Dallas Thornton

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It is estimated that between $600 and $850 billion annually is lost to fraud, waste, and abuse in the US healthcare system, with $125 to $175 billion of this due to fraudulent activity (Kelley 2009). Medicaid, a state-run, federally-matched government program which accounts for roughly one-quarter of all healthcare expenses in the US, has been particularly(More)
Fraud, waste, and abuse in the U.S. healthcare system are estimated at $700 billion annually. Predictive analytics offers government and private payers the opportunity to identify and prevent or recover such billings. This paper proposes a data-driven method for fraud detection based on comparative research, fraud cases, and literature review. Unsupervised(More)
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