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Identifying Medicare fraud in the cardiology specialty
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Identifying Medicare fraud in the cardiology specialty
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1704.pdf
Description
Identifier
Spec
21
Author
Benjamin, Bahati A. L., 1980-
Title
Identifying
Medicare
fraud
in the
cardiology
specialty
Publisher
Central Connecticut State University
Date
2011
;
*
Resource Type
Special Project
Notes
Healthcare
costs
are
projected
to
skyrocket
as
medical
services
become
increasingly
specialized
and
more
expensive
.
Medicare
spending
in
particular
is
growing
rapidly
representing
approximately
16%
of
all
federal
spending
.
Recently
,
Medicare
fraud
has been a
major
focal
point
in the
discussion
of
reforming
our
health
care
system
.
Every
year
,
millions
of
dollars
are
lost
to
fraudulent
claims
and
billing
errors
.
Data
analysis
is
an
important
tool
in
detecting
aberrant
billing
as
it
is
the
beginning
step
in an
investigator’s
analysis
to
identify
true
fraud
. In this
paper
,
our
focus
is
on
identifying
aberrant
providers
based
on a
number
of
independent
variables
utilizing
regression
analysis
.
Identifying
aberrant
billing
activity
will
identify
potential
savings
to the
Medicare
trust
fund
for
future
health
care
reform
as the
Medicare
population
continues
to
increase
. A
discriminant
model
will
later
be
built
utilizing
data
from
providers
identified
as
aberrant
. By
identifying
providers
whose
billing
patterns
differ
significantly
from their
peers
,
aberrant
claims
may
be
identified
early
preventing
fraud
before
it
is
necessary
to
detect
it
.
Subject
Medicare fraud
Department
Department of Mathematical Sciences
Advisor
Miller, Daniel
Type
Text
Digital Format
application/pdf
Language
eng
OCLC number
804653102
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