Unitedhealth Group Incorporated

Gregory H Lyon

Raja Mukherji

Nasim Mahmud

Thomas R Gilbertson

Ryan A Berberian

John J Westhoff

Karen M Harte

John B Cooley

Systems and methods are disclosed for determining fraudulent entities. The method includes retrieving characteristics data associated with known fraudulent entities. A first graph is generated based on the characteristics data associated with the known fraudulent entities, the first graph represents relationships among the fraudulent entities and related entities of the known fraudulent entities. Identification data associated with a target entity is received. Characteristics data associated with the target entity is retrieved using the identification data. A second graph is generated based on the characteristics data associated with the target entity, the second graph represents relationships among the target entity and related entities of the target entity. The first graph and the second graph are compared to generate an association score for the target entity. Investigative targets are determined based on the association score. A presentation of the investigative targets is displayed via a graphical user interface of a device.

Systems and methods for medical fraud detection

Growing community of inventors

Lakeville, MN, United States of America

Gregory H Lyon