AI-Driven Fraud Detection and Security Improvements in Doctor Appointment Systems

Healthcare fraud remains a significant global challenge, with annual costs ranging from $68 billion to $300 billion in the U.S. alone, representing 3-10% of healthcare expenditures (SAS, 2024; Markovate, 2024). These fraudulent activities burden insurers, providers, and patients, increasing operational costs and limiting resources for genuine healthcare needs. With the growing adoption of online healthcare services, doctor appointment systems have become increasingly vulnerable to fraud and security breaches. This paper explores the integration of artificial intelligence (AI) techniques, including machine learning and natural language processing, to enhance fraud detection and strengthen system security. A strategic framework leveraging these technologies is proposed to effectively mitigate fraud while ensuring system integrity and maintaining user trust. The findings demonstrate that AI-based approaches can significantly reduce fraudulent activities and enhance the overall security of healthcare booking systems.

Authors

Publication Details

Journal
INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT
Published
2024-12-23
DOI
https://doi.org/10.55041/ijsrem39967
Primary Topic
Artificial Intelligence in Healthcare
Type
article
Field-Weighted Citation Impact
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article

AI-Driven Fraud Detection and Security Improvements in Doctor Appointment Systems

Santosh Jagtap, Rakesh Panchal
INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT
Artificial Intelligence in Healthcare
article

AI-Driven Fraud Detection and Security Improvements in Doctor Appointment Systems

Santosh Jagtap, Rakesh Panchal
article en

Abstract

Healthcare fraud remains a significant global challenge, with annual costs ranging from $68 billion to $300 billion in the U.S. alone, representing 3-10% of healthcare expenditures (SAS, 2024; Markovate, 2024). These fraudulent activities burden insurers, providers, and patients, increasing operational costs and limiting resources for genuine healthcare needs. With the growing adoption of online healthcare services, doctor appointment systems have become increasingly vulnerable to fraud and security breaches. This paper explores the integration of artificial intelligence (AI) techniques, including machine learning and natural language processing, to enhance fraud detection and strengthen system security. A strategic framework leveraging these technologies is proposed to effectively mitigate fraud while ensuring system integrity and maintaining user trust. The findings demonstrate that AI-based approaches can significantly reduce fraudulent activities and enhance the overall security of healthcare booking systems.

INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENTVol. 08(12)
Peace, Justice and strong institutions
Openalex Percentile: Top 67%
Artificial Intelligence in Healthcare
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