Research Article
Decision Support System (DSS) for Fraud Detection in Health Insurance Claims Using Genetic Support Vector Machines (GSVMs)
Table 2
Sample data size and the corresponding fraud types.
| Fraud types | Sample data size | 100 | 300 | 500 | 750 | 1000 |
| Duplicate claims | 2 | 4 | 4 | 4 | 0 | Uncovered service claims | 4 | 56 | 65 | 109 | 406 | Overbilling claims | 44 | 60 | 91 | 121 | 202 | Unbundled claims | 0 | 18 | 10 | 54 | 0 | Upcoded claims | 2 | 34 | 50 | 122 | 6 | Impersonation claims | 0 | 2 | 10 | 23 | 34 | Total suspected claims | 52 | 174 | 230 | 433 | 648 |
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