KDnuggets : News : 2001 : n04 : item36    (previous | next)

Briefs

SGI MineSet helps detects Medicare fraud
MOUNTAIN VIEW, Calif., Feb. 14 SGI (NYSE: SGI) today announced that
Veridian Information Solutions (VIS) has helped the Health Care
Financing Administration (HCFA) develop a comprehensive solution for
detecting and investigating fraud, waste and abuse in the Medicare
claims system based on SGI(TM) data mining technology.

With the help of SGI, VIS has designed and implemented a data analysis
environment for HCFA that is capable of detecting meaningful
correlations, patterns and trends by sifting through information
extracted from a variety of Medicare databases.

Using just four months of Medicare Part B claims data (800
million-record HCFA data set) , the MineSet application identified
cases with potential overpayments totaling nearly $2 million.

"The MineSet tool allowed our analysts to quickly scan these summary
tables, sorting, binning and aggregating columns on the fly. This
greatly simplified the detection of questionable billing or treatment
practices," said Robert Garcia, lead analyst, VIS. "The MineSet suite
of 3D visualization tools provided the analysts with a means to
quickly identify outlays of interest. The tables used in the data
mining process are, of course, unique to the current application. But
the process used can be applied to any fraud detection or indeed any
data mining task."

See www.sgi.com


KDnuggets : News : 2001 : n04 : item36    (previous | next)

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