1
-
2
of
2
results (0.41 seconds)
Sort By:
-
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
-
Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance
Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral ... ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has ...- Authors: D Wei
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health risks; Modeling & Statistical Methods; Technology & Applications>Analytics and informatics