METHOD AND APPARATUS FOR DETECTING FRAUD

Patent №

US 6,253,186

Granted

2001-06-26

Filed 1996

Owner

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

Lab

AI components

1

ml

Assignment

Recorded

Dataset

AIPD

2023_r1 edition

Application

08696615

A computerized arrangement for detecting potentially fraudulent suppliers or providers of goods or services includes a processor, a storage device, an input device for communicating data to the processor and storage device, and an output device for communicating data from the processor and storage device. The storage device includes a claims data file for storing information relating to a plurality of claims submitted for payment by a selected supplier or provider, one or more encoding lookup tables for use with the claims data file to produce an encoded claims data file, and a neural network program for analyzing the encoded data to produce an indicator of potentially fraudulent activity. The indicator may be compared to a predetermined threshold value by the apparatus or method to identify fraudulent suppliers. In addition to the neural network, at least one expert system may be used in the identification process.

Machine learningG06Q 10/10G06Q 10/06393G06Q 30/0185G06Q 30/0201G06Q 40/08

AI classification

Machine learning1.00
Planning0.49
Knowledge representation0.39
AI hardware0.08
Vision0.01
Natural language0.01
Evolutionary computation0.00
Speech0.00

Ownership

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

assignment · 81480990

Assignors

PENDELTON, JR., E. STEELE

On an employer assignment, the assignors are typically the inventors.

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