Artificial Intelligence Solutions to Detect Fraud in Healthcare Settings: A Scoping Review

Mohammad Sharique Iqbal, Alaa Abd-Alrazaq, Mowafa Househ*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

6 Citations (Scopus)

Abstract

Over the past decade, Artificial Intelligence (AI) technologies have quickly become implemented in protecting data, including detecting fraud in healthcare organizations. This scoping review aims to explore AI solutions utilized in fraud detection occurring in treatment settings. To find relevant literature, PubMed and Google Scholar were searched. Out of 183 retrieved studies, 31 met all inclusion criteria. This review found that AI has been used to detect different types of fraud such as identify theft and kickbacks in healthcare. Additionally, this review discusses how AI techniques used in network mapping fraud can detect and visualize the hacker's network. A proper system must be implemented in healthcare settings for successful fraud detection, which may overall improve the healthcare system.

Original languageEnglish
Title of host publicationAdvances in Informatics, Management and Technology in Healthcare
EditorsJohn Mantas, Parisis Gallos, Emmanouil Zoulias, Arie Hasman, Mowafa S. Househ, Marianna Diomidous, Joseph Liaskos, Martha Charalampidou
PublisherIOS Press BV
Pages20-23
Number of pages4
ISBN (Electronic)9781643682907
DOIs
Publication statusPublished - 2022

Publication series

NameStudies in Health Technology and Informatics
Volume295
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365

Keywords

  • Fraud
  • artificial intelligence
  • deep learning
  • healthcare settings
  • machine learning

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