Monday, November 30, 2015

4 types of prescription medicine fraud and the types of data analysis CMS uses to combat it


1.    Prescription limits exceeded - CMS uses statistical analysis models to flag anomalies

2.    Undocumented claimants using false information - CMS uses data validation models

3.    “Small town scams” - CMS uses pattern analytics models

4.    Benefit plan scams - CMS applies data models to match records

Source: "How Big Data Use In Healthcare Prevents Scams And Fraud,"Digitalist

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