GOAL #2
Expeditious and Accurate
Claims Processing
Introduction
It is therefore crucial that programs strive continually to
improve their processing speed. But accuracy in analyzing
applications is also vital, since state governments have mandated
compensation programs to pay only those applicants that are
eligible and those expenses that are compensable under statutory
provisions. Eligible victims need to be paid promptly, but victims
and expenses that do not fall within statutory requirements must be
denied, also as quickly as a fair and full review of applications can
be performed.
Clearly, programs must learn to balance speed and quality.
The objectives and strategies described in this section are intended
to help states do this.
Sufficient staff and resources to perform work and pay eligible
applicants are extremely important factors in how well a program
performs. Shortages in staff and funding result directly in delays
in processing and payment. Delays can result in backlogs, in
which more and more victims are forced to wait for financial
assistance. Every program should seek an optimal number of
personnel that will help ensure fast and accurate work on applications, and executive and legislative decision makers in state
governments need to be aware that compensation programs need
financial support to provide good service.
Yet every program, regardless of its staffing constraints, can
and should do many things to improve its processing speed and
efficiency. Each program can analyze its work flow and seek to
eliminate duplicative and unnecessary steps. Every program should
explore automation and other technological means to make its
employees as productive as possible. Every manager has a
responsibility to motivate and supervise staff. Tools like policy and
procedure manuals and management reports can be useful to every
program. Each program, no matter what its resources, can take
important steps to improve productivity and performance, and the
objectives and strategies in this section should serve as a guide in
this effort.
Some of the common stumbling blocks to smooth processing,
such as incomplete applications and slow police and provider
response to requests for information, also can be addressed directly
by programs. Clear and simple instructions on forms, training for
victim advocates who help victims apply, and continuing efforts to
impress upon police and providers the importance of quick
turnaround can help tremendously in removing obstacles to
efficiency. (Other sections of this document discuss strategies to
accomplish these goals.)
The objectives in this section are divided into these general areas: processes and work flow; training and management; and issues relating to accuracy and consistency in processing applications. Attention to each of these objectives, and consideration of various strategies by which they can be addressed, should help every program to be as productive as possible, while maintaining a high quality of claims analysis.