MediBuddy Unveils AI-Driven Fraud Detection System ‘Sherlock’ for Healthcare Reimbursements

This advanced system uses artificial intelligence and machine learning to detect fraudulent claims in real time, offering significant potential cost savings.

Bengaluru-based healthtech startup MediBuddy has introduced a new AI-powered fraud detection system named ‘Sherlock,’ which aims to improve the accuracy and security of healthcare reimbursements. 

This advanced system uses artificial intelligence (AI) and machine learning (ML) to detect fraudulent claims in real time, offering significant potential cost savings.

Sherlock is designed to tackle financial fraud in healthcare reimbursements using sophisticated AI and ML algorithms. 

The system continuously adapts and learns from new data to identify and address fraudulent activities such as claim duplication, document tampering, and pricing inconsistencies. 

By monitoring user behavior and detecting anomalies, Sherlock provides instant alerts and detailed analyses, which reduces the need for manual reviews and operational costs.

Satish Kannan, cofounder and CEO of MediBuddy, said, “With Sherlock, we're 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, fostering trust, reducing costs, and protecting our reputation.”

The implementation of Sherlock is expected to achieve up to 20% in cost savings. This figure includes a 10% reduction in fraud within the cashless network and an additional 10% through Sherlock's advanced fraud detection capabilities. 

The system aims to enhance the reimbursement process and the overall security of healthcare claims by minimizing fraudulent activities.

Ongoing Financial Developments

In addition to the launch of Sherlock, MediBuddy is currently raising fresh debt funding from its existing investors, including Innova Capital and Alteria Capital. 

Reportedly, the startup is seeking approximately $8.4 million (around INR 70 Cr) in debt funding. 

This investment will contribute to MediBuddy’s plans to acquire companies in key healthcare sectors such as women’s health, mental health, diabetes, and chronic disease management.

With this funding, MediBuddy has approximately $218 million in combined debt and equity.