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Proceedings Paper

Auditing health insurance reimbursement by constructing association rules
Author(s): I-Jen Chiang
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Paper Abstract

Two months of reimbursement claim data of the admission patients from National Taiwan University Hospital have been used to be the training set (200 MB or so), a quick method has been used to find out the association rules among the illness, the examinations and treatments, the drugs, and the equipment. The filtered rules by setting the minimum support and the minimum confidence are used to screen out a month claimed data from the other hospital. Some unproper orders to the patients are able to checked out. In this paper, we will discuss the algorithm for generalizing association rule and the experiments of using the association rules to screen out the unproper orders in the health reimbursement claims.

Paper Details

Date Published: 6 April 2000
PDF: 8 pages
Proc. SPIE 4057, Data Mining and Knowledge Discovery: Theory, Tools, and Technology II, (6 April 2000); doi: 10.1117/12.381725
Show Author Affiliations
I-Jen Chiang, Taipei Medical College (Taiwan)

Published in SPIE Proceedings Vol. 4057:
Data Mining and Knowledge Discovery: Theory, Tools, and Technology II
Belur V. Dasarathy, Editor(s)

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