Hyma Gollamudi

Title: Hyma Gollamudi: Innovator in Healthcare Fraud Detection

Introduction

Hyma Gollamudi is a notable inventor based in San Diego, CA, who has made significant contributions to the field of healthcare fraud detection. With a total of 3 patents, Gollamudi's work focuses on innovative methods to identify and prevent fraudulent activities within healthcare payment systems.

Latest Patents

One of Gollamudi's latest patents is titled "Detection of upcoding and code gaming fraud and abuse in prospective payment healthcare systems." This invention provides a comprehensive approach to detecting fraud at all levels of the hierarchical coded payment system. It utilizes an unsupervised model that analyzes variables and profiles created from the payment coding activities submitted by entities. By comparing these descriptions with peer entities, the model identifies unusual and potentially inappropriate activities.

Another significant patent is "Sequencing models of healthcare related states." This invention derives transition probability sequencing models and metrics from healthcare claims data to pinpoint potentially fraudulent or abusive practices. By processing healthcare reimbursement claims from various providers, Gollamudi's model identifies sequences of states and determines transition probability metrics based on frequency information. These metrics can be further analyzed using predictive or rule-based models.

Career Highlights

Hyma Gollamudi is currently employed at Fair Isaac Corporation, a company known for its innovative solutions in analytics and decision management. His work at Fair Isaac Corporation has allowed him to apply his expertise in healthcare fraud detection and contribute to the development of advanced analytical tools.

Collaborations

Gollamudi collaborates with talented professionals in his field, including Nallan C Suresh and Jean De Traversay, who bring diverse skills and perspectives to their projects.

Conclusion

Hyma Gollamudi's innovative patents and contributions to healthcare fraud detection highlight his commitment to improving the integrity of healthcare payment systems. His work not only addresses current challenges but also paves the way for future advancements in the field.