Apart from open enrollment season, health plan members rarely think about their benefits. That changes instantly after an accident when the member’s thoughts turn to out-of-pocket expenses and, if they’re injured, how they’re going to handle the daily routines they did when they were healthy. In fact, accidents are one of the most disruptive events in the relationship between the member and the health plan.
In the ideal situation, when a health plan member has an accident, the behind-the-scenes health claims process is simple. They get treatment, recover and never get bothered with questions about the accident or haggle over a bill.
