REPORTING AND ANALYTICS FOR HEALTHCARE FRAUD DETECTION INFORMATION

A healthcare fraud management system receives healthcare claims information associated with a particular entity, and receives historical healthcare information associated with the particular entity. The healthcare fraud management system also performs data mining techniques on the historical healthc...

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Bibliographische Detailangaben
Hauptverfasser:	SCHWEYEN CORRINE L, HAGINS SCOTT, MAHONE SARALYN M, VAN ARKEL JOHN H, CURTIS TERRILL J, TADA DAVID D, WAGNER JAMES J
Format:	Patent
Sprache:	eng
Schlagworte:	CALCULATING COMPUTING COUNTING DATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FORADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORYOR FORECASTING PURPOSES HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATIONTECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING ORPROCESSING OF MEDICAL OR HEALTHCARE DATA INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTEDFOR SPECIFIC APPLICATION FIELDS PHYSICS SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE,COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTINGPURPOSES, NOT OTHERWISE PROVIDED FOR
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Beschreibung
Zusammenfassung:	A healthcare fraud management system receives healthcare claims information associated with a particular entity, and receives historical healthcare information associated with the particular entity. The healthcare fraud management system also performs data mining techniques on the historical healthcare information to produce data mining information associated with the particular entity. The healthcare fraud management system generates reports, associated with the particular entity, based on the healthcare claims information, the historical healthcare information, and the data mining information, and outputs the generated reports to a clearinghouse or a claims processor.