Synthetic Claims Data Generator

What

Python script that generates realistic healthcare claims data for analysis, denial trend identification, and fraud risk scoring.

Why

Real claims data cannot be shared due to PHI restrictions. Synthetic data allows demonstration of healthcare analytics techniques without privacy concerns.

Features

• Generates 100+ claims with realistic fields (payor, amount, denial reason, provider, patient)
• Includes denial rate analysis by payor
• Calculates fraud risk scores based on amount and reason
• Produces visualization of top denial reasons

How to Run

pip install pandas numpy matplotlib faker
python generate_claims.py

Sample Output

• Console output: Summary stats, denial rates, fraud risk claims
• Plot: Bar chart of denial reasons (saves or displays)

Files

• generate_claims.py — Main script
• requirements.txt — Dependencies

Real-World Application

This mimics real claims denial analysis workflows used in revenue cycle management and healthcare analytics.