Mahdi Nasiri

[ 1 ] - Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study

Background We aimed to identify the indicators of healthcare fraud and abuse in general physicians’ drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse.   Methods We applied data mining approach to a major health insurance organization dataset of private sector general physicians’ prescription claims. It involved 5 ste...