Alternative model predicts health insurance reimbursement based on contract limitations.
problem Estimating the ratio of reimbursement to health care expenditures after deductibles and copayments.
method Proposes a Zero-One Inflated Beta regression model using GAMLSS.
result The model provides a dependency structure between reimbursement and contract limitations.
Developed a cost and revenue model for HEMS to estimate breakeven transport volumes under different reimbursement and labor cost assumptions.
problem Estimating breakeven transport volumes for HEMS under varying reimbursement and labor cost assumptions.
method Developed a two-part model: cost framework and actuarial revenue model using healthcare encounter data and payer reimbursement rates.
result Estimated breakeven transport volumes under different reimbursement and labor cost assumptions.
Study compares non-parametric models for predicting medical insurance reimbursement delays.
problem Estimating the time-lapse between medical insurance reimbursement.
method Comparative study of four non-parametric regression models (KNNs, SVMs, Decision Trees, Random Forests) using R-squared metric.
result Each model's performance varies with training data size, feature space, and hyperparameters.
A new model improves homogeneity in burn patient reimbursement.
problem Incomplete homogeneity checks for burn patients using LOS as a proxy.
method Cost-sensitive decision tree model considering patient-level cost and severity of burn.
result Identified groups with increased homogeneity compared to current HRG groups.
Study finds billing codes at IPO boost digital health companies' financial performance.
problem Identifying factors that drive long-term financial success in digital health companies.
method Analyzed 33 digital health IPOs from 2010-2021, comparing companies with and without billing codes.
result Companies with billing codes at IPO were significantly more likely to achieve positive CAGR and higher market capitalization.
This paper considers the problems of modeling and predicting a long-term and ``blurry'' relapse that occurs after a medical act, such as a surgery. The relapse is observed only indirectly, in a ``blurry'' fashion, through longitudinal prescriptions of drugs over a long period of time after the medical act. We introduce…
Optimal student loan repayment strategies vary based on loan size.
problem Finding the most cost-effective repayment strategy for federal student loans.
method Analyzing the impact of different repayment strategies on total cost for varying loan sizes.
result Optimal repayment strategies depend on the loan balance, with different approaches for small, large, and intermediate balances.
Study assesses health plan risk measures for Solvency Capital Requirement.
problem Assessing risk measures for health plans to meet Solvency Capital Requirement.
method Three-part regression model with three GLMs for claim counts, episode allocation, and severity.
result Reduction in regression models compared to traditional methods.
With the increased availability of large databases of electronic health records (EHRs) comes the chance of enhancing health risks screening. Most post-marketing detections of adverse drug reaction (ADR) rely on physicians' spontaneous reports, leading to under reporting. To take up this challenge, we develop a scalable…
In his book with Alan Jolis, Vers un monde sans pauvreté (1997) Yunus gives the example of a microcredit loan of 1000BDT reimbursed via 50 weekly settlements of 22BDT and correctly claims that this corresponds to the annual interest rate of 20%. But this is without taking into account that if the borrower has good reas…
Generative AI agents improve ERP systems by automating complex financial tasks.
problem Static, rule-based workflows limit adaptability and intelligence in ERP systems.
method Introducing Generative Business Process AI Agents (GBPAs) that integrate generative AI with business process modeling and multi-agent orchestration.
result GBPAs achieve up to 40% reduction in processing time and 94% drop in error rate.