Abstract: Data is received that includes a data set characterizing a plurality of insurance provider profiles and/or claims. Thereafter, a minimum volume ellipsoid is determined for the data set. Subsequently, at least one provider profile and/or claim is identified having at least one outlier variable based on a distance that the at least one provider profile and/or claim has relative to a center point of the minimum volume ellipsoid. Data is then provided (e.g., displayed, stored, loaded into memory, transmitted to a remote computing system, etc.) that characterizes the at least one provider profile and/or claim as likely being fraudulent or erroneous. In other variations, the minimum volume ellipsoid is determined using a different data set. Related apparatus, systems, techniques and articles are also described.

Abstract: A scoring model is provided that is trained using historical patient readmission data. The scoring model is used to analyze patient insurance claim data for which patients were readmitted to a healthcare facility in order to characterize whether the corresponding insurance claims are potentially fraudulent or erroneous. Related techniques, apparatus, systems, and articles are also described.

Abstract: Various techniques are described that enable a smaller insurer (or an insurer with a less developed dataset) to be able to characterize whether certain healthcare insurance claim elements are potentially fraudulent or erroneous. Datasets from larger insurers (with well developed datasets) and/or datasets from a consortium of insurers can be leverage by the smaller insurer. Related techniques, apparatus, systems, and articles are also described.

Abstract: Various techniques are described that enable a smaller insurer (or an insurer with a less developed dataset) to be able to characterize whether certain healthcare insurance claim elements are potentially fraudulent or erroneous. Datasets from larger insurers (with well developed datasets) and/or datasets from a consortium of insurers can be leverage by the smaller insurer. Related techniques, apparatus, systems, and articles are also described.