MediProbe Consultancy Services Pvt. Ltd. is an industry leading and pioneering Medical Intelligence Company specializing in Insurance Claims Verification and also active in other allied disciplines. We at MediProbe use top notch, seasoned investigators with years of experience in fraud investigation who leave no stone unturned in their quest to find and expose the truth. We have till date helped save insurance companies Millions of rupees- an astronomical sum they would have lost to fraudulent claims without Mediprobe. The key to this success is our belief in quality and performance and we are proud to have the highest ratio of fraud detection and denial of wrongful/fraudulent claims with concrete evidence. We are the investigator of choice for most Insurance Companies and leading TPAs operating in India. The fact that the number of claim investigations assigned to us has shot up from a measly 60 cases per month just a year ago to over 250 cases per month as of today speaks volumes about our quality and efficiency.

1. MediProbe Consultancy
Services Pvt. Ltd.

2. Content
• MediProbe Overview
• Need To Appoint Investigation Agency
• Our Patented Software
• Our Network
• Financials & Performance

3. MediProbe - Overview
• Pioneers(since 2010) with substantial market share in Medical Intelligence and
Insurance fraud investigation business
• Rapidly growing in terms of Revenue and Client Base
• Our Investigators-Best people in the business
• We have till date helped save insurance companies over Rs. 18Cr.
• Highest claims repudiation rate-65% (Retail Reimbursement) and 68%(Mass
health)
• Low Average Turn Around Time(TAT)- 10 days for reimbursement claims and 24
hours for cashless claims

4. Evolution of MediProbe
MediProbe Services
established
June
2010
Mediprobe crosses the
100 cases benchmark
Dec 2010 Dec 2011
MediProbe enters
Group insurance
Market(investigation
Mediprobe forays
into TPA Audit
Dec 2012 March
2013
Mediprobe officially
incorporated as
MediProbe services
Pvt. Ltd.
Mediprobe crosses
landmark Rs. 25 Cr.
In savingsngs

5. …with a few of our clients

6. …and some more clients!!

7. The Core Team
Dr. Ramesh Khade, CEO, MediProbe Services, started his career as a lecturer of
forensic Medicine after completing his medical education in 1995. He has
witnessed the vast and rapid growth of the Indian Healthcare & Insurance Sector.
In addition to his medical qualificaion, Dr. Khade holds an MD (Homeopathy) and
a PG Degree in Medico legal Studies, Social Work and Journalism
Mr. Prashant Maharaj, Director, MediProbe Services is an Entrepreneur with
years of experience in setting up claims businesses in the UK and various other
process driven ventures
An immensely experienced Claims team- highly accomplished professionals with
medico-legal and insurance backgrounds

8. Our Key Asset-Our People
Our investigators are a bunch of street smart, tech savvy medico-legal
professionals
Over 200+ man years of experience in the field of Medical Intelligence
and Insurance Investigation
Our Claims Managers armed with qualifications like BHMS, MBBS, LLB
etc. & our Operations Executives, finest in the business, make sure that
every case is handled in the best possible manner, thereby ensuring a
low TAT, High Repudiation Rate and Quality Control

9. Key Differentiators
• Highly efficient & user friendly software-allows seamless interface, data entry and
analysis
• A team of highly accomplished Doctors, Lawyers and Insurance professionals
• Most difficult cases solved by deploying undercover agents/detectives-an integral
part of our team
• Pioneers in using spy cams, scanners and other state of the art equipment to
expose fraud and collect evidence

10. Cases we handle
Ombudsman Appeals
Reinvestigation
Consumer Court
High value Claims
International Claims
All this over and above the regular investigation work we undertake

11. Special Services
Emergency Field investigation or verification at any location in India
Special Investigation arrangements in locations we do not normally operate in
Data Analysis of High ICR from any region, any hospital or any particular agent or
corporate client
Special projects for scams
Training programs for Investigation Staff

12. Need To Appoint Investigation Agency
• Rampant Corruption and malpractices in the National Healthcare network(various
Govt. schemes)
• Actual beneficiaries usually involve corrupt healthcare professionals,
pharmacists and hospitals; entities other than the intended individuals/groups
• Fraudulent Life/health Insurance claims- One of the biggest loopholes responsible
for pilferage in the Healthcare system
• Insurance Companies last year lost Rs.30,401 Cr*. to fraud claims-15% the
estimated size of insurance industry
• About 86% frauds occur in Life Insurance segment while 14% in the General
insurance sector^
Source(*): www.ndtv.com
(^): www.indiatoday.intoday.in
•

13. Healthcare Frauds in India- The scary picture

14. Healthcare Frauds in India- The scary picture

15. Our Patented Software-Case Info Screen

16. Our Patented Software-Case Counter/Dashboard

17. Our Patented Software-Case Data Entry Screen

18. Our Investigator Network- A strong Presence in the following states:
• Maharashtra
• Gujarat
• Rajasthan
• Karnataka
• Kerala
• Haryana
• Orissa
• Bihar
• Goa
• New Delhi(including entire NCR)
• Madhya Pradesh
• Uttar Pradesh
• Andhra Pradesh
• Punjab
• West Bengal
• Dadra & Nagar Haveli

19. Numbers you can’t overlook
Policy/Claim/work
Type
Cases
Investigated
Repudiated Repudiation Ratio Total Cost of
Claims
Savings made
Retail Cashless 520 282 54 11395084 6153325
GHI Cashless 80 24 28 2795828 782831
Reatial
reimbursement
1100 655 65 55603416 36142220
GHI
Reimbursement
760 320 52 20812968 10822743
IPA+GPA+JPA 55 25 48 94243908 45237075
SMC 45 31 62 93960598 58255570
Travel 85 34 38 4675000 1776500
Mass Health 440 332 68 33504330 22782944
Projects 27 12 42 1900320 798134
Seeding Activities 122 73 75 Nil Nil
Total 3234 1804 285387122 182757342

20. Contact us
All enquiries may please be directed to:
Dr. Ramesh Khade
M:+91 9422223656
Email: rameshkhade@mediprobe.co.in
OR
Mr. Kshitij Thorat
M: +91 7774002098
+91 8805509702
Email: kshitij@mediprobe.co.in