Unitedhealth Group Incorporated

Nasim Mahmud

Raja Mukherji

Karen M Harte

Ryan A Berberian

John J Westhoff

John B Cooley

Thomas R Gilbertson

Gregory H Lyon

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

Dublin, Ireland

Nasim Mahmud