August 2014

Book Chapter

Fraud Detection in Healthcare

By:
Chandola, Varun ; Schryver, Jack C; Sukumar, Sreenivas R
Page Number:
371-392
Book Title:
Healthcare Data Analytics
Publication Date:
August 2014
Publisher Location:
CRC Press, London, United Kingdom

Abstract

We discuss the problem of fraud detection in healthcare in this chapter. Given the recent scrutiny of the ineciencies in the US healthcare system, identifying fraud has been on the forefront of the eorts towards reducing the healthcare costs. In this chapter we will focus on understanding the issue of healthcare fraud in detail, and review methods that have been proposed in the literature to combat this issue using data driven approach.