What if Enterprise applications
became socially aware?

Transforming Enterprises with SET Universal Platform

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Time for front-end fraud prevention

Only 5% of the overall 'fraud, abuse and improper payments' committed
are discovered with current efforts

Intelligent fraud prevention matters!

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Effectively prevent Recipient-Fraud
with world-class beneficiary profiling

Did you know:
Medicaid loses ~$29 Billion to fraud annually

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What we do

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, aiding in making informed decisions and thus transforming the enterprises from focusing on "better transactions" to "better decisions".

Digital Harbor has been at the forefront of creating “first-of-its-kind” technologies, platforms and solutions across multiple verticals. We were the first to create “link analytics” platform for intelligence agencies, first to create smart client technology for web, first to create model-driven frameworks for J2EE, first to create a unified composite application platform, first to create Know Your Customer (KYC) and first to create Know Your Provider (KYP).

Proven in some of the largest US Financial Institutions and Government Intelligence agencies, Digital Harbor now focuses on U.S. healthcare segment.  Digital Harbor has already resulted in a cost saving of more than $500 million to its customers in the healthcare segment.

Our Solutions

Know Your Provider

Provider lifecycle management in compliance with ACA requirements for provider enrollment, screening and continuous monitoring.

Portal
Enrollment
Screening
Monitoring
Know Your
Provider

Know Your Audit

Prevents and detects fraud using audits. Provides compliance dashboard, claims analysis and an understanding of overpayments and recovery

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Know Your
Audit

Know Your Care-giver

Monitoring long term care employees, including their background screening and rap back for continuous workforce monitoring

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Know Your
Care-giver

Know Your Claim

Facilitates claims' review and adjudication. Includes predictive analytics to detect frauds early and take remediation actions.

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Know Your
Claim

Know Your Beneficiary

Effectively prevent recipient-fraud with world-class beneficiary profiling.

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Know Your
Beneficiary

What makes Digital Harbor different

What makes Digital Harbor different
Organizations employing knowledge workers have transformed the management of complex and unpredictable processes. Our intelligent software solutions allows our customers to maximize predictability and effectiveness and minimize risks, costs and delays associated with such processes.
- Rohit Agarwal
Meet the Team

Testimonials

  • We chose Digital Harbor because we were convinced that only they provided the complete solution required by us to unearth the risks associated with provider enrollment and management One of the largest Medicaid provider State on selecting the entire KYP suite of products
  • The most exciting thing I have ever seen since Mosaic Vinton Cerf, Father of Internet on PiiE technology
  • Using automated provider screening and monitoring solutions from Digital Harbor, not only we have reduced process times by 75%, but also found exceptions and taken actions which otherwise would have gone unnoticed South-east Medicaid provider state after using KYP Screening and Monitoring

S.E.T. Universal Platform


Social Form
A generational business enablement design that is intended to cut-down complexities in filling intricate business applications, for the user through intelligent conversations. Social Forms talks to users and assists in completing complex applications, that sometimes run for hundreds of pages, with ease
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Social Case
Designed to capture and store disparate data pertaining to one or more party / incident / transaction, while enabling seamless collaboration between the user, the application and all the stakeholders, to chat, to share and to get expert insights about the case-under-consideration; all this while capturing and linking knowledge to enhance research and investigation within the workflow
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Social Analytics
Proactively assists knowledge workers / users in forming realistic opinion about the case-under-evaluation by detecting all the anomalies, by considering all the available cues and by recommending the next best possible course of action to achieve the desired result
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What’s trending?... Learn more from our latest blogs

Healthcare security and data protection – a unique challenge

December 26, 2016

Healthcare ecosystem’s core mission is to provide the best care possible to the end users. This industry is in the process of transforming the delivery of care to end users… View Article

S.E.T. Universal Platform

December 15, 2016

Did you know?  ~30% of the knowledge workers across industries think that their IT tools at work are much worse than those that they use at home. So, who is a Knowledge Worker? Enterprise… View Article

While Medicaid focus on mere member eligibility, the MCOs reap the benefit

December 8, 2016

The attitude, the opportunity and the environment together bolsters certain individuals to abuse the healthcare system. When it comes to ineligible beneficiaries, fraud permeates in different dimensions from eligibility abuse and card sharing to… View Article

Doctor Shoppers? Not all of them… or are they?

August 31, 2016

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

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