Credit card fraud detection by adaptive neural data mining

The prevention of credit card fraud is an important application for prediction techniques. One major obstacle for using neural network training techniques is the high necessary diagnostic quality: Since only one financial transaction of a thousand is invalid no prediction success less than 99.9% is acceptable. Due to these credit card transaction proportions complete new concepts had to be developed and tested on real credit card data. This paper shows how advanced data mining techniques and neural network algorithm can be combined successfully to obtain a high fraud coverage combined with a low false alarm rate

Electronic fraud detection in the U.S. Medicaid Healthcare Program: lessons learned from other industries

It is estimated that between $600 and$850 billion annually is lost to fraud, waste, and abuse in the US healthcare system,with $125 to$175 billion of this due to fraudulent activity (Kelley 2009). Medicaid, a state-run, federally-matchedgovernment program which accounts for roughly one-quarter of all healthcare expenses in the US, has been particularlysusceptible targets for fraud in recent years. With escalating overall healthcare costs, payers, especially government-runprograms, must seek savings throughout the system to maintain reasonable quality of care standards. As such, the need foreffective fraud detection and prevention is critical. Electronic fraud detection systems are widely used in the insurance,telecommunications, and financial sectors. What lessons can be learned from these efforts and applied to improve frauddetection in the Medicaid health care program? In this paper, we conduct a systematic literature study to analyze theapplicability of existing electronic fraud detection techniques in similar industries to the US Medicaid program

The role of IT/IS in combating fraud in the payment card industry

The vast growth of the payment card industry (PCI) in the last 50 years has placed the industry in the centre of attention, not only because of this growth, but also because of the increase of fraudulent transactions. The conducted research in this domain has produced statistical reports on detection of fraud, and ways of protection. On the other hand, the relevant body of research is quite partial and covers only specific topics. For instance, the provided reports related to losses due to fraudulent usage of cards usually do not present the measures taken to combat fraud nor do they explain the way fraud happens. This can turn out to be confusing and makes one believe that card usage can be more negative than positive. This paper is intended to provide accumulative and organized information of the efforts made to protect businesses from fraud. We try to reveal the effectiveness and efficiency of the current fraud combating techniques and show that organized worldwide efforts are needed to take care of the larger part of the problem. The research questions that will be addressed in the paper are: 1) how can IT/IS help in combating fraud in the PCI?, and 2) is the implemented IT/IS effective and efficient enough to bring progress in combating fraud? Our research methodology is based on a case study conducted in a Macedonian bank. The research is explorative and will be mostly qualitative in nature; however some quantitative aspects will be included. The findings indicate that fraud can take up many forms. A classification of the different forms of data theft into different fraudulent appearances was made. We showed that the benefits from implementing the fraud reduction efforts are multiple. Results show that a bank has to be very small to experience losses from fixed expenditures coming from the implementation of the fraud reduction IT/IS. Medium-sized and large banks should not even see any problems arising from those expenditures. Based on the empirical data and the presented facts we can conclude that the fraud reduction IT/IS do have a positive effect on all sides of the payment process and fulfills the expectations of all stakeholders

Risky business: managing electronic payments in the 21st Century

On June 20 and 21, 2005, the Payment Cards Center of the Federal Reserve Bank of Philadelphia, in conjunction with the Electronic Funds Transfer Association (EFTA), hosted a day-and-a-half forum, “Risky Business: Managing Electronic Payments in the 21st Century.” The Center and EFTA invited participants from the financial services and processing sectors, law enforcement, academia, and policymakers to explore key topics associated with the challenge of effectively managing risk in a payments environment that is increasingly electronic. The meeting’s goal was to identify areas of potential risk and explore interindustry solutions. This paper provides highlights from the forum presentations and ensuing conversations.