GitHub - yang5hi/Healtchare_Fraud_Detector: Healthcare provider fraud detector is a classification machine learning project to predict the potential fraudulent providers based on the healthcare claims filed.

Classification - predict the potentially fraudulent providers based on the healthcare claims filed

Data Source Kaggle - Healthcare Provider Fraud Detection Analysis
Features Claim Dates, Doctor IDs, Patient info (DOB, DOD, Gender, Chronicle Conditions..), Procedure Codes, Diagnosis Codes, Reimbursement Amount, Deductible Amount, Geo Locations, Length of Hospital Stay
Target y for each provider (0 - Not Potential Fraud, 1 - Potential Fraud)
Outcomes
- Identify important variables in detecting the behavior of potentially fraud providers
- Label potential fraud providers
- Study fraudulent patterns in the provider's claims
Performance Metrics
- F1-score
- ROC AUC

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Name		Name	Last commit message	Last commit date
Latest commit History 4 Commits
img		img
.gitignore		.gitignore
1_Defining_Fraud_Detection_Project.ipynb		1_Defining_Fraud_Detection_Project.ipynb
2a_Data_Merge.ipynb		2a_Data_Merge.ipynb
2b_Claim_Level_EDA.ipynb		2b_Claim_Level_EDA.ipynb
2c_Claim_Level_Basemodel.ipynb		2c_Claim_Level_Basemodel.ipynb
3a_Provider_Level_Data_Transform_YS.ipynb		3a_Provider_Level_Data_Transform_YS.ipynb
3b_Provider_Level_EDA_initial.ipynb		3b_Provider_Level_EDA_initial.ipynb
3c_Provider_Level_Basemodel_0809Data.ipynb		3c_Provider_Level_Basemodel_0809Data.ipynb
3d_Provider_Level_Basemodel_0815Data.ipynb		3d_Provider_Level_Basemodel_0815Data.ipynb
3e_Provider_Level_Basemodel_0817Data.ipynb		3e_Provider_Level_Basemodel_0817Data.ipynb
3f_Provider_Level_Basemodel_Final.ipynb		3f_Provider_Level_Basemodel_Final.ipynb
3g_Provider_Level_GridsearchCV.ipynb		3g_Provider_Level_GridsearchCV.ipynb
README.md		README.md
Transformer.ipynb		Transformer.ipynb
Transformer.py		Transformer.py
zz_Provider_Level_Basemodel_Agg_Pipeline.ipynb		zz_Provider_Level_Basemodel_Agg_Pipeline.ipynb
zz_Provider_Level_Random_Guess.ipynb		zz_Provider_Level_Random_Guess.ipynb