Our Expertise

Automate the Claims Investigation Process

Codesyntrix CIMS (Claims Investigation & Management System) is a comprehensive solution designed to streamline and automate the claims investigation process for insurance companies. It offers a centralized platform to manage claims, track investigations, and ensure compliance with regulatory requirements. CIMS isn’t just a management system—it becomes a next-generation AI-powered claims intelligence platform that empowers insurers to handle investigations faster, smarter, and with greater accuracy.
AI-Enhanced Capabilities
  • AI-Based Document Extraction: Automatically extracts and digitizes information from hospital records, patient documents, and medical reports, reducing manual data entry and errors.
  • Intelligent Fraud Detection: Uses machine learning models to identify suspicious patterns and anomalies in claims data,hospital activities helping insurers mitigate fraud risks.
  • Natural Language Processing (NLP): Analyzes unstructured data such as medical notes, investigation reports, and customer communications to surface relevant insights quickly.
  • Smart Workflow Automation: AI-driven routing ensures that claims are assigned to the right investigators based on complexity, priority, and expertise.
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Process Methodology

Claims Initiation

New suspected claims will be triggered through the API provided or will be saved in excel.
Process Methodology

Auto Allocation

Claims registered in CIMS will automatically assigned to Vendor/Field Investigator/Medical Representative. All types of automatic allocation can be configured in the system.
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Process Methodology

Reporting format

Reporting format helps Field Investigator to provide observations in real-time while visiting Patient's site.Field Investigator will get their format visit-wise. In case of no-network area,data will be saved locally and our smart mobile app mechanism will start sending dato to backend database once user comes under good network area.Provided with Drop-down based reporting format so that reporting will be easier and not difficult to write manually,saving time and focus on investigation part.
Process Methodology

Upload Investigation Images

Field Investigator can upload images or investigation documents through the provided mobile app solution. Images will be provided with GPS coordinates with date time. All Images will be synced on real-time,thereby removing manual intervention to upload images seperately. If in case of no-network area,our smart mobile app will save data in offline and once user comes into network area,images will start syncing into backend server. In case of offline mechanism,no data will be visible to user as these images will be saved encrypted.
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Process Methodology

Comprehensive Case Review & Quality Validation

  • Supervisors/Medical Representatives perform a thorough review once the Field Executive completes the on‑site investigation.
  • All supporting images are carefully validated to ensure authenticity and accuracy.
  • GPS coordinates are verified to confirm field visit legitimacy.
  • Every observation is checked for quality, consistency, and compliance with defined standards.
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Why Choose Our CIMS Solution?

You no longer need to take notes, then enter it later into a database. All your information is entered only once – at the time of field Investigation.

Save valuable time

You no longer need to take notes, then enter it later into a database. All your information is entered only once – at the time of field Investigation.

You no longer need to manage several files at once. Everything is one place - on your handheld computer during your field Investigation.

Improve efficiency

You no longer need to manage several files at once. Everything is one place - on your handheld computer during your field Investigation.

View,edit,schedule,track your report and automate your process for the reporting.It helps to remove manual process of creating reports.

Smart Tacking System

View,edit,schedule,track your report and automate your process for the reporting.It helps to remove manual process of creating reports.

Benefits

Better Dashboard Reporting

Our comprehensive CIMS Dashboard Reporting helps Insurance Companies and Agencies to track real-time status of the claims.

Boost Productivity

Our GPS-based system helps insurance companies verify claim closures accurately by capturing real-time location, date/time-stamped images, and secure image transfers without manual handling.

Integrated with Offline Module

Our offline feature ensures no data or image loss in no‑network areas, and all information syncs automatically once connectivity is restored.

Earlier Data Search

CIMS speeds up claim‑related decisions by automatically checking past records using patient and hospital documents. It identifies whether a claim or investigation was previously initiated and alerts the respective insurer for further action.

Cloud Hosted SaaS Model

We are providing you the application on SaaS(Software as-a-service) based model where in our applications will be hosted to our 24*7 available and secured cloud servers.

Smart Tacking System

View,edit,schedule,track your report and automate your process for the reporting.It helps to remove manual process of creating reports.