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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- 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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A Comparative Analysis of Chronic and Non-Chronic Insured Commercial Member Cost Trends
A Comparative Analysis of Chronic and Non-Chronic Insured Commercial Member Cost Trends Disease management DM is increasingly encountered in health plans and employer groups as a health care ...- Authors: Ian G Duncan, Robert Bachler, Iver Juster
- Date: Jun 2005
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Thought leadership
- Topics: Enterprise Risk Management>Compliance; Experience Studies & Data>Disability; Experience Studies & Data>Morbidity; Health & Disability>Health care; Health & Disability>Health risks