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Quality Service The CPF claim processing application has numerous built-in edit checks
designed to prevent input and processing errors during claim entry and
review. To illustrate with a simple example, the application will not
permit the entry of a year of death that is prior to the year of birth.
The application also limits the available input choices for a number
of fields based on the circumstances surrounding the claim. The CPF has a rigorous internal audit program, led by an Audit Manager with a direct reporting line to the CPF Board of Directors. The internal audit department is responsible for both internal and external audits. The internal audit process for the claim processing function is based on the scientific sampling of all data entry fields, with greater emphasis placed on those fields affecting claim value. Actual error rates are compared to member approved benchmarks, and are used as a basis for modifying training plans as appropriate. Error rates are calculated for all individual fields and on a summary basis as well (e.g., by department and by employee). Error rates have been consistently below benchmarks, and are currently in the range of 1% to 2%. Internal audit also includes detailed procedures covering all administrative functions. Third-Party Audits The CPF also subjects
its systems, performance and practices to independent third-party audits.
These audits have covered the CPF’s server
and internet security, its operating efficiency, and the adequacy of
its internal controls. The findings from these engagements have been
extremely favorable. | |
| Claims
Processing Facility, Inc. East-West Tech Center 1771 W. Diehl Road, Suite 220 Naperville, IL 60563 |
Phone
630-281-6500 Facsimile 630-281-6700 |
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