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Automatic Recommender System of Development Platforms for Smart Contract–Based Health Care Insurance Fraud Detection Solutions: Taxonomy and Performance Evaluation

Automatic Recommender System of Development Platforms for Smart Contract–Based Health Care Insurance Fraud Detection Solutions: Taxonomy and Performance Evaluation

For the detection of health care insurance fraud, the fraud scenarios were based on the study by Ismail and Zeadally [22], which proposes a taxonomy of 12 fraud scenarios that are divided into 7 categories, as shown in Figure 1. The first category is commission-based, which includes 3 fraud scenarios. The first scenario involves a health care provider directing patients to specific hospitals, clinics, pharmacies, medications, or equipment suppliers in return for a commission.

Rima Kaafarani, Leila Ismail, Oussama Zahwe

J Med Internet Res 2024;26:e50730