Detecting and Combating Fraudulent Health Insurance Claims Using ANN

This work was funded by the National Nature Science Foundation of China (71774069), 2014 “Six Talent Peaks” Project of Jiangsu Province (2014- JY-004) Abstract While governments and private sector stakeholders are taking steps to improve the access and quality of health care service to its citizenry, a lot of resources are lost every year due to fraudulent health insurance claims. The aim of this paper is to explore a more robust and accurate ways of predicting fraudulent health insurance claims by the use of artificial neural network (ANN). Using the fraud diamond theory (FDT)’s fraud elements as fraud indicators, a fraud prediction model was created to determine whether a claim presented by a subscriber (individual) is fraudulent or non-fraudulent by varying severally the number of epoch, hidden layer number and threshold of the artificial neural network on a 14 input data to obtain an optimal parameter for the model.The model was able to predict accurately 98.98% with an MSE of 0.0086, which outperformed other artificial neural network (ANN) methods used to predict fraudulent health care claims. The incorporation of the capacity indicator of the fraud diamond theory (FDT) makes this model a tool not only for prediction but also pre-empting the occurrence of fraud. This study is the first to adopt the fraud diamond theory’s fraud elements as fraud indicators together with artificial neural network (ANN) in predicting fraudulent health insurance claims. Keywords: health insurance claim, ANN, fraud prediction model, fraud diamond theor

GPU acceleration of object classification algorithms using NVIDIA CUDA

The field of computer vision has become an important part of today\u27s society, supporting crucial applications in the medical, manufacturing, military intelligence and surveillance domains. Many computer vision tasks can be divided into fundamental steps: image acquisition, pre-processing, feature extraction, detection or segmentation, and high-level processing. This work focuses on classification and object detection, specifically k-Nearest Neighbors, Support Vector Machine classification, and Viola & Jones object detection. Object detection and classification algorithms are computationally intensive, which makes it difficult to perform classification tasks in real-time. This thesis aims in overcoming the processing limitations of the above classification algorithms by offloading computation to the graphics processing unit (GPU) using NVIDIA\u27s Compute Unified Device Architecture (CUDA). The primary focus of this work is the implementation of the Viola and Jones object detector in CUDA. A multi-GPU implementation provides a speedup ranging from 1x to 6.5x over optimized OpenCV code for image sizes of 300 x 300 pixels up to 2900 x 1600 pixels while having comparable detection results. The second part of this thesis is the implementation of a multi-GPU multi-class SVM classifier. The classifier had the same accuracy as an identical implementation using LIBSVM with a speedup ranging from 89x to 263x on the tested datasets. The final part of this thesis was the extension of a previous CUDA k-Nearest Neighbor implementation by exploiting additional levels of parallelism. These extensions provided a speedup of 1.24x and 2.35x over the previous CUDA implementation. As an end result of this work, a library of these three CUDA classifiers has been compiled for use by future researchers