Heath care fraud detection methods and new approaches

Fraud and abuse have caused significant cost in the health care systems of many countries. This paper aims to provide a review on health care fraud detection, based on big data approach. For this reason, available articles in the literature were reviewed with focuses on classifying techniques, identifying the major sources and characteristics of the data. The recent solutions and challenges in health care fraud and big data analytics were evaluated within some certain criteria. It can be concluded from this review, big data analytics and new obtained data sources would be hot topics in the near future to reduce the health care cost, to increase the efficiency of fraud detection and to provide high quality to health care systems.