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Text Mining for Fraudulent Patterns

Using an approach of text mining of claim diaries, Magnify introduces a new product called, FraudFocus. 

FraudFocusTM, Magnify's predictive modeling-based claims fraud product, continuously reviews claims, beginning at first notice of loss and thereafter whenever a claim is updated throughout the entire life of the claim. The "heart" of the FraudFocusTM approach is predictive modeling, which relies on advanced statistical analysis of claims data to develop algorithms (models) that can accurately identify claims likely to be fraudulent. Predictive modeling is a proven fraud detection technology. In the credit card industry, predictive modeling has been utilized for years to reduce fraud losses by 30% or more. Opportunities exist in Worker's Comp to apply predictive models in a similar manner to identify claimant fraud, provider fraud and policy fraud simultaneously.

Couple this approach with a streaming feed of medical bill analysis, and the possibilities are endless.

Continue reading "Text Mining for Fraudulent Patterns" »

Posted on April 03, 2005 at 10:16 PM | Permalink

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