Fraud in Healthcare Service

Fraud Detection for Healthcare

Fraud detection in healthcare is an important yet difficult problem. We present a fraud screening solution to identify suspicious pharmacies from a large dataset of pharmacy claims. Our solution has stemmed from collaboration with medical claim investigators and proven usefulness to investigators by discovering real fraud cases. We focus on a concrete problem of probabilistic outlier detection ...

Factors Influencing Healthcare Service Quality

Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context.   Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian hea...

Skilling And The Pursuit Of Healthcare Fraud

Fee-for-Disservice: medicare fraud in the home healthcare industry.

factors influencing healthcare service quality

background the main purpose of this study was to identify factors that influence healthcare quality in the iranian context.   methods exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in iranian hea...