Know Your Provider
Provider lifecycle management in compliance with ACA requirements for provider enrollment, screening and continuous monitoring.
Digital Harbor 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 transforms the way knowledge workers, across the industries, make decision by binding social media concepts with mainstream business processes.
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 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
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