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11/9/2011National Health Care Antifa Association (NCAA) Part D Fraud Schemes Fraud Detection & Investigation in Specialty Areas Presented By: Matthew H. Bells, MA Kelly Giancristoforo, CFE, AFI November
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How to fill out healthcare fraud data mining
How to fill out healthcare fraud data mining
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Gather healthcare data from various sources such as claims, billing records, and patient records.
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Clean and preprocess the data to ensure accuracy and consistency.
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Use data mining techniques such as clustering, classification, and anomaly detection to identify patterns of potential fraud.
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Investigate suspicious cases further to verify fraudulent activity and take appropriate action.
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Health insurance companies
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What is healthcare fraud data mining?
Healthcare fraud data mining is the process of analyzing large amounts of healthcare data to identify patterns, anomalies, and potential fraudulent activities.
Who is required to file healthcare fraud data mining?
Healthcare providers, insurance companies, and government agencies are required to file healthcare fraud data mining reports.
How to fill out healthcare fraud data mining?
Healthcare fraud data mining reports can be filled out electronically through secure online portals provided by regulatory authorities.
What is the purpose of healthcare fraud data mining?
The purpose of healthcare fraud data mining is to detect and prevent fraudulent activities in the healthcare industry, ultimately reducing costs and improving patient care.
What information must be reported on healthcare fraud data mining?
Information such as patient demographics, provider services, billing codes, and payment data must be reported on healthcare fraud data mining reports.
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