Publications -> Conference Papers

A Fraud Resilient Medical Insurance Claim System


Authors: Y. Shi, C. Sun, Q. Li, L. Cui, H. Yu, and C. Miao
Title: A Fraud Resilient Medical Insurance Claim System
Abstract: As many countries in the world start to experience population aging, there are an increasing number of people relying on medical insurance to access healthcare resources. Medical insurance frauds are causing billions of dollars in losses for public healthcare funds. The detection of medical insurance frauds is an important and difficult challenge for the artificial intelligence (AI) research community. This paper outlines HFDA, a hybrid AI approach to effectively and efficiently identify fraudulent medical insurance claims which has been tested in an online medical insurance claim system in China.
Keywords: 
Conference Name: 30th AAAI Conference on Artificial Intelligence (AAAI'16)
Location: Phoenix, USA
Publisher: AAAI
Year: 2016
Accepted PDF File: A_Fraud_Resilient_Medical_Insurance_Claim_System_accepted.pdf
Permanent Link: http://www.aaai.org/ocs/index.php/AAAI/AAAI16/paper/view/11813
Reference: Y. Shi, C. Sun, Q. Li, L. Cui, H. Yu, and C. Miao, “A fraud resilient medical insurance claim system,” in Proceedings of the 30th AAAI Conference on Artificial Intelligence (AAAI’16). AAAI, February 2016, pp. 4393–4394.
bibtex: 
@inproceedings{LILY-c71, 
    author	= {Shi, Yuliang and Sun, Chenfei and Li, Qingzhong and Cui, Lizhen and Yu, Han and Miao, Chunyan},
    title	= {A Fraud Resilient Medical Insurance Claim System},  
    booktitle	= {Proceedings of the 30th AAAI Conference on Artificial Intelligence (AAAI'16)}, 
    year		= {2016}, 
    month	= {February}, 
    pages	= {4393-4394}, 
    location	= {Phoenix, USA},
    publisher	= {AAAI},
 }