|Title:|| Statistical Issues in Medical Fraud Assessment|
|Date:|| Monday 24th June 2013|
|Author(s) :|| Ekin, T.; Ieva, F.; Ruggeri, F.; Soyer, R.|
|Abstract:|| In this paper we provide a survey of the statistical issues in medical fraud assessment. We discuss different types of medical fraud and the type of fraud data that arise in different situations and give a review of the statistical
methods that use such data to assess fraud. We also discuss "conspiracy fraud" and the associated dyadic data and introduce Co-clustering methods which have not been previously considered in the medical fraud literature.
In so doing, we present some recent work on Bayesian co-clustering for fraud assessment and its extensions. Furthermore, we discuss potential use of decision theoretic methods in fraud detection and demonstrate an example for evaluating fraud detection tools.|