Fraud Detection in Healthcare Insurance Claims Using Machine Learning
Author
Abstract
Suggested Citation
Download full text from publisher
References listed on IDEAS
- Helen I. Doerpinghaus & Joan T. Schmit & Jason Jia‐Hsing Yeh, 2008. "Age and Gender Effects on Auto Liability Insurance Payouts," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 75(3), pages 527-550, September.
- William Lesch & Brent R. Baker, 2013. "Balancing the Insurance Equation: Understanding the Climate for Managing Consumer Insurance Fraud and Abuse," Journal of Insurance Issues, Western Risk and Insurance Association, vol. 36(1), pages 82-120.
Most related items
These are the items that most often cite the same works as this one and are cited by the same works as this one.- Ha van Dung, 2014. "Short-term precaution, insurance and saving mechanisms in rural Vietnam," Working Papers CIE 82, Paderborn University, CIE Center for International Economics.
- Renee Flasher & Melvin A. Lamboy-Ruiz, 2019. "Impact of Enforcement on Healthcare Billing Fraud: Evidence from the USA," Journal of Business Ethics, Springer, vol. 157(1), pages 217-229, June.
- Ayuso, Mercedes & Bermúdez, Lluís & Santolino, Miguel, 2015. "The dynamics of one-sided incomplete information in motor disputes," International Review of Law and Economics, Elsevier, vol. 41(C), pages 77-85.
- Miguel Santolino & Jean-Philippe Boucher, 2009. "Modelling the disability severity score in motor insurance claims: an application to the Spanish case," IREA Working Papers 200902, University of Barcelona, Research Institute of Applied Economics, revised Jan 2009.
- Haithem Zourrig & Jeongsoo Park, 2019. "The effects of cultural tightness and perceived unfairness on Japanese consumers’ attitude towards insurance fraud: the mediating effect of rationalization," Journal of Financial Services Marketing, Palgrave Macmillan, vol. 24(1), pages 21-30, June.
- Xiao Lin & Mark J. Browne & Annette Hofmann, 2022. "Race discrimination in the adjudication of claims: Evidence from earthquake insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(3), pages 553-580, September.
- Mercedes Ayuso & Lluís Bermúdez & Miguel Santolino, 2011. "“Influence of the claimant’s behavioural features on motor compensation outcomes”," IREA Working Papers 201108, University of Barcelona, Research Institute of Applied Economics, revised Jun 2011.
- Mary Kelly & Anne Kleffner & Maureen Tomlinson, 2010. "First‐Party Versus Third‐Party Compensation for Automobile Accidents: Evidence From Canada," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 13(1), pages 21-44, March.
More about this item
Keywords
fraud; insurance claims; artificial neural networks (ANN); logistic regression (LR); random forest (RF); Saudi Arabia;All these keywords.
Statistics
Access and download statisticsCorrections
All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jrisks:v:11:y:2023:i:9:p:160-:d:1233014. See general information about how to correct material in RePEc.
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .
Please note that corrections may take a couple of weeks to filter through the various RePEc services.