Deep Learning: Detecting Fraudulent Healthcare Provider using AutoEncoder
Introduction In this article, I will share my experience that how to use the power of deep neural networks to effectively identify fraudulent healthcare providers from the health care transactions that can be identified as anomalies in a dataset. For this solution, I used autoencoder machine l earning algorithm and implemented it in the H2O platform. Let us start with the definition. An anomaly refers to a data instance that is significantly different from other instances in the dataset. Often these considered as statistical outliers or errors in the data before developing a predictive model. But sometimes an anomaly in the data may indicate some potentially harmful events that have occurred previously. In health care insurance claim data, those are fraudulent claims. Health Care Fraud Healthcare provider fraud is one of the biggest problems facing Medicare. According to the government, the total Medicare spending increased exponentially due to fraud in Medicare claims....