Medical Claims History Mining

A New Medicare Advantage Fraud Case Is Taking Aim …

https://www.npr.org/sections/health-shots/2021/09/14/1036776812/medicare-advantage-fraud-data-mining

The civil complaint of fraud, filed this week, is the first by the federal government to target a data mining company for allegedly helping a Medicare Advantage program to game federal billing...

Data Mining in Medical Billing and Coding | Healthcare …

https://www.osplabs.com/insights/data-mining-in-medical-coding-and-billing/

With the ongoing instances of fraud in medical billing and coding continually rising, data mining is now being looked at to address and identify frauds and thereby …

Data Mining in the Healthcare Industry: Key Benefits

https://demigos.com/blog-post/data-mining-in-the-healthcare-industry-benefits-examples/

Data Mining Medical Records with Machine Learning – 5 …

https://emerj.com/ai-sector-overviews/data-mining-medical-records-with-machine-learning-5-current-applications/

In a case study the company claims that it helped the US Army Medical Corps avoid 1,666 patient readmissions over four years and to save $33 million per facility within the same …

6 ways big data analytics can improve insurance claims …

https://www.sas.com/en_us/insights/articles/risk-fraud/big-data-analytics-improves-claims-processing.html

But claims are usually assigned based on limited data – resulting in high reassignment rates that affect claim duration, settlement amounts and ultimately, the customer …

Data Analytics in Claims Processing: Tools and Benefits

https://demigos.com/blog-post/data-analytics-in-claims-processing/

The DRG code in the claim often summarizes a range of HCPCS codes, revenue codes (high-level services such as labor room, physical therapy, and …

[PDF] Mining medical claims data with exploratory to …

https://www.researchgate.net/publication/264818684_Mining_medical_claims_data_with_exploratory_to_confirmatory_statistical_methods

To address that gap, we propose an evidence-based approach to mining claims data to not only identify patterns of care, but also examine how individual, organisational and contextual factors...

Mining Claims – Western Mining History

https://westernmininghistory.com/mining-claims/

Mining claims are of four different types – Lode, Placer, Millsite, and Tunnel, with the following breakdown for the overall number of claims and percentages of each type. Lode claims – 481,484 Placer claims – …

A Medical Claim Fraud/Abuse Detection System based …

https://www.academia.edu/en/10464418/A_Medical_Claim_Fraud_Abuse_Detection_System_based_on_Data_Mining_A_Case_Study_in_Chile

This paper describes an effective medical claim fraud/abuse detection system based on data mining used by a Chilean private health insurance company. Fraud and abuse in …

Mining Claims | Bureau of Land Management

https://www.blm.gov/programs/energy-and-minerals/mining-and-minerals/locatable-minerals/mining-claims

Mining claims are staked for locatable minerals on public domain lands. Locatable minerals include both metallic minerals (gold, silver, lead, etc.) and nonmetallic minerals …