Illegality and Fraud Information System in NHIS – Fraud Detection

Summary

Accessible NHIS Global Hub slide deck on the Illegality and Fraud Information System. Documents that NHIS uses big-data analysis techniques to detect illegal establishments and fraudulent claims, added an AI prediction model in 2021, piloted the AI prediction and social network models in 2022, and operationalises the system through NHIS data marts, composite indicators, prediction models, and investigator review workflows.