Machine Learning and AI for Healthcare Fraud Detection and Prevention

Presented by

Aleksandar Lazarevic, Senior Director, Aetna

About this talk

The United States spent around $3.5 trillion or 18% of GDP on healthcare. According to FBI, the amount of this spending lost due to fraud, waste, and abuse (FWA) ranged between $90 billion and $330 billion! This talk will offer practical advice on how to effectively organize and join various healthcare data sources such as claim and clinical data, how to set-up the problem, and how to design an effective machine learning solution to identify FWA leads and expedite investigator review using intuitive visualization to understand the risk factors contributing to those leads.

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