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Intelligent Fraud Prevention Matters

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Data is paramount for business             From effective anti-money laundering for a bank to thwarting a fraudulent claim for an insurance company, enterprises world-over rely heavily on data to prevent the occurrence of fraud. Especially for those involving knowledge workers, the importance of data is second to none.                                                                                                                          Knowledge workers are those who collate, review and analyze complex data about a case / entity under evaluation, to create information patterns to support decision making on the case, thereby directly or indirectly impacting the company’s top line and growth. For example: A bank’s underwriter should decide whether or not to sanction loan to a particular applicant. The decision is crucial as it would eventually result in either the bank’s increased revenue or an addition to the list of bad-debts.

Business Intelligence tools have limitations

While business intelligence applications help the knowledge workers in evaluating the accumulated data, they still face substantial challenges in seamlessly aggregating real-time data from various disparate sources and in generating patterns from this live data with reference to their historic numbers. Automating complex business transactions involving knowledge workers have always remained a challenge. Also, the derived conclusions from such applications, without continuous update, are inaccurate. In a Healthcare enterprise, a Provider may come out clean during screening, but, might deviate the compliance mandate, a day, a week or a month later and manage to not get identified by the system.

System requires Intelligence

The intelligence of a system lies in its ability to connect relevant discrete data about an individual / entity, to generate rich analytical insights on the occurrence of potential fraudulent event and to result in huge cost saving. All these in a socially collaborative platform adds great value to the end-users. The knowledge workers need such an intelligent and intuitive system that could reduce the process complexities, prevent the occurrence of fraud and make the work simple.

The United States health care expenses are estimated to reach $3.5 Trillion by 2017. Therefore, when almost 3% of the country’s total Health Care expenses are lost to Fraud, which equates to ~$70 Billion annually, it is high time to invest in process innovation to drive massive transformation in handling complex business transactions. Intelligent Fraud Prevention definitely matters.

 Connecting the Dots

Effectively preventing fraud, across industries, under the flagship of “Know Your Risk” suite, Digital Harbor offers seamless provider credentialing, predictive analytics based fraud detection and investigative case management to the knowledge workers. With its next-gen Social Enterprise Technology, Digital Harbor brings social media concepts for seamless collaboration within and between the analysts and the applicants. This simplifies complex business transactions aiding in decision making and overcomes the limitations of traditional business intelligence tools by analyzing near real-time and real-time data, for the knowledge workers across industries. Digital Harbor has already resulted in a cost saving of more than $500 million to its customers in the Healthcare segment.

Digital Harbor pioneered the “Know Your Customer (KYC)” solution for the banking industry in the U.S. which later became a norm across industries and regions. After entering the Healthcare segment in 2009, Digital Harbor has become one of the fastest growing companies in this sector and is already a trusted partner of some of the leading Health care organizations across the United States.

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