New Delhi: The National Health Authority’s (NHA) has identified fraudulent claims worth 582.11 crore under Ayushman Bharat PM-JAY since the scheme's launch in 2021.
Ayushman Bharat PM-JAY is the world's biggest health assurance scheme for the poor, providing free health cover of up to 5 lakh per family per year.
NHA’s National Anti-Fraud Unit (NAFU) has deployed 62 trigger-based techniques such as application of Artificial Intelligence (AI)/Machine Learning (ML), facial comparison NLP (Natural Language Processing), etc to detect potential fraud and safeguard financial transactions from unethical practices.
Also Read | Centre to train joint directors for Ayushman Bharat Digital Mission
“These triggers have enabled NAFU to identify confirmed fraudulent claims worth 582.11 crore under Ayushman Bharat PM-JAY. The system demonstrates an average trigger efficacy of approximately 45%, indicating a robust fraud detection mechanism,” the health ministry annual report 2024-25 said.
Using Optical Character Recognition (OCR) and NLP technologies, the system has flagged 28,000 claims as suspicious under Ayushman Bharat PM-JAY. Of these, 14,000 claims have been confirmed as fraudulent, with a total fraud value of 31 crore.
Facial comparison technology has identified 2,790 claims as suspicious. Of these, 119 claims amounting to 18 lakh have been confirmed as fraudulent.
Also Read | Odisha becomes latest state in the country to implement Ayushman Bharat PM-JAY
Machine learning (ML) and...
Singer Neha Kakkar recently performed in Australia; however, fans were in dismay as she allegedly turned up late to the show in Melbourne. ADVERTISEMENT Clips shared from the concert show people r...