Initial expectations call provides support to plan members

December 10, 2019

To improve plan members’ experience, 3sHealth Employee Benefits implemented the “initial expectations call.”

For some people, the process of applying for disability benefits can be challenging. Many plan members are unfamiliar with the process, and they don’t know how long it takes for a claim to be approved and when they will receive benefit payments. These factors increase plan members’ stress at a time when they are already feeling unwell.

To help address these unknowns and reduce stress, the initial expectations call is now the first step in the disability claim process.

As soon as 3sHealth is notified that a plan member is applying for disability benefits, a Benefit Services Officer calls the plan member to talk them through the process and to answer all of their questions. The plan member can also choose to receive information in writing.

After a disability claim is received, the remaining steps in the process are:

  • An adjudicator reviews the application to see if all information is correctly submitted;
  • The adjudicator phones the plan member for an interview, which helps the adjudicator understand the claimant’s current situation; and
  • The plan member and the adjudicator discuss the supports needed on the plan member’s path to health.

Plan members have provided positive feedback on the initial expectations call, noting that “getting a call when all your paperwork is received as per the previous process was good, because there are so many different areas that you rely on. But knowing where your paperwork is and getting an understanding of the entire process up front is even better.”

Read more: This service came about as a part of 3sHealth's new approach to disability claims management.
 


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