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Inappropriate payments by insurance organizations or third party payers occur because of errors, abuse and fraud. The scale of this problem is large enough to make it a priority issue for health systems. Traditional methods of detecting health care fraud and abuse are time-consuming and inefficient. Combining automated methods and statistical knowledge lead to the emergence of a new interdisciplinary branch of science that is named Knowledge Discovery from Databases (KDD). Data mining is a coredoi:10.5539/gjhs.v7n1p194 pmid:25560347 pmcid:PMC4796421 fatcat:ihkxwrhmbfewti2jtu7tkxrdva