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Upgrade to ProYou are a Senior Healthcare Data Scientist at UnitedHealth. UnitedHealth's claims pipeline uses a heuristic flag for denial-prediction QA: if a claim's total_paid_amount is less than 50% of total_billed_amount, flag it as denial-suspected. You're auditing this heuristic against the actual claim_status field. Compute precision, recall, F1, and the full confusion matrix.
You are a Senior Healthcare Data Scientist at UnitedHealth. UnitedHealth's claims pipeline uses a heuristic flag for denial-prediction QA: if a claim's total_paid_amount is less than 50% of total_billed_amount, flag it as denial-suspected. You're auditing this heuristic against the actual claim_status field. Compute precision, recall, F1, and the full confusion matrix.