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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...
| Autores principales: | , , , , , , |
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
BioMed Central
2023
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| Materias: | |
| 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 |