首页> 外国专利> Characterizing Healthcare Provider, Claim, Beneficiary and Healthcare Mercant Normal Behavior Using Non-Parametric Statistical Outlier Detection Scoring Techniques

Characterizing Healthcare Provider, Claim, Beneficiary and Healthcare Mercant Normal Behavior Using Non-Parametric Statistical Outlier Detection Scoring Techniques

机译:使用非参数统计离群值检测评分技术表征医疗保健提供者,索赔,受益人和医疗保健商人的正常行为

摘要

This invention uses non-parametric statistical measures and probability mathematical techniques to calculate deviations of variable values, on both the high and low side of a data distribution, from the midpoint of the data distribution. It transforms the data values and then combines all of the individual variable values into a single scalar value that is a “good-ness” score. This “good-ness” behavior score model characterizes “normal” or typical behavior, rather than predicting fraudulent, abusive, or “bad”, behavior. The “good” score is a measure of how likely it is that the subject's behavior characteristics are from a population representing a “good” or “normal” provider, claim, beneficiary or healthcare merchant behavior. The “good” score can replace or compliment a score model that predicts “bad” behavior in order to reduce false positive rates. The optimal risk management prevention program should include both a “good” behavior score model and a “bad” behavior score model.
机译:本发明使用非参数统计量度和概率数学技术来计算从数据分布的中点开始在数据分布的高端和低端的变量值的偏差。它转换数据值,然后将所有单个变量值组合为一个“良好”分数的单个标量值。这种“良好”行为评分模型表征了“正常”或典型行为,而不是预测欺诈,辱骂或“不良”行为。 “好”分数是对受试者行为特征来自代表“好”或“正常”提供者,索赔,受益人或医疗保健商人行为的人群的可能性的度量。 “好”分数可以代替或补充预测“坏”行为的分数模型,以减少误报率。最佳的风险管理预防计划应同时包括“良好”行为评分模型和“不良”行为评分模型。

著录项

相似文献

  • 专利
  • 外文文献
获取专利

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号