Fraud detection in healthcare

摘要

#$%^&*AU2020202131A120200416.pdf#####ABSTRACT OF THE DISCLOSURE A system for, among other purposes, detecting health care fraud, comprises a data import component for importing health care data from data source(s) such health care providers, insurers, or pharmacies; data repositor(ies) in which the data import component creates health care objects such as provider objects that describe health care providers, patient objects that represent health care recipients, and health care event objects that describe one or more of: health care claims, prescriptions, medical procedures, or diagnoses; a correlation component that identifies correlations between the health care objects; a graph generator component that generates graphs of networks identified based at least on the correlations identified by the correlation component, the graphs comprising linked nodes that represent health care objects in the identified networks; and an interface generator that generates interfaces that display the graphs generated by the graph generator.