Healthcare Fraud Research Paper

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Pages: 1

Healthcare fraud is a very important and difficult task. With the increase in the size of the data it has become more difficult to detect fraud with the traditional methods. In earlier times it was easy to do all the fraud detection check using manual methods because of less complexity and fewer amounts of data. But now there is a high demand for sophisticated methods and techniques for fraud detection using new technologies.
This paper discusses about detecting frauds in healthcare insurance from large databases using clustering technique. The paper applies two clustering methods SAS EM and CLUTO. The methods include defining data and the preprocessing steps and also data transformation. The last part of the paper compares the two clustering

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Healthcare Compliance: Research Identity-Theft Cases

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Ethical Healthcare Issues Essay

Running Head: ETHICAL HEALTHCARE Ethical Healthcare Issues Paper Wanda Douglas Health Law and Ethics/HCS 545 October 17, 2011 Nancy Moody Ethical Healthcare Issues Paper In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies…

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WHITE PAPER WHERE CAN $700 BILLION IN WASTE BE CUT ANNUALLY FROM THE U.S. HEALTHCARE SYSTEM? ROBERT KELLEY VICE PRESIDENT, HEALTHCARE ANALYTICS THOMSON REUTERS OCTOBER 2009 INTRODUCTION How America will pay for healthcare is a subject on the mind of virtually every American today. As Congress determines who will pick up the tab for this important and growing expense, it is worthwhile to take a close look at the cost of healthcare itself. Are there areas where expenses can be cut without…

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Pfizer company Essay

Company Overview: Pfizer is an international pharmaceutical company and is considered one of the leading companies in this industry with Lipitor and Viagra as its most known manufactured drugs. The company grew from a one building medicine manufacturer to a multinational company running its operations all over the world. In addition, the mergers and acquisitions that the business went through ensured that Pfizer name is associated with any global resource specialized in health and well-being industry…

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office he created the “Health Insurance Portability and Accountability Act (HIPAA), and it included fraud and abuse control, health insurance portability, and group health plan requirements (Physicians Billing Associates International 2006). This was created only to help protect patients’ medical records, and personal health records worldwide. Basically, in the future this can help the healthcare workers to have control over the patients’ information. There are three issues that facing patients’…

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The possible financial crimes and the impact of it on shareholders in the corporate world Essay

This paper, however, cannot give out a specific definition of financial crimes, considering we have numerous varied definition around the world. Even in the United States, I have found different answers for it. So in this paper, I listed a number of definitions of financial crime given by different scholars. Also, I combine some real cases to help understand the term and impact it brings to shareholders. Keywords: financial crimes, corporate world, shareholders. Introduction The research topic…

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State Government Research Paper

for small business growth and development, a geographical oasis that attracts Americans from all backgrounds and social classes to live and prosper and a balanced atmosphere for the political efficacious North Carolinians. The research question that I explore in this paper is the effects of the conservative agenda and why North Carolina should continue the southern motif of laissez-faire politics. The issue is important because from the birth of our nation, the founding fathers had an idea independence…

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Evolution Of Health Care Information Systems

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Health Insurance

PART I Directions: Using Microsoft® Word to save and submit your work, please provide detailed and elaborate responses to the following questions. Your responses should include examples from the reading assignments. 1. What are the five basic types of health insurance? What are their benefits and limitations? There are five basic types of health insurance available under group and individual policies. Hospital expense insurance is the most common type of health insurance. This form of health insurance…

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The Sarbanes-Oxley Act: An Ethical Perspective

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