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| The Role of the Claims Services Department |
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CAP-MPT's claims services brings over 30 years of experience to the management of professional liability claims in California. Our greatest strength is our staff of 22 Claims Specialists who have diverse backgrounds in law, medicine, nursing, and insurance claims management.
The Claims Services Department manages the direction and control of incidents, depositions, lawsuits, arbitration demands, and pre-litigated claims. If we can intervene early in a claim, we have been successful in avoiding further claimant action and potential litigation. Early resolution techniques include the Patient Assistance Services program, investigation of incidents, and aggressive management of 90 day letters ( also known as "notices of intent to sue") and litigated matters.
Our Hotline provides Members with 24-hour access to answers concerning urgent risk management issues arising in their practice. The Hotline also provides the means to report claims and adverse events during routine business hours.
Other tools available for case management are specialized units for birth injuries and diet drug litigation. We will be implementing an orthopedic unit dedicated to the exclusive management of orthopedic cases.
Furthermore, Claims Services has access to our dedicated law firm of attorneys specializing in medical professional liability defense and a vast network of experienced medical consultants in every discipline.
What you can expect from us
You can expect to receive prompt and active management of your claim. As a physician-owned company, we are dedicated to the concerns of our physician Members and not driven by economic profit. Our claims handling philosophy reflects that view.
We recognize the impact a claim has on you, your family and your practice. It also raises credentialing issues. We strive to make you an integral part of the decision making process in the handling of your case.
What we expect from you
- Don't speak to patients' attorneys. Don't be fooled by attorneys claiming to be investigating a potential malpractice claim against a fellow doctor.
- Follow our advice - CAP has the expertise to safely guide you through the claim and litigation process.
- Send us a complete copy of your chart as soon as possible.
- DO NOT alter the medical record under any circumstances.
DO NOT add any note in the medical record.
- Put the original medical record in a safe place.
- Create a medical-legal file in which to keep copies of correspondence between yourself and CAP Claims staff and/or attorney - DO NOT place claim or litigation-related materials in the patient's record.
- Cooperate with CAP in the investigation of the case. This includes scheduling time to meet with our claims staff and attorneys and attending meetings and court ordered appearances, as required.
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