UNSUPERVISED METHOD OF IDENTIFYING ABERRANT BEHAVIOR BY AN ENTITY WITH RESPECT TO HEALTHCARE CLAIM TRANSACTIONS AND ASSOCIATED COMPUTER SOFTWARE PROGRAM PRODUCT, COMPUTER DEVICE, AND SYSTEM

摘要

An unsupervised method of identifying aberrant behavior by an entity with respect to healthcare claim transactions is provided. A coordinate space is defined with a dimensionality corresponding to a number of selected ranked variables defining a representative behavior of a peer group with respect to a reference source of claim transactions, the peer group comprising a plurality of entites. A central tendency of the representative behavior is then determined from the claim transactions of the reference source, as a result of the selected ranked variables being applied thereto, and with respect to the coordinate space. The selected ranked variables are then applied to a new source of claim transactions for entites corresponding to the peer group so as to define a corresponding element for each entity. After mapping the elements with respect to the coordinate space, a score is then determined for each element with respect to the central tendency. A threshold criteria is then applied to the scores such that a threshold-exceeding score indicates an aberrant behavior by the corresponding entity. An associated computer software program product, computer device, and system are also provided.