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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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Case 3: Improving LTC Projections with Predictive Analytics
Case 3: Improving LTC Projections with Predictive Analytics Third article in a series on how to use predictive analytics to improve the development of long-term care projection assumptions.- Authors: Missy Gordon, Joseph Long
- Date: Aug 2018
- Competency: Professional Values>Practice expertise; 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: Long-Term Care News
- Topics: Experience Studies & Data>Long-term care - Experience Studies & Data; Long-term Care>Long-term care insurance; Modeling & Statistical Methods>Regression analysis; Predictive Analytics
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Mortality Improvement: The Ultimate Onion
Mortality Improvement: The Ultimate Onion Identifies current trends and considerations when setting the mortality improvement assumption for individual life insurance in the US. Life reinsurance; ...- Authors: Jay Biehl, Edward Hui
- Date: Nov 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Reinsurance News
- Topics: Demography>Mortality - Demography; Demography>Longevity; Demography>Population data; Experience Studies & Data>Mortality; Life Insurance>Pricing - Life Insurance; Modeling & Statistical Methods>Forecasting; Predictive Analytics; Reinsurance>Life reinsurance; Reinsurance>General reinsurance
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Proactively Managing Life Insurance Risks
Proactively Managing Life Insurance Risks The article explores the possibility of using the emerging technology for life insurers to build a monitor system for better risk and profitability ...- Authors: Feng Sun, Amy Tran
- 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: Enterprise Risk Management; Experience Studies & Data>Mortality; Life Insurance>Product development - Life Insurance; Predictive Analytics
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective ...- 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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Case 2: Improving LTC Projections with Predictive Analytics
Case 2: Improving LTC Projections with Predictive Analytics Second article in a series on how to use predictive analytics to improve the development of long-term care projection assumptions.- Authors: Missy Gordon, Joseph Long
- Date: Apr 2018
- 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: Long-Term Care News
- Topics: Experience Studies & Data>Disability; Experience Studies & Data>Long-term care - Experience Studies & Data; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Modeling & Statistical Methods>Regression analysis; Predictive Analytics