Heterograph Neural Networks Plus LLMs to Expose Collusive Billing
Most billing abuse does not look dramatic when viewed one claim at a time. A single encounter may appear ordinary, a single procedure may be defensible, and... Read more.
Vertical Federated Learning for Payment Integrity Across Competing Payers
Payment integrity has a fragmentation problem: each payer sees only part of the pattern, while the most sophisticated abuse often spreads across organizational boundaries.... Read more.