prepay Overpayment Detection AI-powered, provider-level scenarios flagging for errors & potential improper payments before a claim is paid Learn more Medical Record Review Automated, generative AI-powered validation of claims and supporting documentation ...