Related papers: ML-Driven Approaches to Combat Medicare Fraud: Adv…
Fraud detection is a challenging task due to the changing nature of fraud patterns over time and the limited availability of fraud examples to learn such sophisticated patterns. Thus, fraud detection with the aid of smart versions of…
With healthcare being critical aspect, health insurance has become an important scheme in minimizing medical expenses. Following this, the healthcare industry has seen a significant increase in fraudulent activities owing to increased…
Medicare fraud results in considerable losses for governments and insurance companies and results in higher premiums from clients. Medicare fraud costs around 13 billion euros in Europe and between 21 billion and 71 billion US dollars per…
This paper describes a practical approach of using supervised machine learning (ML) models to assist safety investigators to classify aviation occurrences into either incident or serious incident categories. Our implementation currently…
Heart disease is a serious global health issue that claims millions of lives every year. Early detection and precise prediction are critical to the prevention and successful treatment of heart related issues. A lot of research utilizes…
Credit card fraud remains a significant challenge due to class imbalance and fraudsters mimicking legitimate behavior. This study evaluates five machine learning models - Logistic Regression, Random Forest, XGBoost, K-Nearest Neighbors…
Machine learning has automated much of financial fraud detection, notifying firms of, or even blocking, questionable transactions instantly. However, data imbalance starves traditionally trained models of the content necessary to detect…
Predicting the probability of default (PD) of prospective loans is a critical objective for financial institutions. In recent years, machine learning (ML) algorithms have achieved remarkable success across a wide variety of prediction…
Class imbalance remains a critical challenge in machine learning (ML), particularly in the medical domain, where underrepresented minority classes lead to biased models and reduced predictive performance. This study introduces…
The expansion of digital payment systems has heightened both the scale and intricacy of online financial transactions, thereby increasing vulnerability to fraudulent activities. Detecting fraud effectively is complicated by the changing…
Telecommunication fraud is an acute problem that leads to substantial material losses and compromises the reliability of telecom systems worldwide. Only effective and efficient detection mechanisms can help to deal with these threats,…
The provision of social care applications is crucial for elderly people to improve their quality of life and enables operators to provide early interventions. Accurate predictions of user dropouts in healthy ageing applications are…
As online fraud becomes more sophisticated and pervasive, traditional fraud detection methods are struggling to keep pace with the evolving tactics employed by fraudsters. This paper explores the transformative role of machine learning in…
The insurance industry, with its large datasets, is a natural place to use big data solutions. However it must be stressed, that significant number of applications for machine learning in insurance industry, like fraud detection or claim…
This research introduces an innovative method for identifying credit card fraud by combining the SMOTE-KMEANS technique with an ensemble machine learning model. The proposed model was benchmarked against traditional models such as logistic…
The growing integration of drones into civilian, commercial, and defense sectors introduces significant cybersecurity concerns, particularly with the increased risk of network-based intrusions targeting drone communication protocols.…
Fraud detection remains a critical task in high-stakes domains such as finance and e-commerce, where undetected fraudulent transactions can lead to significant economic losses. In this study, we systematically compare the performance of…
We ascertain and compare the performances of AutoML tools on large, highly imbalanced healthcare datasets. We generated a large dataset using historical administrative claims including demographic information and flags for disease codes in…
The credit card has become the most popular payment method for both online and offline transactions. The necessity to create a fraud detection algorithm to precisely identify and stop fraudulent activity arises as a result of both the…
The US federal government spends more than a trillion dollars per year on health care, largely provided by private third parties and reimbursed by the government. A major concern in this system is overbilling, waste and fraud by providers,…