Know Your Provider
Provider lifecycle management in compliance with ACA requirements for provider enrollment, screening and continuous monitoring.
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.
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
The federal government is increasingly concerned over the growth of healthcare fraud and abuse of privileges over the past few decades. Task forces, teams, and many programs have been put… View Article
The loss to the healthcare payer comes in three forms – fraud, abuse, and waste. On an estimate, around $456 is lost every year and authorities think that this can… View Article
Fraud of any form costs the health insurance payer something more than money alone. A huge effort has to go into the Health System to investigate whether the incident was… View Article
Before one defines fraud in health care services, it is important to make the distinction between waste and abuse. Waste is the overuse of any material while abuse is unknowing… View Article