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Integrating Claims-Based and Survey-Based Data to Estimate Program Savings
Savings An approach to quantify medical intervention savings when medical claims data is not available by ... by leveraging overlapping measurement techniques. Health care costs;Health care quality;Estimation Methods ...- Authors: Andrew Mackenzie, Ian G Duncan
- Date: Oct 2017
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis
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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