MUMBAI, India, June 22 -- Intellectual Property India has published a patent application (202641048594 A) filed by Merlyn Jennie G on April 16, 2026, for Ayushmanshield:a Real-Time Behavioural Risk Scoring And Five Node Fraud Propagation Network Analysis.
Inventors include Merlyn Jennie G; Sheetal Rose Joseph; and Dhanalakshmi S.
The application for the patent was published on June 12, 2026, under issue no. 24/2026.
Abstract: This invention introduces an advanced system designed to detect fraudulent activities in large-scale public healthcare insurance programs, specifically under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-J AY). The system continuously monitors insurance claim data and identifies suspicious activities using intelligent analysis techniques. The proposed solution integrates multiple analytical approaches, including behavioral risk assessment, anomaly detection, time-based pattern recognition, and a five-entity network model to uncover coordinated fraud. It examines interactions among patients, doctors, hospitals, third-party administrators, and pharmaceutical providers to generate dynamic risk scores based on unusual behaviors. The system is capable of identifying irregularities in claim values, detecting abnormal submission timings, and uncovering hidden relationships between entities through network-based analysis. By enabling early identification of organized fraud, the system helps reduce financial losses and enhances transparency in public healthcare schemes.
Disclaimer: Curated by HT Syndication.
