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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Design and Pricing of Tiered Network Health Plans
Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical ... quality and cost-effectiveness standards. Accountable care organizations= ACO;Assumptions;Behavioral econo ...- Authors: Peter Horman
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
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Product Matters
Practices By Hua Li and Alex Zaidlin 20 Long-Term Care Meeting Needs through Product Flexibility By ... entrance to the parks so that the guests can take care of their basic needs first (strollers, sunscreen ...- Authors: Society of Actuaries
- Date: Jul 2016
- Competency: External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Product Matters!
- Topics: Annuities>Product development - Annuities; Life Insurance>Product development - Life Insurance
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Risk Management, August 2018
2017 Actuarial Research Conference (ARC) on health care fraud detection. In the March issue of Risk Management ... health insurance fraud detection method. This health care fraud study aims to develop a pro- phetic modeling ...- Authors: Society of Actuaries
- Date: Aug 2018
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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Agile Methodology: The Future of Insurance Product Development?
date on project status. The product own- er’s primary focus is on product content. • Scrum Master ... Silver Spring, MD 22 | FEBRUARY 2016 LONG TERM CARE Agile Methodology … What does this look like in ...- Authors: Kelly Rabin, Gary Baluta
- Date: Feb 2016
- Competency: External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Product Matters!
- Topics: Annuities>Product development - Annuities; Life Insurance>Product development - Life Insurance
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The Fundamental Trends Reshaping Life Insurance
with an apartment for life and op- tional medical care and other features. The product is aimed at older ... of the cost of comprehensive, long-term health-care policies. And the benefits of the plan are so simple ...- Authors: Bartlomiej Maciaga, Achim Schwetlick, Alpesh Shah
- Date: Jul 2016
- Competency: External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Product Matters!
- Topics: Annuities>Product development - Annuities; Life Insurance>Product development - Life Insurance
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Full Issue
that provide a form of non-underwritten long-term care benefit are becoming more available. These riders ... demonstrated the increased prevalence of long-term care and chronic illness riders on universal life. Each ...- Authors: Society of Actuaries
- Date: Feb 2016
- Competency: External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Product Matters!
- Topics: Annuities>Product development - Annuities; Life Insurance>Product development - Life Insurance
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Risk Management, March 2017
Offi- cer, Application of ERM National Long-Term Care Needs and Parameter Uncertainty. Finally, be on ... have a clearer picture of the future of health care. Brexit will eventually get moving along. Teresa ...- Authors: Society of Actuaries
- Date: Mar 2017
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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A Review of Root Cause in Insurer Insolvencies and Impairments
liability; Life & Annuity, Health, including long- term care (LTC); and Health cooperatives. Figure 1 Number ... circumstances. Some insurer insolvencies point to one primary causal driver, such as fraud. However, a majority ...- Authors: David Heppen, Veronika Cooper
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management>Operational risks; Enterprise Risk Management>Risk measurement - ERM; Finance & Investments>Investments
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The Complications of Cyber Risk Quantification
set of losses associated with cyber attacks…The direct revenue losses for the companies involved in a ... unlikely. Alli- anz’s Donavan sees a “standard of care” evolving along the lines of the National Institute ...- Authors: Society of Actuaries
- Date: Mar 2017
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management