US Patent 11373752 Detection of misuse of a benefit system

Systems and methods are provided for automatically detecting misuse of a benefit system. Information relating to benefit provision (e.g., receiver information, service performed, equipment used, materials provided, provider information, etc.) may be parsed from claims data to determine patterns for benefit receivers and/or benefit providers. The patterns may be analyzed to determine specific patterns indicative of fraud/benefit abuse and the particular benefit receivers/providers/events may be tagged as a lead for investigation.