BriefsData mining to fight healthcare fraudSep 10, 2002. Independence Blue Cross is a large East coast healthcare provider. Edward J. Litchko, director of IBC's corporate and financial investigations department, said the company uses a sophisticated software data mining tool to analyze all claims submitted by medical providers and pharmacies and compare them against member enrollment data and overall provider information. Any trends, patterns or aberrant billing practices are targeted for an in-depth audit or investigation. As a result, IBC has already recovered more than $11.4 million. Here is full story from Philadelphia Business Journal. . |
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