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Validating a Novel Health Insurance Fraud Detection Method
detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ... 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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Calibrating Risk Score Model with Partial Credibility
Armstrong This article first appeared in the July 2015 issue of Forecasting & Futurism. It is reprinted ... Risk adjustment models are commonly used in managed care programs to ensure that participating health plans ...- 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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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