For most people, navigating new coverage can be tricky. Resources are often scarce, resulting in a general lack of clarity amongst members on when and how to use benefits effectively. Often employees spend far too much time navigating a painful claims process or stressed about whether they’ll suffer a financial burden rather than focusing on their road to recovery.
At Ansel, we know that every dollar counts, that’s why we’re integrating claims so that members don’t have to file claims to receive benefits, with educational tools and dedicated support along the way.
Here’s a real-life example of a member who received benefits with Ansel—
Meet Kate, a Ansel Member
Kate’s coverage began with Ansel in January. Her employer not only funded 100% of the premium, but also provided Ansel with access to their employees' medical claims data from their major medical provider. After receiving welcome emails from Ansel upon her coverage effective date, Kate learned that members are encouraged to register in the member portal where they can set up payment preferences so that when benefits are due, payments can be issued more quickly.
With claims integration, Ansel was able to pay Kate for a catastrophic condition she did not know she was eligible for under her coverage. Not only did she receive the benefit within the first few months of her coverage, but she was also given personal guidance from Ansel’s dedicated Member Services Team, who reached out by phone to review the coverage with her, and explain the benefit payment.
After speaking with her Member Care Representative, Kate learned that she was eligible for additional benefits based on the active treatment she has been receiving for a catastrophic medical condition. These payments would also be paid through claims integration without any action from Kate, and would help her cover out of pocket costs associated with her high deductible health plan.
How Ansel Helped Kate
“Claims integration enables us to make sure no benefits fall through the cracks, but it does not work alone. At Ansel Member Services, we take the time to talk to members to build trust, and help them gain confidence that their plan is showing up for them and that they have dedicated support, every step of the way.” — Hope Rudolph, Member Care Representative, Ansel
Claims integration model makes employees lives easier
Even though we made it easy for members to file claims, we know that sometimes, when dealing with a health issue, filing a claim or worrying about receiving a benefit can be stressful. That’s why we can use electronic health data to determine whether members are eligible for Ansel benefits, and file claims for members so they can focus on their recovery.
Members can receive multiple benefits
Members may be eligible for multiple benefit payments while they are in active treatment. Conditions within the same coverage category (Moderate; Severe; Catastrophic) are eligible for additional payments if subsequent medical encounters are separated by a specified number of days, referred to as benefit separation periods. This way, Ansel provides continued value when members face unexpected medical issues that may bring additional financial strain.
Dedicated support for members when they need it most
Just because we’re automating the submission of claims, that doesn’t mean we aren’t here to help. Our Member Care Representatives look out for people who have more serious diagnoses that may require ongoing treatment because we know that receiving a benefit sooner can help alleviate the unnecessary financial strain. Here at Ansel, we know that the best way to help real people on the road to recovery is with dedicated support every step of the way.
To learn more about how Ansel can integrate claims and help your team get the most out of their benefits, check out our plan and get in touch.
*Note: This is based on a real-life scenario, but no real names were used out of respect for our members and their privacy.
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