The healthcare sector deals with large volumes of electronic data related to patient services. This article describes two novel applications that leverage big data to detect fraud, abuse, waste, and errors in health insurance claims, thus reducing recurrent losses and facilitating enhanced patient care. The results indicate that claim anomalies detected using these applications help private health insurance funds recover hidden cost overruns that aren’t detectable using transaction processing systems. This article is part of a special issue on leveraging big data and business analytics.
Author(s): Srinivasan, U.