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.

Internal Audits

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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