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  • Validating a Novel Health Insurance Fraud Detection Method
    Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...

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    • 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
  • Controlling Indirect Selection under Healthcare Reform
    Controlling Indirect Selection under Healthcare Reform This dissertation by Tia Sawhney will help you understand this issue and start measuring it, or start promoting equitable public policy.

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    • Authors: Tia Sawhney
    • Date: Nov 2012
    • Competency: Technical Skills & Analytical Problem Solving
    • Topics: Economics>Health economics; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Payment models; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Modeling efficiency; Predictive Analytics