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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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Working With Health Care Coalitions
RECORD OF SOCIETY OF ACTUARIES 1986 VOL. 12 NO. 4A WORKING WITH HEALTH CARE COALITIONS Moderator: ... speaking on health care coalitions expectations. We then have a response from Bill Rosenberg on insurers' ...- Authors: Andrea B Castell, James P Hilferty, William H Rosenberg, Charles J Sherfey, Jean M Wodarczyk, Joseph H Rosmann
- Date: Oct 1986
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Professional network leverage; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health information technology; Technology & Applications>Analytics and informatics