So what is the role played by third parties in India?  Is is like what imageoccurs in the US?  Again as I mentioned part of the “sell” of the consultants is that they will save money and increase revenues…Killer Algorithms in the software perhaps once again.  If you read earlier today we have the US government doing a survey on this topic but if they had a querying solution such as IBM Watson on the job, it could be done easier and much faster. 

Office of Inspector General Publishes Survey To Help Study Fraud With EHR Technologies, Namely Medical Records/Billing Software Used by Hospitals– HHS And SEC Continue Getting Their Non-Algorithmic Fannies Kicked–Attack of the Killer Algorithms Chapter 46

If you have not seen the series here’s a compilation of links that show how the attacks occur in every day life with automation processes and how the use of flawed data is on the rise as predictive analytics have their limits and it’s the integrity of the data queried…sometimes this occurs just for the sake of making money, i.e. “hey dude lets write some queries and algorithms, spin it with marketing and get rich”…BD


Attack of the Killer Algorithms–Digest & Links for All Chapters–on How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You


NEW DELHI: Nazia is 10 years old. But, according to a claim filed by Chhattisgarh-based Shaheed Hospital with the Rashtriya Swasthya Bima Yojna (RSBY), she has delivered a baby after a caesarean operation. Mukul (name changed) is only 7. But Agarwal Hospital, Raipur, has made a claim for removing cataract from his eyes.

A large number of similar implausible claims, being made by private hospitals enrolled to treat poor patients under the RSBY scheme, have prompted the finance ministry to advise public sector insurers to exercise greater vigilance.

The hugely popular RSBY is the country's largest health insurance scheme covering 32.4 million poor families. About 7,000 private hospitals like Shaheed Hospital are enlisted to help treat poor patients and are reimbursed by the scheme.

Several private hospitals and nursing homes in Bihar and Chhattisgarh, among other states, have been reportedly performing unnecessary or fictitious surgeries to claim up to 30,000 in insurance cover available to each RSBY cardholding family. The government has de-empanelled 260 hospitals found to be indulging in similar malpractices, according to the labour ministry.

http://economictimes.indiatimes.com/news/politics/nation/private-hospitals-perform-fake-surgeries-to-claim-thousands-in-insurance-cover/articleshow/16934229.cms

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