Health insurance is important for many people, but unfortunately it is susceptible to frauds, therefore expenditures for covering the funds show exponential growth. The victims of this kind of scams are not only the institutions that provide the funds and treatments, but also are the ones who ...
The Fig.1explains the most popular classification of the frauds in healthcare insurance system. Fraud can be identified through the services availing as well as providing patterns. Availing patterns such as repetition of services, age inconsistency, gender inconsistency, and visit frequency can leads...
19Major Pharmaceutical Frauds: Deep Pockets and Low-Hanging FruitPharmaceutical firms are among the world’s wealthiest corporations. By July 2008, the ten largest pharmaceutical companies in the United States had annual PHARMACEUTICAL, EQUIPMENT, AND SUPPLY INDUSTRIES 121revenues ranging from $20.2 ...
Itexus uses predictive AI software and incorporates special algorithms to monitor backlogs, detect frauds, and drive data-driven day-to-day decisions. Implementing RPA in your finance and banking processes can bring many benefits, including increased efficiency, reduced costs, and improved customer ...
In addition, the United States Federal Trade Commission warns customers to prevent frauds of coronaviruses, such as disregarding online test kits and vaccine promises. Consumers need to be effectively safeguarded against counterfeit home surveillance equipment. The General Public Prosecutor should actively...
In summary, in the existing researches, the common methods for intelligently identifying medical insurance frauds using data mining algorithms are machine learning, neural networks, integrated learning, etc., and have achieved certain research results [30]. However, many of the researches are theoretica...