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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- 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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Inside the Medical Information Bureau
and group insurance account manager. He has had direct exposure to sales and marketing processes, underwriting ... play within an underwriting operation. MIB's primary business service to the life insurance industry ...- Authors: John R Avery, John Luff, Stacy Gill, John Detwiler
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Experience Studies & Data>Morbidity; Health & Disability>Disability insurance; Health & Disability>Health care; Life Insurance
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Health Section Issues New IBNR Study
Health Section Issues New IBNR Study Summary of the health section council’s research project ... traditional lag, Paid PMPM, etc.) is applied. 6. Care should be taken in determining which IBNR method ...- Authors: Steven Siegel, Cabe Chadick
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Actuarial Profession>Standards of practice; Financial Reporting & Accounting; Health & Disability>Health care; Modeling & Statistical Methods>Modeling efficiency