Fraud detections in the health care industry

One more opportunity to implement data mining techniques in the health care industry will be helping the healthcare insurers to detect fraud transactions so that the other patients can receive better and more affordable healthcare services. This occurs when individuals deceive an insurance company to try to obtain money to which they are not entitled. It happens when someone puts false information on an insurance application and when false or misleading information is given or important information is omitted in an insurance transaction or claim. Apart from the data we have collected from the patients, we will be gathering one more dataset where we will be having the details of all hospitals in the locality, diagnosis, quality. Evaluation: Here we cannot accurately classify whether a transaction is default or not, because of the challenges faced while collecting the data related to the hospitals.