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Fraud detection in automobile insurance claims: A statistical review

Developments of Artificial Intelligence Technologies in Computation and Robotics, 2020
Automobile insurance fraud detection has become critically important for reducing the costs of insurance companies. This survey paper categorises, compares, and summarises from almost all published data mining-based technical and review articles in automated automobile insurance fraud detection.
Liu, Xi, Yang, Jian-Bo, Xu, Dong-Ling
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Geographic Market Definition in Commercial Health Insurer Matters: A Unified Approach for Merger Review, Monopolization Claims, and Monopsonization Claims

The Antitrust Bulletin, 2023
We provide a methodology for geographic market definition when the product(s) being purchased or sold has an intrinsic geographic component, such as (1) the sale of commercial health plans and (2) the purchase of health care providers’ services by commercial health plans.
Haas-Wilson, Deborah   +2 more
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Using Insurance Claims Data and Medical Record Reviews to Assess the Quality of Medical Care

Journal For Healthcare Quality, 1997
This article examines the possibilities and limitations of using computerized insurance claims and outpatient medical records to evaluate a Medicaid managed care program. The quality of medical care delivered to enrollees 1 1/2 years into the MassHealth managed care program's operation is discussed in the context of an evaluation that was conducted by ...
C H, Ellenbecker   +2 more
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Review on use of German health insurance medication claims data for epidemiological research

Pharmacoepidemiology and Drug Safety, 2009
AbstractPurposeThe objective was to evaluate the use of German health insurance claims data on medications over the last 10 years by a review of published studies.MethodsPubMed and Scopus were searched for relevant studies published in 1998 through 2007.ResultsA total of 70 studies were included.
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