An Intelligent Data Mining System to Detect Healthcare Fraud
Giusseppi A. Forgionne (University of Maryland-Baltimore County, USA), Aryya Gangopadhyay (University of Maryland-Baltimore County, USA) and Monica Adya (University of Maryland-Baltimore County, USA)
Copyright: © 2002
The chapter begins with an overview of the types of healthcare fraud. Next, there is a brief discussion of issues with the current fraud detection approaches. The chapter then develops information technology based approaches and illustrates how these technologies can improve current practice. Finally, there is a summary of the major findings and the implications for healthcare practice.