Know Your Provider
Provider lifecycle management in compliance with ACA requirements for provider enrollment, screening and continuous monitoring.
Digital Harbor, a leader in the field of Fraud Prevention, offers the industry’s most advanced end-to-end operational intelligence suite for detection, investigation, assessment and monitoring of fraud. With its indigenous Social Enterprise Technology (SET) Universal Platform, a next-gen in-house platform, Digital Harbor seamlessly enables collaboration within and between the knowledge workers and all the relevant stakeholders, thus aiding in making informed decisions. Digital Harbor transforms the enterprises from focusing on "better transactions" to "better decisions".
Proven in some of the largest US Financial Institutions and Government Intelligence agencies, Digital Harbor now focuses on U.S. healthcare segment. Digital Harbor is working with Centers for Medicare & Medicaid Services (CMS) to lead automation-based transformation in restructured federal contracts (MAC, ZPIC, RAC, MIC). Digital Harbor is the only COTS ECaM platform, being used in both Medicare and Medicaid contracts. Digital Harbor has already resulted in a cost saving of more than $500 million to its customers in the healthcare segment.
Prevents and detects fraud using audits. Provides compliance dashboard, claims analysis and an understanding of overpayments and recoveryRead more
Monitoring long term care employees, including their background screening and rap back for continuous workforce monitoringRead more
Facilitates claims' review and adjudication. Includes predictive analytics to detect frauds early and take remediation actions.Read more
Effectively prevent recipient-fraud with world-class beneficiary profiling.Read more
Let’s begin with a story – A patient consults a physician for a particular chronic ailment; buys a controlled drug based on the physician’s prescription; not satisfied with the results, visits multiple physicians; gets multiple… View Article