Procedure code overutilization detection from healthcare claims using unsupervised deep learning methods

BACKGROUND: Fraud, Waste, and Abuse (FWA) in medical claims have a negative impact on the quality and cost of healthcare. A major component of FWA in claims is procedure code overutilization, where one or more prescribed procedures may not be relevant to a given diagnosis and patient profile, result...

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Detalles Bibliográficos
Autores principales: Suesserman, Michael, Gorny, Samantha, Lasaga, Daniel, Helms, John, Olson, Dan, Bowen, Edward, Bhattacharya, Sanmitra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536726/
https://www.ncbi.nlm.nih.gov/pubmed/37770866
http://dx.doi.org/10.1186/s12911-023-02268-3

Internet

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536726/
https://www.ncbi.nlm.nih.gov/pubmed/37770866
http://dx.doi.org/10.1186/s12911-023-02268-3

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