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provider-aberrant-billing-detection
provider-aberrant-billing-detection PublicMedicare provider aberrant billing pattern detection using peer-group z-scores, Isolation Forest, and cross-method validation. Built on CMS DE-SynPUF. Snowflake + SAS + Python.
Jupyter Notebook 1
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medicare-upcoding-unbundling-engine
medicare-upcoding-unbundling-engine PublicMedicare fraud detection engine validated on CMS DE-SynPUF Medicare Claims
Jupyter Notebook 1
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medicare-phantom-billing-engine
medicare-phantom-billing-engine PublicMedicare fraud detection engine validated on CMS DE-SynPUF Medicare Claims
Jupyter Notebook 1
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