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Although health care providers have more than 47 million health insurance clients in Brazil, these companies still have processes that are manual. One of these processes is that of the medical audit that performs the analysis of each account with expenses that were incurred by the operator's beneficiary in any hospital, clinic or laboratory. Each account is reviewed to make sure that there is nothing outside the context of a surgery, examination or consultation. The costs of these audits are high and the outcome is varied and according to the auditor's individual knowledge. In addition to being a lengthy process, these bills will only be paid to those who provided the service after the auditors' review which brings dissatisfaction to those awaiting payment. Manual execution of this process is susceptible to failure and fraud. In this context, Machine Learning algorithms are used to assist in the audit process in various areas of knowledge. Thus, this paper presents a survey on the application of Machine Learning algorithms in medical audits, analyzing which algorithms are most used. [ABSTRACT FROM AUTHOR]

The audit is an independent source of information, covering all the processes that make up a quality assurance system In this sense,this study had as main objective to analyze the scientific production on audit in the supplemental health and by specific objectives to identify the main themes present in the scientific production and to discuss possible approximations and distances in the researches that were the object of the analysis. It is an integrative review of the literature that adopted the thematic content analysis technique. The paper analyzed the studies in the Brazilian Digital Library of Theses and Dissertations (BDTD), in the Latin American and Caribbean Literature database in Health Sciences - LILACS and in the virtual library Scientific Electronic Library Online - SciELO. Fourteen studies were identified and the themes that emerged from the analysis of these studies were: health quality improvement and cost reduction. It was concluded that while some studies have underscored that the improvement of health quality and cost reduction may be considered as complementary actions, other productions have revealed tension and even antagonistic relations that emerge between these elements. [ABSTRACT FROM AUTHOR]