A Fraud Detection Approach with Data Mining in Health Insurance

Volume: 62, Pages: 989 - 994
Published: Oct 1, 2012
Abstract
Fraud can be seen in all insurance types including health insurance. Fraud in health insurance is done by intentional deception or misrepresentation for gaining some shabby benefit in the form of health expenditures. Data mining tools and techniques can be used to detect fraud in large sets of insurance claim data. Based on a few cases that are known or suspected to be fraudulent, the anomaly detection technique calculates the likelihood or...
Paper Details
Title
A Fraud Detection Approach with Data Mining in Health Insurance
Published Date
Oct 1, 2012
Volume
62
Pages
989 - 994
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