A framework for the detection of fraudulent transaction in healthcare management

Project Title

A framework for the detection of fraudulent transaction in healthcare management

Project Area of Specialization Software EngineeringProject Summary

Financial Fraud and scamming are becoming a problem globally. It is having diverse effect on the insurance providing companies. Financial frauds range from insurance fraud to credit fraud and telecommunication fraud. Healthcare fraud is also becoming more and more common. These frauds are perpetrated by falsifying techniques that appear to be true in the face of the victims. Fraud is a global phenomenon and is defined by a wrongful or criminal ploy for the financial or personal gain.

Medicare is important for all individuals but due to high prices not everyone is able to get ahold of expensive medicare health services.For this America is providing financial asistance so people are able to get health facilities [https ://www.medic are.gov]. Due to these facilities America has experienced a raise in the elderly population since 2004. These health care facilities is facing a number of difficuilties which inculdes bad actors.These bad actors causes allocated funds to be reduced by fake claims.

Therefore in this project ,we are indentifiyiing beneficiary culrpit who are the roots of fake claims by using data mining techniques and algorithms on publicaly availlable datasets.

Project Objectives

Main objectives of this project is :

• Identification of beneficiary culpurit.
• Minimizing the lose of company.
• Predicting future trends of beneficiary.

Project Implementation Method

This is be a web based project that will be built using python as backend language in which algorithms are implemented. Html/css is also used for the front end interface and web application.

Datasets are manuplated in sqlite as well as google colab while implementation.

Benefits of the Project

This porject have high social impact because it will help to maximize indentification of beneficiary culprits and minimize comapny lose.

Technical Details of Final Deliverable

final deliverable is a web based application which will be able to identify the beneficiary culprit from the knowledge base.

Final Deliverable of the Project HW/SW integrated systemCore Industry OthersOther IndustriesCore Technology Big DataOther Technologies OthersSustainable Development Goals Good Health and Well-Being for People, Peace and Justice Strong InstitutionsRequired Resources

Item Name	Type	No. of Units	Per Unit Cost (in Rs)	Total (in Rs)
			Total in (Rs)	0
Laptops	Equipment	0	90000	0