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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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Cancer Experience Study Data Requirements
Cancer Experience Study Data Requirements Data requirements for the Society of Actuaries cancer experience study, ... and claim information. Assumptions;Cancer;Health care costs; 6858 6/1/2005 12:00:00 AM ...- Authors: Society of Actuaries
- Date: Jun 2005
- Competency: Communication; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Topics: Experience Studies & Data; Health & Disability; Modeling & Statistical Methods>Data mining
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Estimating the Impact of Disease and Treatment on Life Expectancy
Estimating the Impact of Disease and Treatment on Life Expectancy Analysis of the impact ... perspective on the long term costs to the health care system of chronic medical conditions. Global markets;Life ...- Authors: Tzu-Chun Kuo, Philipp Vetter
- Date: Jan 2011
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Demography>Longevity; Health & Disability>Health care quality; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging ... users for more effective screening and follow-up care. Predictive modeling;Health risks;Data mining=Big ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Health Watch
- Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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Calibrating Risk Score Model with Partial Credibility
Risk adjustment models are commonly used in managed care programs to ensure that participating health plans ... commercial population. However, the variety of managed care populations (and benefits) is much larger than the ...- Authors: Sheamus Parkes, Brad Armstrong
- Date: Oct 2015
- Competency: Results-Oriented Solutions>Actionable recommendations; 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: Expanding Horizons
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Predictive Analytics
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Using Hadoop and Spark for Distributed Predictive Modeling
Using Hadoop and Spark for Distributed Predictive Modeling The newer predictive modeling tools ... H2O Compared to MLlib, which might seem like a direct application of the Spark engine, H2O was aiming ...- Authors: Dihui Lai, Qichun Xu
- Date: Jul 2016
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Modeling & Statistical Methods>Data mining; Predictive Analytics
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Calibrating Risk Score Model with Partial Credibility
adjustment models are commonly used in man-aged care programs to ensure that participating health plans ... mercial population. However, the variety of managed care populations (and benefits) is much larger than ...- 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