Related Experiment Video
Updated: Dec 17, 2025
A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
How to Extract and Explore Big Data for Fraud Detection in the Healthcare Sector: The EOPYY Case Study
Spiros Georgakopoulos1, Parisis Gallos1, Vassilis Plagianakos1,2
1Hellenic National Organization for the Provision of Health Services, Greece.
Abstract:
Big Data technologies can contribute to medical fraud detection. The aim of this paper is to present the methodological approach of the Hellenic National Organization for the Provision of Health Services (EOPYY) in data analysis to detect financial or medical fraud. To analyze the data for fraud detection, a selection of prescription data from the year 2018 were examined. The Local Correlation Integral algorithm was applied to detect any outliers on the dataset. The results revealed that 7 out of 879 cases could be characterized as outliers. These outliers must be further investigated to determine if they have been associated with fraud. According to the results of this study, this outliers' detection approach can support and help the fraud detection process conducted by the auditing services in Healthcare sector.
More Related Videos
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:18Steps in Outbreak Investigation
01:25Ethical Standards I
The Code of Ethics provisions outline the nurse's duty to the patient, the healthcare team, the profession, and society. The Code's fundamental principles include advocacy,...
01:18Healthcare Agencies I
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...