Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study

• Main Authors: Hossein Joudaki (Author), Arash Rashidian (Author), Behrouz Minaei-Bidgoli (Author), Mahmood Mahmoodi (Author), Bijan Geraili (Author), Mahdi Nasiri (Author), Mohammad Arab (Author)
• Format: Book
• Published: Kerman University of Medical Sciences, 2016-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Background We aimed to identify the indicators of healthcare fraud and abuse in general physicians' drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse. Methods We applied data mining approach to a major health insuran...