A Medical Claim Fraud/Abuse Detection System based on Data Mining: A Case Study in Chile.
Pedro A. OrtegaCristián J. FigueroaGonzalo A. RuzPublished in: DMIN (2006)
Keyphrases
- data mining
- data mining techniques
- fraud detection
- anomaly detection
- detection rate
- automatic detection
- detection accuracy
- rough sets
- real world
- detection algorithm
- knowledge discovery
- object detection
- data analysis
- intrusion detection
- medical diagnosis
- false alarms
- data mining applications
- health insurance
- machine learning
- false positives
- detection method
- text mining
- case study
- web mining
- association rule mining
- data mining methods
- test bed
- transaction data
- association rules
- decision support
- medical domain
- previously unknown
- medical data
- social network analysis
- web intelligence
- data mining algorithms