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Validating a Novel Health Insurance Fraud Detection Method
detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ... detection in Medicare. Enterprise Risk Management = ERM;Own Risk Solvency Assessment = ORSA; Health care ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Actuarial Aspects of Alternative Care
Actuarial Aspects of Alternative Care Presenter discusses issues related to alternative care, as well ... in regard to alternative care. From the Record of the Society of Actuaries, Vol. 24, No. 1. Health care ...- Authors: Lee Eric Launer
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality
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Health Practice Advancement Committee, Health Section Council, and AAA Health Practice Council Committee Update
Practice Council Committee Update Open meeting of the Society's Health Benefit Systems Practice Advancement ... Council, as well as the American Academy of Actuaries' Health Practice Council. The three committees ...- Authors: Application Administrator, Thomas Corcoran, James Murphy
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Public interest representation
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
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Surplus and the ACA
Surplus and the ACA Surplus and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ...- Authors: Daniel Pribe
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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Genomic Testing: Cost-Saving or Cost-Inflating for Payers?
for Payers? As private payers ponders the early adoption of genomic testing to guide treatment pathways ... financially sound? cancer;health economics;Return on investment 6442480953 2/1/2018 12:00:00 AM ...- Authors: Didier Serre
- Date: Feb 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Assess decision effectiveness
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Health Care Reform: Essential Health Benefits and Actuarial Value
Health ... Article from The ACA@5 August 2015 Issue 1 16 | AUGUST 2015 THE ACA@5 Health Care Reform: ... Knuth on Oct. 1, 2013, thus allowing individuals and small groups who wanted to remain on pre- ACA ...- Authors: Catherine Knuth
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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The ACA’s Medical Loss Ratio Provisions: Looking Back
The ACA’s Medical Loss Ratio Provisions: Looking Back The ACA’s Medical Loss Ratio Provisions Patient ...- Authors: Rowen Bell
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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Managed Mental Health and Other Ancillary Benefits
Managed Mental Health and Other Ancillary Benefits This session discussion ... prescription drug, and vision benefits. From Record of Society of Actuaries Vol. 19, No. 1B. Health care costs;Prescription ...- Authors: Robert J Nelsen, Peter R Barnett, Kimberly C Babbin, Joan M Pearson
- Date: Apr 1993
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health care
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Letter from the Editor
Letter from the Editor Recap of content contained in the January 2014 issue of the Health Watch newsletter ...- Authors: Kurt Wrobel
- Date: Jan 2014
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Health Insurance and the Valuation Actuary
Health Insurance and the Valuation Actuary Panelists discuss the role of the valuation actuary in health ... health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2. Asset valuation;Cash ...- Authors: Application Administrator, Michael Francescone, Frank E Knorr, Glenn A Giese
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Disability insurance; Health & Disability>Health care; Health & Disability>Health insurance; Long-term Care>Long-term care insurance