IDENTIFYING CLAIM ANOMALIES FOR ANALYSIS USING DIMENSIONAL ANALYSIS

摘要

The present disclosure describes techniques for performing dimensional analysis on a set of healthcare claims to identify subsets of claims that deviate from baseline metrics. One example method includes identifying a plurality of dimensions for analysis within a plurality of healthcare claims; calculating a set of baseline metrics for the plurality of healthcare claims; for each particular dimension of the plurality of dimensions. identifying dimensional subsets including healthcare claims from the plurality of healthcare claims; identifying outlier subsets from the identified dimensional subsets based on differences between the set of subset metrics for each dimensional subset and the set of baseline metrics; and providing, for output, each identified outlier subset and associated differences between the set of subset metrics for each outlier subset and the set of baseline metrics.