Health Insurance Claims Review. By analyzing the aforementioned techniques, we will get a clear idea for the future work in health insurance claim fraud detection. The claims data of health insurance review and assessment service (hira) contains 46 million patients per year that account for 90% of the total population in korea and.
If you are seeking a planned treatment, inform the insurance company beforehand. Conclusion in conclusion, this paper reviews two approaches for detecting fraudulent behavior in health insurance claim. Star health rejected my cashless claim when my dad was admitted for the first time.