Computer-aided auditing of prescription drug claims
Author
Abstract
Suggested Citation
DOI: 10.1007/s10729-013-9247-x
Download full text from publisher
As the access to this document is restricted, you may want to search for a different version of it.
References listed on IDEAS
- Jing Li & Kuei-Ying Huang & Jionghua Jin & Jianjun Shi, 2008. "A survey on statistical methods for health care fraud detection," Health Care Management Science, Springer, vol. 11(3), pages 275-287, September.
- Hyman, David A, 2001. "Health Care Fraud and Abuse: Market Change, Social Norms, and the Trust "Reposed in the Workmen."," The Journal of Legal Studies, University of Chicago Press, vol. 30(2), pages 531-567, June.
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.- Rajeev K. Goel, 2020. "Medical professionals and health care fraud: Do they aid or check abuse?," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 41(4), pages 520-528, June.
- van Capelleveen, Guido & Poel, Mannes & Mueller, Roland M. & Thornton, Dallas & van Hillegersberg, Jos, 2016. "Outlier detection in healthcare fraud: A case study in the Medicaid dental domain," International Journal of Accounting Information Systems, Elsevier, vol. 21(C), pages 18-31.
- Edward C. Malthouse & Wei-Lin Wang & Bobby J. Calder & Tom Collinger, 2019. "Process control for monitoring customer engagement," Journal of Marketing Analytics, Palgrave Macmillan, vol. 7(2), pages 54-63, June.
- Thuy Nguyen & Victoria Perez, 2020. "Privatizing Plaintiffs: How Medicaid, the False Claims Act, and Decentralized Fraud Detection Affect Public Fraud Enforcement Efforts," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 87(4), pages 1063-1091, December.
- 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.
- Bayerstadler, Andreas & van Dijk, Linda & Winter, Fabian, 2016. "Bayesian multinomial latent variable modeling for fraud and abuse detection in health insurance," Insurance: Mathematics and Economics, Elsevier, vol. 71(C), pages 244-252.
- Dionne, Georges, 2012.
"The empirical measure of information problems with emphasis on insurance fraud and dynamic data,"
Working Papers
12-10, HEC Montreal, Canada Research Chair in Risk Management.
- Georges Dionne, 2012. "The Empirical Measure of Information Problems with Emphasis on Insurance Fraud and Dynamic Data," Cahiers de recherche 1233, CIRPEE.
- Howard, David H. & McCarthy, Ian, 2021.
"Deterrence effects of antifraud and abuse enforcement in health care,"
Journal of Health Economics, Elsevier, vol. 75(C).
- David H. Howard & Ian McCarthy, 2020. "Deterrence Effects of Antifraud and Abuse Enforcement in Health Care," NBER Working Papers 27900, National Bureau of Economic Research, Inc.
- Zhang, Liangwei & Lin, Jing & Karim, Ramin, 2015. "An angle-based subspace anomaly detection approach to high-dimensional data: With an application to industrial fault detection," Reliability Engineering and System Safety, Elsevier, vol. 142(C), pages 482-497.
- Tahir Ekin & Francesca Ieva & Fabrizio Ruggeri & Refik Soyer, 2017. "On the Use of the Concentration Function in Medical Fraud Assessment," The American Statistician, Taylor & Francis Journals, vol. 71(3), pages 236-241, July.
- Dmitriy Vorobyev, 2011. "Towards Detecting and Measuring Ballot Stuffing," CERGE-EI Working Papers wp447, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
- Jiong Gong & R. Preston McAfee & Michael A. Williams, 2016.
"Fraud Cycles,"
Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 172(3), pages 544-572, September.
- Jiong Gong & Preston McAfee & Michael A Williams, 2011. "Fraud Cycles," Levine's Working Paper Archive 661465000000001154, David K. Levine.
- Gong, Jiong & McAfee, R. Preston & Williams, Michael, 2011. "Fraud cycles," MPRA Paper 28934, University Library of Munich, Germany.
- Kang, HeeChung & Hong, JaeSeok & Lee, KwangSoo & Kim, Sera, 2010. "The effects of the fraud and abuse enforcement program under the National Health Insurance program in Korea," Health Policy, Elsevier, vol. 95(1), pages 41-49, April.
- Sayaka Nakamura & Cory Capps & David Dranove, 2007.
"Patient Admission Patterns and Acquisitions of “Feeder” Hospitals,"
Journal of Economics & Management Strategy, Wiley Blackwell, vol. 16(4), pages 995-1030, December.
- Sayaka Nakamura & Cory Capps & David Dranove, 2007. "Patient Admission Patterns and Acquisitions of "Feeder" Hospitals," EAG Discussions Papers 200701, Department of Justice, Antitrust Division.
- Philippe Bernard & Najat El Mekkaoui De Freitas & Bertrand B. Maillet, 2022.
"A financial fraud detection indicator for investors: an IDeA,"
Annals of Operations Research, Springer, vol. 313(2), pages 809-832, June.
- Philippe Bernard & Najat El Mekkaoui de Freitas & Bertrand Maillet, 2022. "A Financial Fraud Detection Indicator for Investors: An IDeA," Post-Print hal-02312401, HAL.
- Chamal Gomes & Zhuo Jin & Hailiang Yang, 2021. "Insurance fraud detection with unsupervised deep learning," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(3), pages 591-624, September.
- A. James O'Malley & Thomas A. Bubolz & Jonathan S. Skinner, 2021. "The Diffusion of Health Care Fraud: A Network Analysis," NBER Working Papers 28560, National Bureau of Economic Research, Inc.
- Rajeev K. Goel, 2021.
"Are health care scams infectious? Empirical evidence on contagion in health care fraud,"
Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(1), pages 198-208, January.
- Goel, Rajeev K., 2020. "Are health care scams infectious? Empirical evidence on contagion in health care fraud," Open Access Publications from Kiel Institute for the World Economy 233680, Kiel Institute for the World Economy (IfW Kiel).
- Farbmacher, Helmut & Löw, Leander & Spindler, Martin, 2022. "An explainable attention network for fraud detection in claims management," Journal of Econometrics, Elsevier, vol. 228(2), pages 244-258.
- Michael Manocchia & Alyssa Scott & Morgan C. Wang, 2012. "Health consumer susceptibility to medical care fraud: an exploratory analysis," International Journal of Public Policy, Inderscience Enterprises Ltd, vol. 8(1/2/3), pages 136-148.
More about this item
Keywords
Audit; Fraud; Abuse;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:kap:hcarem:v:17:y:2014:i:3:p:203-214. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .
Please note that corrections may take a couple of weeks to filter through the various RePEc services.