{"id":399,"date":"2023-06-26T13:57:47","date_gmt":"2023-06-26T13:57:47","guid":{"rendered":"http:\/\/www.delcpf.com\/?page_id=399"},"modified":"2024-08-09T11:42:34","modified_gmt":"2024-08-09T11:42:34","slug":"claim-review","status":"publish","type":"page","link":"https:\/\/www.delcpf.com\/?page_id=399","title":{"rendered":"Claim Review"},"content":{"rendered":"[vc_row][vc_column][vc_column_text]At Delaware Claims Processing Facility, we have the most experienced and dedicated staff in the industry.\u00a0 Our analysts are experts at extracting pertinent information from raw documents \u2013 including complex and sensitive medical reports, legal documents, and settlement-specific supplementary documents. Our staff\u2019s expertise extends to so much more than mere information extraction.\u00a0 They are able to intelligently and systematically filter that information through complex rule sets to draw accurate and useful conclusions\u2014leading to more effective and efficient claim resolutions.<\/span><\/p>\n

We have crafted a unique approach to claim review that is informed by our decades of experience. \u00a0This approach involves standardized, documented, and monitored processes designed to maintain exceptional review quality, as we work in high transaction volumes.\u00a0 Our reviewers adhere to a set of best practices that ensure each claim is approached in exactly the same manner, resulting in consistent and predictable outcomes.<\/span><\/p>\n

We categorize tasks by complexity and route them only to the individuals best-suited for the job. \u00a0By minimizing how many individuals touch each claim, we also reduce the potential for error and delay.\u00a0 Further, utilizing and optimizing such specialized teams and automation allows our reviewers to focus their energy on reviewing actionable claims.\u00a0<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=”stretch_row”][vc_column css_animation=”left-to-right”][vc_tta_tour spacing=”5″ gap=”5″ autoplay=”5″ active_section=”1″][vc_tta_section 1=”style=““color:” 2=”#000000;“>Automation“” tab_id=”1687777646832-85cd417c-be18″ title=”Automation”][vc_column_text color=”#1e73be”]\n

Automation<\/span><\/strong><\/p>\n

We automate tasks wherever possible, so that we preserve our most valuable resource \u2013 our claim reviewers \u2013 for actionable claims.<\/span><\/p>\n

We excel at identifying how and where to enhance our process with technology, and we integrated automation into all aspects of our review process. For example, we build logic into our systems to identify anomalous fact patterns and to ensure reviewers apply our processing guidelines consistently and accurately. We utilize automatic system checks to confirm whether all of a claim\u2019s critical information has been reviewed and given the individualized attention it deserves.<\/span><\/p>\n

Our sophisticated technology is one of our strengths, but so is our understanding that many tasks require the detailed attention and human judgment of one of our reviewers. We focus on automation to ensure our reviewers\u2019 attention and energy is where it should be: on finalizing the most complete, actionable claims.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section 1=”style=““color:” 2=”#000000;“>General” 3=”Review” 4=”Teams“” tab_id=”1687777646832-3021316b-3275″ title=”General Review Teams”][vc_column_text color=”#1e73be”]\n

General Review Teams<\/span><\/strong><\/span><\/p>\n

The backbone of DCPF\u2019s strategy are the Review Teams. These teams are organized into highly efficient, modular units, supported by a dedicated manager who shares the same workplace. This hands-on approach facilitates on the spot mentorship, support, and supervision. Our review teams are cross-trained to process claims for multiple settlements at a time, which turns them into a dynamic and flexible workforce that can scale at the drop of a hat.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section 1=”style=““color:” 2=”#000000;“>Deficiency” 3=”Response” 4=”Unit“” tab_id=”1687777822579-db9262ab-82c6″ title=”Deficiency Response Unit”][vc_column_text color=”#1e73be”]\n

Deficiency Response Unit<\/span><\/strong><\/span><\/p>\n

Not all claims are submitted in satisfactory fashion. When this happens, deficiencies are applied to identify the critical errors that will prevent a claim from moving forward. The Deficiency Response Unit screens newly submitted information and documentation to ensure that the submission properly addresses the deficiency communicated to the claim. This is a critical piece of ensuring efficiency in the overall review process.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section 1=”style=““color:” 2=”#000000;“>Specialized” 3=”Review” 4=”Teams“” tab_id=”1687778247514-643ae331-ed55″ title=”Specialized Review Teams”][vc_column_text color=”#1e73be”]\n

Specialized Review Teams<\/span><\/strong><\/p>\n

DCPF understands that no two claims are alike. Some claims are more challenging and complex, requiring more attention. We route these more complex claims to our specially-trained Complex Review Teams. This way, we ensure each claim receives the appropriate care, while avoiding interruptions to our overall claims process.<\/span><\/p>\n

Having a dynamic, highly educated, and experienced staff allows us to utilize our teams\u2019 backgrounds to the greatest benefits of our claimants. We have several teams that provide specialized review. Staff by nurses and legal professionals, for example; these teams are able to draw upon their specialized skills and experiences when processing claims \u2013 yet another strength that elevates the DCPF experience above the rest.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section 1=”style=““color:” 2=”#000000;“>Quality” 3=”Assurance” 4=”Teams“” tab_id=”1687778319915-4c937117-ab73″ title=”Quality Assurance Teams”][vc_column_text color=”#1e73be”]\n

Quality Assurance Teams<\/span><\/strong><\/p>\n

At DCPF, our paramount focus is accuracy. We have a deep understanding and respect for the importance of our work. We see every meritorious claim that is wrongfully denied as an individual deprived of their just compensation. We created specialty teams and processes to provide consistently exceptional quality. We also tirelessly test ourselves against our own standards and procedures\u2014while always striving to improve the standards and procedures themselves.<\/span><\/p>\n

We believe that we can never stop learning and improving. This is more than just a pretty sentiment to us, and we prove it by placing dedicated QA personnel in each department. We use algorithms to strategically target and QA claims that have a greater likelihood for errors.<\/span>[\/vc_column_text][\/vc_tta_section][\/vc_tta_tour][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=”View More Services” title_align=”separator_align_left” align=”align_right” color=”custom” border_width=”3″ accent_color=”#cccccc”][\/vc_column][\/vc_row][vc_row][vc_column width=”1\/4″ css=”.vc_custom_1690483952565{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 25px !important;padding-right: 25px !important;padding-bottom: 20px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}” min_height=”190px”]

Claim & Document Handling<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1690481926037{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 55px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}” min_height=”190px”]

Reporting<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1690482349231{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-right: 25px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}” min_height=”190px”]

Quality Assurance<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1690483715955{border-top-width: 5px !important;padding-top: 40px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-top-color: #cccccc !important;border-top-style: solid !important;}” min_height=”190px”]

Claimant Relations<\/a><\/h2><\/div><\/div>[\/vc_column][\/vc_row][vc_row][vc_column width=”1\/4″ min_height=”190px” css=”.vc_custom_1690483764350{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 55px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}”]

Finance<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1690483891691{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 55px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}” min_height=”190px”]

Training<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ min_height=”190px” css=”.vc_custom_1690483684771{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 40px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}”]

Information Technology<\/a><\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/4″ css=”.vc_custom_1690480580698{border-top-width: 5px !important;border-right-width: 0px !important;border-bottom-width: 0px !important;border-left-width: 0px !important;padding-top: 55px !important;padding-right: 25px !important;padding-bottom: 30px !important;padding-left: 25px !important;background-color: #f6f6f6 !important;border-left-color: #cccccc !important;border-left-style: solid !important;border-right-color: #cccccc !important;border-right-style: solid !important;border-top-color: #cccccc !important;border-top-style: solid !important;border-bottom-color: #cccccc !important;border-bottom-style: solid !important;}” min_height=”190px”]

Web Support<\/a><\/h2><\/div><\/div>[\/vc_column][\/vc_row]\n","protected":false},"excerpt":{"rendered":"

[vc_row][vc_column][vc_column_text]At Delaware Claims Processing Facility, we have the most experienced and dedicated staff in the industry.\u00a0 Our analysts are experts at extracting pertinent information from raw documents \u2013 including complex and sensitive medical reports, legal documents, and settlement-specific supplementary documents.…<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/pages\/399"}],"collection":[{"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.delcpf.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=399"}],"version-history":[{"count":31,"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/pages\/399\/revisions"}],"predecessor-version":[{"id":2279,"href":"https:\/\/www.delcpf.com\/index.php?rest_route=\/wp\/v2\/pages\/399\/revisions\/2279"}],"wp:attachment":[{"href":"https:\/\/www.delcpf.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}