Recognised as
Technology Fast 500 | 2018 | North America
winner

by Deliotte

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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 Risk Management, offers the industry’s most advanced end-to-end operational intelligence suite for detection, investigation, assessment and monitoring of risk and fraud. With its indigenous Social Enterprise Technology (SET) Universal Platform, Digital Harbor seamlessly enables collaboration both within and between the enterprise knowledge workers, end users and all relevant stakeholders, aiding in effective risk management and in making informed decisions; 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 products 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 Member

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

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Know Your
Member

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 digitalharbor 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 dharbor, 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 frauds and abuses: No more! 

August 16, 2019

Healthcare expenditure continues to grow without any signs of budgetary cuts. In the last fiscal year, the expenditure crossed $1 trillion mark and of this spending, Medicare and Medicaid accounted… View Article

Huge Losses To Insurance Companies Due To Cases Of Healthcare Fraud

August 4, 2019

The loss to insurance companies through healthcare fraud is growing every day. Interesting cases of fraud keep cropping up now and then. Estimates put this loss at between $60 and… View Article

Increasing Dominance Of Artificial Intelligence In Healthcare Services

July 20, 2019

The healthcare system is increasing its dependence on Artificial Intelligence (AI) to deliver services such as data management in the departments of claims, processing, and payment. There is no denying… View Article

Preventing Different Kinds of Healthcare Fraud

July 6, 2019

We are seeing an increase in a new crime wave spreading throughout the country – healthcare fraud. All sorts of criminals and fraudsters are trying to exploit this and the… View Article

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