scholarly journals Analysis of Health Care Billing via Quantile Variable Selection Models

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1274
Author(s):  
Tahir Ekin ◽  
Paul Damien
Keyword(s):  
Health Care ◽  
Variable Selection ◽  
Common Factors ◽  
Fraud Detection ◽  
Health Care Insurance ◽  
Billing Data ◽  
Policy Makers ◽  
Regression Framework ◽  
Selection Approach ◽  
The Common

Fraudulent billing of health care insurance programs such as Medicare is in the billions of dollars. The extent of such overpayments remains an issue despite the emerging use of analytical methods for fraud detection. This motivates policy makers to also be interested in the provider billing characteristics and understand the common factors that drive conservative and/or aggressive behavior. Statistical approaches to tackling this problem are confronted by the asymmetric and/or leptokurtic distributions of billing data. This paper is a first attempt at using a quantile regression framework and a variable selection approach for medical billing analysis. The proposed method addresses the varying impacts of (potentially different) variables at the different quantiles of the billing aggressiveness distribution. We use the mammography procedure to showcase our analysis and offer recommendations on fraud detection.

America's Health Care Reforms

1994 ◽  
Vol 24 (1) ◽  
pp. 32-33 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Johanna Westbrook
Keyword(s):  
Health Care ◽  
New Deal ◽  
Insurance Coverage ◽  
Bill Clinton ◽  
Health Care Insurance ◽  
American Population ◽  
Health Care Reforms ◽  
Policy Makers ◽  
Care Costs ◽  
The New Deal

President Bill Clinton is currently proposing the most sweeping changes to American social policy since the New Deal by Roosevelt in the 1930s. Major concerns about escalating health care costs, a mushrooming health care bureaucracy and a growing proportion of the American population who can no longer afford adequate health care insurance coverage have motivated Clinton's plan for health care reform. Ideas about telemedicine, the electronic medical record and more comprehensive and advanced information systems are already being canvassed during the course of the debate. Australian clinicians and policy makers are following the American debate closely. So too, should health information managers. America watching should prove interesting, stimulating and professionally rewarding.

Health Care Insurance Fraud Detection Using Blockchain

2020 ◽  
Author(s):  
Gokay Saldamli ◽  
Vamshi Reddy ◽  
Krishna S. Bojja ◽  
Manjunatha K. Gururaja ◽  
Yashaswi Doddaveerappa ◽  
...  
Keyword(s):  
Health Care ◽  
Fraud Detection ◽  
Insurance Fraud ◽  
Health Care Insurance

HEALTHCARE CHALLENGES IN GILGIT BALTISTAN: THE WAY FORWARD

1970 ◽  
Vol 7 (2) ◽  
pp. 113-116
Author(s):  
Amimah Fatima Asif
Keyword(s):  
Health Care ◽  
Healthcare Delivery ◽  
Medical Personnel ◽  
Political Regime ◽  
Quality Healthcare ◽  
Accident And Emergency ◽  
Long Time ◽  
The Common ◽  
Gilgit Baltistan ◽  
And Child Health

Quality healthcare delivery is the bedrock to exponentially accelerate the development of a country. Unfortunately, in Pakistan healthcare has been neglected since a long time, with the common man bearing the brunt of this acute situation. There are critical challenges in health care, with paucity of trained human resource and deficit of regulated infrastructure and service delivery being the predominant dilemmas. Primary and secondary healthcare are in an unseemly state, to say the least. Maternal and child health care, accident, and emergency departments and mental health are among the most undermined and forsaken areas of healthcare, primarily in the far flung Gilgit Baltistan region of Pakistan. The only way forward is if the political regime, administration and the medical personnel work in concurrence to revise the health infrastructure of the country.

Improving Practices for Selecting a Subset of Important Predictors in Psychology: An Application to Predicting Pain

2019 ◽  
Author(s):  
Sierra Bainter ◽  
Thomas Granville McCauley ◽  
Tor D Wager ◽  
Elizabeth Reynolds Losin
Keyword(s):  
Variable Selection ◽  
Bayesian Variable Selection ◽  
Limited Information ◽  
Online Application ◽  
Stochastic Search Variable Selection ◽  
Selection Approach ◽  
Pain Ratings ◽  
Research Questions ◽  
Standard Techniques ◽  
Search Variable

In this paper we address the problem of selecting important predictors from some larger set of candidate predictors. Standard techniques are limited by lack of power and high false positive rates. A Bayesian variable selection approach used widely in biostatistics, stochastic search variable selection, can be used instead to combat these issues by accounting for uncertainty in the other predictors of the model. In this paper we present Bayesian variable selection to aid researchers facing this common scenario, along with an online application (https://ssvsforpsych.shinyapps.io/ssvsforpsych/) to perform the analysis and visualize the results. Using an application to predict pain ratings, we demonstrate how this approach quickly identifies reliable predictors, even when the set of possible predictors is larger than the sample size. This technique is widely applicable to research questions that may be relatively data-rich, but with limited information or theory to guide variable selection.

scholarly journals N-soliton solutions and the Hirota conditions in (1 + 1)-dimensions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Wen-Xiu Ma
Keyword(s):  
Common Factors ◽  
Soliton Solutions ◽  
Higher Order ◽  
Kdv Equations ◽  
The Common ◽  
Bilinear Formulation ◽  
Generalized Kdv Equations ◽  
Hirota Bilinear

Abstract We analyze N-soliton solutions and explore the Hirota N-soliton conditions for scalar (1 + 1)-dimensional equations, within the Hirota bilinear formulation. An algorithm to verify the Hirota conditions is proposed by factoring out common factors out of the Hirota function in N wave vectors and comparing degrees of the involved polynomials containing the common factors. Applications to a class of generalized KdV equations and a class of generalized higher-order KdV equations are made, together with all proofs of the existence of N-soliton solutions to all equations in two classes.

scholarly journals Understanding Urban Commercial Vehicle Driver Behaviors and Decision Making

2021 ◽  
pp. 036119812110035
Author(s):  
Giacomo Dalla Chiara ◽  
Klaas Fiete Krutein ◽  
Andisheh Ranjbari ◽  
Anne Goodchild
Keyword(s):  
Commercial Vehicle ◽  
Operating Time ◽  
Common Belief ◽  
Policy Makers ◽  
Factors Affecting ◽  
Urban Freight ◽  
The Road ◽  
Commercial Drivers ◽  
The Common ◽  
Printed Materials

As e-commerce and urban deliveries spike, cities grapple with managing urban freight more actively. To manage urban deliveries effectively, city planners and policy makers need to better understand driver behaviors and the challenges they experience in making deliveries. In this study, we collected data on commercial vehicle (CV) driver behaviors by performing ridealongs with various logistics carriers. Ridealongs were performed in Seattle, Washington, covering a range of vehicles (cars, vans, and trucks), goods (parcels, mail, beverages, and printed materials), and customer types (residential, office, large and small retail). Observers collected qualitative observations and quantitative data on trip and dwell times, while also tracking vehicles with global positioning system devices. The results showed that, on average, urban CVs spent 80% of their daily operating time parked. The study also found that, unlike the common belief, drivers (especially those operating heavier vehicles) parked in authorized parking locations, with only less than 5% of stops occurring in the travel lane. Dwell times associated with authorized parking locations were significantly longer than those of other parking locations, and mail and heavy goods deliveries generally had longer dwell times. We also identified three main criteria CV drivers used for choosing a parking location: avoiding unsafe maneuvers, minimizing conflicts with other users of the road, and competition with other commercial drivers. The results provide estimates for trip times, dwell times, and parking choice types, as well as insights into why those decisions are made and the factors affecting driver choices.

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