Enriched system for suspicious interaction record detection
US10187399B2 · kind B2 · utility
Assignee
Inventor
Key dates
| Filing date | Feb 25, 2016 |
| Grant date | Jan 22, 2019 |
| Priority date | — |
| Expiry date | Aug 21, 2036 |
Classification
- Technology area (CPC H)Electricity
- CPC primaryH04W12/63
- WIPO fieldDigital communication
- WIPO sectorElectrical engineering
Abstract
Systems and methods for improved detection of fraud, waste, and abuse are provided, based on the analysis of enriched relationships and aggregated metrics thereof. An enriched relationship record associates patient and provider information to provide an enhanced view of patient data, provider data, and interaction data for a given entity. Aggregated metrics provide an enhanced view of a particular entity's activities based on the entity's interactions with other entities and data and metadata from the related entities' enriched relationship records. The enriched relationship records and aggregated metrics may be used to audit the entity and produce a report indicative of suspicion levels for the entity engaging in fraud, waste, or abuse.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.