Patent ID: 8214232

Claim:
An article comprising a non-transitory machine-readable storage medium embodying instructions that when performed by one or more machines result in operations comprising: receiving data characterizing at least one healthcare entity based on one, or a set of, healthcare insurance claims; transforming the data into a problem space R N , the problem space R N being computed using a dataset D derived from datasets from a plurality of healthcare insurers, wherein Eigen vectors of R N are computed using D and a first M (<N) principal components of the Eigen vectors, E D , are retained; projecting a data point from a dataset containing D or elements of D on M dimensional principal components followed by re-projection to the N dimensional space to compute divergence from the original position in the R N space, wherein M<N and the divergence (ε) indicates a degree of anomaly for the given data point; determining (i) that the at least one healthcare entity has a potentially fraudulent or erroneous component if the divergence (ε) is above a pre-defined threshold, or (ii) that the at least one healthcare entity is not potentially fraudulent and it does not include an erroneous component if the divergence (ε) is within a pre-defined threshold; and initiating provision of data indicating that the healthcare insurance claim is potentially fraudulent or erroneous based on the determination.