Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study.

Abstract

BACKGROUND We aimed to identify the indicators of healthcare fraud and abuse in general physicians' drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse. METHODS We applied data mining approach to a major health insurance organization dataset of private sector general physicians… (More)
DOI: 10.15171/ijhpm.2015.196

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