Artificial intelligence in medicine, 2017-01, Vol.75, p.40-50
2017
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Details
- Autor(en) / Beteiligte
- Titel
- The evaluation of trustworthiness to identify health insurance fraud in dentistry
- Ist Teil von
- Artificial intelligence in medicine, 2017-01, Vol.75, p.40-50
- Ort / Verlag
- Netherlands: Elsevier B.V
- Erscheinungsjahr
- 2017
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- Highlights • The Economist says 10% of health care expenditure ($272 billion) was wasted on fraudulent claims in 2012. • Previous studies aimed at other types of fraud are inadequate for solving cross-dentist health insurance fraud. • We devise a social-network-based risk evaluation to detect fraudulent claims in dentistry. • By experiment, using real-world or artificial data, our method can effectively identify undetected frauds in the past in dentistry claims data. • Integrating our method with previous research can provide higher accuracy.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0933-3657eISSN: 1873-2860DOI: 10.1016/j.artmed.2016.12.002Titel-ID: cdi_proquest_miscellaneous_1883183433
- Format
- –
- Schlagworte
- Data Mining, Dentistry, Fraud, Fraud identification, Humans, Insurance, Health, Internal Medicine, Other, Retrospective Studies, Social network, Taiwan, Trustworthiness evaluation