Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
2003-02-06
2010-10-12
Gilligan, Luke (Department: 3626)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S003000, C706S015000
Reexamination Certificate
active
07813937
ABSTRACT:
Transaction-based behavioral profiling, whereby the entity to be profiled is represented by a stream of transactions, is required in a variety of data mining and predictive modeling applications. An approach is described for assessing inconsistency in the activity of an entity, as a way of detecting fraud and abuse, using service-code information available on each transaction. Inconsistency is based on the concept that certain service-codes naturally co-occur more than do others. An assessment is made of activity consistency looking at the overall activity of an individual entity, as well as looking at the interaction of entities. Several approaches for measuring consistency are provided, including one inspired by latent semantic analysis as used in text analysis. While the description is in the context of fraud detection in healthcare, the techniques are relevant to application in other industries and for purposes other than fraud detection.
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Allmon Andrea L
de Traversay Jean
Ianakiev Krassimir G
Pathria Anu K
Suresh Nallan C
Fair Isaac Corporation
Gilligan Luke
Mintz Levin Cohn Ferris Glovsky and Popeo P.C.
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