An interactive machine-learning-based electronic fraud and abuse detection system in healthcare insurance
The nature of problem and claim management environment are well-defined. Very comprehensive literature revive is presented. An IML based novel DSS detecting fraud and abuse in healthcare insurance is developed. Unlike earlier studies, the system embraces all relevant actors and commodities. Real data are used for the evaluation and perform better results wrt previous studies.
decision support systems fraud detection health insurance interactive machine learning machine intelligence