Page Comparison

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Identify cases of unusual patterns of insurance use that demonstrate suspicious utilization of program benefits by providers and beneficiaries

Input

• Provider identifier

• Beneficiary identifier

• Benefit plan

• Claims identifier

• Provider accumulators

• Beneficiary accumulators

• Medical history

• Provider performance

• Beneficiary benefits utilization

Output

• List of suspected cases

• Fraud case identifier

• Case inquiry

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