Mumbai: In a strategic move to combat financial fraud in health care reimbursements, MediBuddy has launched a state-of-the-art fraud detection system called ‘Sherlock‘. This system harnesses the power of artificial intelligence (AI), machine learning (ML), and analysis of data to detect and prevent fraudulent activities in real time.
Sherlock is equipped with sophisticated AI and ML algorithms that adapt and evolve to recognize emerging fraud patterns. By monitoring user behavior and identifying anomalies, the system provides instant alerts and analytics, addressing issues such as claims duplication, document manipulation, pricing discrepancies, and compliance failures. This automation reduces reliance on manual reviews, significantly saving time and operational costs.
Satish Kannan, Co-Founder and CEO of MediBuddy, said, “Fraud in healthcare reimbursement claims threatens the integrity of the system. With Sherlock, we are equipping our partners and users with a powerful tool to detect and prevent fraud, ensuring a more efficient and transparent claims process. Our solution identifies potential risks early, building trust, reducing costs and protecting our reputation.”
Sherlock’s capabilities are expected to save up to 20 percent of costs. This includes a 10 percent reduction in fraud thanks to the cashless network and an additional 10 percent thanks to Sherlock’s advanced fraud detection features. By minimizing fraudulent activities, the AI-powered system can improve the reimbursement process, but also strengthen the overall security and efficiency of the healthcare claims system, according to MediBuddy.
