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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ...- 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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Statistical Tools for Actuaries?First in New Series of Guides Available
Series of Guides Available Recognizing an opportunity to help serve its members in this age of increased ... oversight, the Health Section of the Society of Actuaries commissioned a series of guides on the use of statistical ...- Authors: Steven Siegel
- Date: Jan 2008
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Seasonal Flu Impacts: Flu Science Meets Actuarial Science
Science Meets Actuarial Science By Bethany McAleer The seasonal flu comes every year with very broad (and ... cost implications. As individuals, our interest in the flu is focused on making sure we’re following recommendations ...- Authors: Bethany McAleer
- Date: Oct 2018
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Calibrating Risk Score Model with Partial Credibility
Calibrating Risk Score Model with Partial Credibility This article describes a method that can ... when re-fitting a risk score model to a population of only moderate size. Learn how to use concepts like ...- Authors: Sheamus Parkes, Bradley Armstrong
- Date: Jul 2015
- Competency: 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: Predictive Analytics and Futurism Newsletter
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; Predictive Analytics
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The Bottom Line on BehavioralHealth Care Costs
The Bottom Line on BehavioralHealth Care Costs This article reviews the cost of behavioral health care ... care and looks at how the involvement of Primary Care Physicians leads to a less efficient and effective ...- Authors: Stephen P Melek
- Date: Mar 2005
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Chairperson's Corner
Chairperson's Corner Recap of Health Section's 2014 events and member survey. ... Chairperson's Corner Recap of Health Section's 2014 events and member survey. Health economics ...- Authors: Donna Kalin
- Date: Jan 2014
- Competency: Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Predictive Modeling: Considerations for Care Management Applications
Predictive Modeling: Considerations for Care Management Applications Considerations in ... Management Applications Considerations in the applications of Predictive Modeling for health care management ...- Authors: Keith Passwater, Brent Seiler
- Date: Apr 2004
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan
Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan With many pharmacy benefit plans ... and discussion also needs to be given to the other end of the pharmacy cost spectrum to see how costs ...- Authors: Steven D Berna
- Date: Sep 2006
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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What’s New on the RxManagement Horizon?
New on the RxManagement Horizon? Health Section News, August 2005, Issue 50 which discusses the effective ... management of prescription drug utilization and coverage that continue to represent one of the biggest challenges ...- Authors: JEFF ALLAN SCHULTE
- Date: Aug 2005
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Health Expectancy Abstract
Health Expectancy Abstract This paper presents a different approach to ... measuring Health Expectancy, especially as it relates to the elderly population. This new actuarial approach is ...- Authors: Application Administrator, John M Bragg, James C Brooks
- Date: Jan 2008
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care