If you’ve ever faced an unexpected medical issue, you know the stress that may come with it. Having a plan in place to help make sure you’re covered — and receiving added assistance through the process — may help ease your worries, especially when it comes to a faster pay-out.
It may be helpful to have someone in your corner to take some of the administrative process out of the equation so you can focus on what’s most important — your recovery.
For those who are enrolled in supplemental health plans, such as accident, critical illness or hospital indemnity plans, an integrated claims program may help create a better, more seamless experience.
It’s not uncommon for people to forget they’ve enrolled in a supplemental health plan — especially with how busy life can be. But that lack of awareness may lead to a delayed pay-out or no pay-out at all following a qualified accident, critical illness diagnosis or hospital stay. To help address that, a program known as Benefit Assist from UnitedHealthcare is helping speed up this process by utilizing artificial intelligence that identifies potential supplemental health claims in medical claim data.
Here’s how it works:
- After a possible covered critical illness diagnosis, hospital stay or accident is identified, a Benefit Assistant contacts an eligible UnitedHealthcare plan participant.
- The Benefit Assistant has the ability to initiate the claim on the behalf of the employee.
- This helps facilitate a faster pay-out for the member, to help enable the person to focus on healing and recovery.
Since the program’s initial roll-out, 77% of supplemental health claims have been initiated by Benefit Assistants. Payouts can reach up to $5,000 or more under accident and hospital indemnity plans and up to $40,000 for critical illness coverage.* This process is designed to help get these pay-outs to members sooner and more efficiently, and since the program began, it has helped increase the dollars paid by 66%**.
“Through Benefit Assist, we are helping to avoid those scenarios where people are having to wait for the benefit pay-out under their supplemental plan or, in some cases, maybe they don't realize that they have a benefit pay-out that they just need to file for,” said Tom Wiffler, CEO, UnitedHealthcare Specialty Benefits. “This builds on an integrated approach for companies that combine medical coverage with specialty benefits through a single health care company, with the goal of helping to improve health outcomes, drive productivity and reduce costs.”
Benefit Assist is offered to eligible members enrolled in both a UnitedHealthcare medical and UnitedHealthcare Supplemental Health plan, including accident, critical illness or hospital indemnity protection. Check with your employer to see if this is an option for you.
*For illustration purposes only, with actual coverage amounts varying by plan; coverage amounts reflect a benefit pay-out per plan participant per year.
**UnitedHealthcare Book of Business, 1/1/2020-11/23/2020.
***Benefit Assist may not be available to UnitedHealthcare members in New York.
 Review of the impact of the integrated approach on the UnitedHealthcare Key and National Account Book of Business, 2018