Built for health & public-benefit program integrity
Catch enrollment fraud
before it's approved
Is that uploaded paystub genuine? Detectory renders a forensic verdict on every document, then connects the fakes to the synthetic identities and broker rings behind them, with referral-grade audit trails.
Built to the standards public programs require
paystub_march.pdf
APP-48292 · SEP: loss of coverage · broker M. Torres
Synthetic paystub. SSN active on 3 other policies.
14 applications share this template · 3 devices · 1 broker
The reality at the front door
The enrollment front door is wide open
The December 2025 GAO investigation put numbers on what program integrity teams already knew: eligibility verification alone isn't stopping organized enrollment fraud.
$186B
improper payments, FY2025
Up from $162B the year before. The leak is widening, not closing.
Source: GAO
23 of 24
GAO fake applications approved
Undercover filings with fake SSNs and unsupported income sailed through.
Source: GAO, Dec 2025
200K+
unauthorized plan switches
Consumers moved between plans without consent in a single year.
Source: CMS
850+
brokers suspended by CMS
The fraud is organized. It runs through agents and brokers, not one bad form.
Source: CMS
Outstanding Verifications
When trusted data sources fail, the document is all you have
Every state-based marketplace knows the workflow: electronic verification can't confirm income or citizenship, an OV notice goes out, and an applicant uploads a document your team must judge by eye. Detectory answers the one question that queue was never built to answer: is this document real?
A verdict on every upload
Every document submitted to clear an outstanding verification gets a forensic verdict in seconds: genuine, fraudulent, or needs human review. Your OV queue stops being a stack of unanswerable PDFs.
Legitimate enrollees clear faster
Most uploads are genuine. Those verify instantly and coverage continues without a 90-day cliff, without added friction, and without staff hours spent squinting at paystubs.
Federal funds are never paid twice
Cross-program duplicate detection flags the same identity enrolled in both your marketplace and Medicaid, so reconciliation happens before payment, not after an audit finds it.
EARNINGS STATEMENT
Meridian Staffing LLC · Pay period 05/16 - 05/31
- Font kerning inconsistent with issuer templateAnomaly
- PDF metadata: created 11 min before uploadAnomaly
- Employer EIN does not resolve to active entityAnomaly
- OCR income figures internally consistentPass
Verdict: Likely fraudulent
Confidence 96.2% · routed to human review, not auto-denied
Capabilities
From a single fake paystub to the ring behind it
Four detection layers score every application in real time. It starts with a verdict on each document, because a forged paystub is rarely alone: the same template, broker, and identity pattern usually spans hundreds of applications.
Document Forensics & Authenticity Verdicts
A genuine-or-fraudulent verdict on every uploaded document: tamper, template-deviation, metadata, and OCR-consistency signals on IDs, paystubs, tax forms, and special-enrollment letters. The fakes a human reviewer can’t catch at scale.
- Authenticity verdict
- Metadata analysis
- Template deviation
- OCR consistency
Synthetic-Identity & SSN Intelligence
Fabricated, duplicate, and deceased SSNs. One SSN spread across many policies. We resolve who the applicant really is before coverage is granted.
- SSA death-match
- Cross-policy SSN reuse
- Identity resolution
Broker & Ring Analytics
The fraud is organized. We map the ring behind the applications: shared brokers, reused SSNs, device clusters, and enrollment velocity. Not just one bad form.
- Broker velocity
- Device clustering
- Template reuse graphs
Referral-Grade Audit Trail
Defensible evidence, human-in-the-loop. Every flag survives Congress, CMS, and your MFCU, and you never wrongly cut off a legitimate enrollee.
- Chain of evidence
- Reviewer sign-off
- Export-ready packets
Customer benefit
A 2 to 8 workflow, not a nicer document queue
Detectory changes what the team can see and prove. Reviewers get fast answers on real documents, investigators see the organized pattern behind the uploads, and leaders get evidence they can take to CMS, an MFCU, or an oversight hearing.
Live marketplace workflow
Before versus after Detectory
Before
2/10PDFs judged by eye
After
8/10Docs
scored
Ring
linked
Packet
ready
Forensic verdict in seconds
Case workflow
You stay in control. Every action is defensible.
Five stages from monitoring to referral. A human signs off before anyone loses coverage, so your evidence holds up and no legitimate enrollee is ever wrongly cut off.
Level 1
Monitor
Score every application across four fraud layers
Every application entering your marketplace is scored in real time across documents, identity, ring behavior, and eligibility signals. Clean applications flow through untouched.
Live scoring stream
- APP-48310Clear
- APP-48311Clear
- APP-48312Flag
- APP-48313Clear
1,284 scored today · 3 flagged · 0 friction added
Getting started
From application to referral in one pipeline
Three stages, one integration. Here is what your program integrity team actually sees at each step.
Ingest
Sits alongside your hub — no rip-and-replace
Applications, uploaded documents, and broker submissions flow in from the marketplace and eligibility systems you already run.
Connected sources
Score
Four detection layers, in real time, pre-eligibility
Every application is scored before eligibility is determined — across documents, identity, ring behavior, and eligibility signals.
Detection layers
- Document forensicsauthenticity
- Synthetic identitySSN / face reuse
- Broker & ringshared templates
- Eligibility signalscross-program
Refer
Investigator-ready, human-in-the-loop
High-risk cases route to a queue with a referral packet and full audit trail, formatted for the bodies that hold you accountable.
Referral packet
- Chain of evidence
- Reviewer sign-off
- Export: MFCU · CMS · Council
Beachhead and expansion
Start with health marketplaces. Expand across public benefits.
The wedge is health exchange enrollment integrity: SEP proof, outstanding verification, synthetic identity, and broker-ring detection before approval. The natural adjacency is Medicaid, SNAP, unemployment, and other public programs with the same eligibility documents and fraud patterns.
Built for government
A compliance path your procurement team can trust
Public programs can't buy what they can't certify. Here's exactly where we are and where we're headed. No vague “enterprise-grade security” hand-waving.
Baseline
SOC 2 readiness
Security, availability, and confidentiality controls organized for customer review and audit readiness.
Next
NIST 800-63 IAL2 + CMS MARS-E
Identity-proofing assurance and the ACA exchange security baseline your CISO will ask about first.
Data controls
IRS Pub. 1075 alignment
A safeguard path for programs that touch federal tax information and subsidy eligibility data.
Scaling
StateRAMP
A state cloud security path for moderate-impact program integrity workloads.
Roadmap
FedRAMP
A federal authorization roadmap for CMS and Treasury-scale program integrity workloads.
Prove your marketplace is clean
See Detectory score real enrollment fraud, from fake documents and synthetic identities to the broker rings behind them, in a 30-minute walkthrough. No sales pitch, just the product.