System and method for detecting healthcare insurance fraud
作者： Debra Pacha , Raul Ariza , Stephen Ratcliff
DOI:
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摘要: The invention comprises a method and system of detecting identifying fraud arising from healthcare claim. includes storage means for storing data base containing source related to A memory is used set user-defined rules fraud. processing coupled the comparing in means. If violates rules, relevant portion identified flagged as fraudulent data. then forwarded special investigator comprehensive analysis. transformed graphs charts illustrate patterns so that easily detected identified.
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