Unsupervised fraud detection in Medicare Australia
AusDM '11 Proceedings of the Ninth Australasian Data Mining Conference - Volume 121
AusDM '11 Proceedings of the Ninth Australasian Data Mining Conference - Volume 121
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This paper describes our experience with applying data mining techniques to the problem of fraud detection in spatio-temporal health data in Medicare Australia. A modular framework that brings together disparate data mining techniques is adopted. Several generally applicable techniques for extracting features from spatial and temporal data are also discussed. The system was evaluated with input from domain experts and was found to achieve high hit rates. We also discuss some lessons drawn from the experience.