An Intelligent Data Mining System to Detect Health Care Fraud

The chapter begins with an overview of the types of healthcare fraud. Next, there is a brief discussion of issues with the current fraud detection approaches. The chapter then develops information technology based approaches and illustrates how these technologies can improve current practice. Finally, there is a summary of the major findings and the implications for healthcare practice

Role of Artificial Intelligence (AI) art in care of ageing society: focus on dementia

open access articleBackground: Art enhances both physical and mental health wellbeing. The health benefits include reduction in blood pressure, heart rate, pain perception and briefer inpatient stays, as well as improvement of communication skills and self-esteem. In addition to these, people living with dementia benefit from reduction of their noncognitive, behavioural changes, enhancement of their cognitive capacities and being socially active. Methods: The current study represents a narrative general literature review on available studies and knowledge about contribution of Artificial Intelligence (AI) in creative arts. Results: We review AI visual arts technologies, and their potential for use among people with dementia and care, drawing on similar experiences to date from traditional art in dementia care. Conclusion: The virtual reality, installations and the psychedelic properties of the AI created art provide a new venue for more detailed research about its therapeutic use in dementia

Correlating Medi-Claim Service by Deep Learning Neural Networks

Medical insurance claims are of organized crimes related to patients, physicians, diagnostic centers, and insurance providers, forming a chain reaction that must be monitored constantly. These kinds of frauds affect the financial growth of both insured people and health insurance companies. The Convolution Neural Network architecture is used to detect fraudulent claims through a correlation study of regression models, which helps to detect money laundering on different claims given by different providers. Supervised and unsupervised classifiers are used to detect fraud and non-fraud claims

Privacy Violation and Detection Using Pattern Mining Techniques

Privacy, its violations and techniques to bypass privacy violation have grabbed the centre-stage of both academia and industry in recent months. Corporations worldwide have become conscious of the implications of privacy violation and its impact on them and to other stakeholders. Moreover, nations across the world are coming out with privacy protecting legislations to prevent data privacy violations. Such legislations however expose organizations to the issues of intentional or unintentional violation of privacy data. A violation by either malicious external hackers or by internal employees can expose the organizations to costly litigations. In this paper, we propose PRIVDAM; a data mining based intelligent architecture of a Privacy Violation Detection and Monitoring system whose purpose is to detect possible privacy violations and to prevent them in the future. Experimental evaluations show that our approach is scalable and robust and that it can detect privacy violations or chances of violations quite accurately. Please contact the author for full text at [email protected]

Super-resolution community detection for layer-aggregated multilayer networks

Applied network science often involves preprocessing network data before applying a network-analysis method, and there is typically a theoretical disconnect between these steps. For example, it is common to aggregate time-varying network data into windows prior to analysis, and the tradeoffs of this preprocessing are not well understood. Focusing on the problem of detecting small communities in multilayer networks, we study the effects of layer aggregation by developing random-matrix theory for modularity matrices associated with layer-aggregated networks with $N$ nodes and $L$ layers, which are drawn from an ensemble of Erd\H{o}s-R\'enyi networks. We study phase transitions in which eigenvectors localize onto communities (allowing their detection) and which occur for a given community provided its size surpasses a detectability limit $K^*$. When layers are aggregated via a summation, we obtain $K^*\varpropto \mathcal{O}(\sqrt{NL}/T)$, where $T$ is the number of layers across which the community persists. Interestingly, if $T$ is allowed to vary with $L$ then summation-based layer aggregation enhances small-community detection even if the community persists across a vanishing fraction of layers, provided that $T/L$ decays more slowly than $\mathcal{O}(L^{-1/2})$. Moreover, we find that thresholding the summation can in some cases cause $K^*$ to decay exponentially, decreasing by orders of magnitude in a phenomenon we call super-resolution community detection. That is, layer aggregation with thresholding is a nonlinear data filter enabling detection of communities that are otherwise too small to detect. Importantly, different thresholds generally enhance the detectability of communities having different properties, illustrating that community detection can be obscured if one analyzes network data using a single threshold.Comment: 11 pages, 8 figure