IWEBCARE: AN ONTOLOGICAL APPROACH FOR FRAUD DETECTION IN THE HEALTHCARE DOMAIN

摘要

The European iWebCare project (FP6-2004-IST-4-028055) aims at designing and developing a flexible fraud detection web services platform, which will be able to serve e-government processes of fraud detection and prevention, in order to ensure quality and accuracy and minimize loss of health care funds. This paper discusses the approach this project adopts and which involves the introduction of a fraud detection methodology combining business process modelling and knowledge engineering as well as the development of an integrated fraud detection platform combining an ontologybased rule engine and a self-learning module based on data mining.