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2021 | OriginalPaper | Buchkapitel

Fraudulent Detection in Healthcare Insurance

verfasst von : C. Arunkumar, Srijha Kalyan, Hamsini Ravishankar

Erschienen in: Advances in Electrical and Computer Technologies

Verlag: Springer Nature Singapore

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Abstract

Our paper provides an extensive study of detecting fraudulent claims in healthcare insurance by leveraging machine learning algorithms. By using the publicly available medicare dataset, we are able to classify as fraud and non-fraud providers. Moreover, synthetically minority oversampling technique is used to avoid the class imbalance problem. Furthermore, a hybrid approach is used which is based on clustering and classification. Additionally, we have used other machine learning algorithms to check the efficiency of the best-suited algorithm.

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Metadaten
Titel
Fraudulent Detection in Healthcare Insurance
verfasst von
C. Arunkumar
Srijha Kalyan
Hamsini Ravishankar
Copyright-Jahr
2021
Verlag
Springer Nature Singapore
DOI
https://doi.org/10.1007/978-981-15-9019-1_1

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