Machine Learning In Analytics To Limit Healthcare Fraud

To most Americans, the phrase "Medicare Fraud" brings up images of individuals who cheat the system to collect healthcare when they don't need it. While those cases do exist, that's not what really concerns fraud analysts, insurance companies, and government agencies. The strong majority of fraud cases involve healthcare providers. The problem is that there are so many providers that current healthcare solutions aren't advanced enough to identify fraud in the vast amount of information. One example is the problem of prescription billing abuse. That area is a great example of where machine learning (ML) can have a direct input on a real world problem.