发明名称 |
Fraud detection method and system |
摘要 |
A method for determining the legitimacy of an insurance claim includes the steps of receiving codes that identify a service for which payment is requested from an insurance provider. Services that might have been upcoded or miscoded to the claimed service are also identified. An insured, a patient or a family member or care giver can be queried about the occurrence of observable aspects of the service that is billed as well as a service that might have been upcoded to what is billed. Responses to the queries suggest the legitimacy or illegitimacy of the claim. |
申请公布号 |
US8725524(B2) |
申请公布日期 |
2014.05.13 |
申请号 |
US20030639978 |
申请日期 |
2003.08.13 |
申请人 |
FANO ANDREW E.;ACCENTURE GLOBAL SERVICES LIMITED |
发明人 |
FANO ANDREW E. |
分类号 |
G06Q50/22;G06Q10/00;G06Q40/00;G06Q50/24 |
主分类号 |
G06Q50/22 |
代理机构 |
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代理人 |
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主权项 |
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地址 |
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