Abstract
In this paper, we provide a comprehensive review of methodology for detecting anomalies based on the literature, industry expert and our findings. We elicit links between health service providers based on their shared customer base. Looking at the connections of providers, their geographical arrangements and statistical comparison of profile attributes, we highlight links which could be classified as suspicious or fraudulent behaviour.
Recommended Citation
Feczak, Szabolcs and Hossain, Liaquat, "Towards A Complex Adaptive Link Prediction In Health Insurance Fraud" (2011). UK Academy for Information Systems Conference Proceedings 2011. 16.
https://aisel.aisnet.org/ukais2011/16
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