FRAUD DETECTION IN HEALTHCARE
    3.
    发明申请
    FRAUD DETECTION IN HEALTHCARE 审中-公开
    卫生检查中的FRAUD检测

    公开(公告)号:US20140278479A1

    公开(公告)日:2014-09-18

    申请号:US13949043

    申请日:2013-07-23

    CPC classification number: G06F19/328 G06Q10/063 G06Q50/22

    Abstract: A system for, among other purposes, detecting health care fraud, comprises a data import component for importing health care data from data source(s) such health care providers, insurers, or pharmacies; data repositor(ies) in which the data import component creates health care objects such as provider objects that describe health care providers, patient objects that represent health care recipients, and health care event objects that describe one or more of: health care claims, prescriptions, medical procedures, or diagnoses; a correlation component that identifies correlations between the health care objects; a graph generator component that generates graphs of networks identified based at least on the correlations identified by the correlation component, the graphs comprising linked nodes that represent health care objects in the identified networks; and an interface generator that generates interfaces that display the graphs generated by the graph generator.

    Abstract translation: 包括用于从医疗保健提供者,保险公司或药店等数据来源导入保健数据的数据导入部件,用于检测医疗保健欺诈的系统, 数据存储器(数据),其中数据导入组件创建医疗保健对象,例如描述医疗保健提供者的提供者对象,代表医疗保健者的患者对象以及描述以下一个或多个的医疗保健事件对象:医疗保健声明,处方 ,医疗程序或诊断; 识别卫生保健对象之间的相关性的相关分量; 图形生成器组件,其生成至少基于由相关组件识别的相关性所标识的网络的图,所述图包括表示所识别的网络中的医疗保健对象的链接节点; 以及一个接口生成器,用于生成显示图形生成器生成的图形的接口。

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