Results 41 to 50 of about 161,189 (267)
Proceedings of the International Florida Artificial Intelligence Research Society Conference, 2021 Every year, health insurance fraud costs taxpayers billions of dollars and puts patient’s health and welfare at risk. Existing solutions to detect fraudulent providers (hospitals, physicians, etc.) aim to find unusual pattern at claim level features but ...
Nitish Kumar +5 more
doaj +1 more source
Using Benford\u27s Law to Detect Fraud in the Insurance Industry [PDF]
, 2002 Benford\u27s Law is the mathematical phenomena that states that the first digits or left most digits in a list of numbers will occur with an expected logarithmic frequency.
Akers, Michael D., Maher, Meredith
core +1 more source
ESG Performance and Credit Risk: Evidence From Chinese Manufacturing Companies
International Journal of Finance &Economics, EarlyView.ABSTRACT This study investigates the effect of corporate environmental, social, and governance (ESG) performance on credit risk using a sample of manufacturing firms listed on China's Shanghai and Shenzhen A‐share markets from 2009 to 2021. Employing fixed effects, the generalised method of moments, and instrumental variable models, we find that ...
Yanan Wang +4 more
wiley +1 more source
Analisis Faktor Internal dan Eksternal sebagai Bahan Penyusun Strategi Pencegahan Fraud Dana Kapitasi Puskesmas di Kota Semarang [PDF]
, 2015 National Health Insurance Programme (JKN) is part of National Social Insurance System (SJSN) which is held by mandatory social health insurance based on regulation number 40 year 2004.
Arso, S. P. (Septo) +2 more
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Journal of Organizational Behavior, EarlyView.ABSTRACT In the course of a workday, employees attend to various tasks whose challenge might be equal to, higher than, or lower than employees' present level of capabilities. Moreover, employees encounter these tasks sequentially throughout the day with different levels of prior motivation. Investigating carryover effects in motivation from one task to
Sherry (Qiang) Fu +4 more
wiley +1 more source
A Continuous Theory of Income Insurance [PDF]
In this paper we treat an individual’s health as a continuous variable, in contrast to the traditional literature on income insurance, where it is regularly treated as a binary variable.
Lindbeck, Assar, Persson, Mats
core +3 more sources
Deep Learning for Fraud Prediction in Preauthorization for Health Insurance
International Journal of Engineering and Advanced Technology, 2022 Health insurance fraud remains a global menace despite the controls implemented to address it; one of such controls is preauthorization. Although, preauthorization promises reduction in fraud, waste and abuse in healthcare, it places undue administrative burden on healthcare service providers and delay in patient care.
Aishat Salau +2 more
openaire +1 more source
Data‐Driven Marketing Processes: A Roadmap for Big Data Analytics Adoption in a Brazilian SaaS SME
Knowledge and Process Management, EarlyView.ABSTRACT Small and medium‐sized enterprises (SMEs) often face unique challenges in integrating advanced digital technologies due to limited resources and organizational constraints. While much attention has been given to large firms' adoption of big data analytics (BDA) and artificial intelligence (AI), less is known about how SMEs can leverage these ...
Fabricio Venancio +2 more
wiley +1 more source
Getting the Haves to Come out Behind: Fixing the Distributive Injustices of American Health Care [PDF]
, 2006 Hyman criticizes an article by Havighurst and Richman regarding the distributive injustices of US health care.
Hyman, David A.
core +4 more sources
International Journal of Information Management Data Insights, 2022 Since Bitcoin's success, there has been a greater emphasis on researching the use of blockchain in a wide range of applications, such as agriculture, education, government, voting systems, etc.
Anokye Acheampong Amponsah +2 more
doaj +1 more source