Update: Path to Health disability claims management redesign

July 28, 2020

To better serve our plan members, 3sHealth’s Employee Benefits team has designed a new approach to disability claims management. We call it the “Path to Health.” The team has worked hard this year to implement the following improvements:

• Building our team
Three new adjudicators and four new advisors are in place. The advisors are improving the daily work for the claims services team.
 
• Making forms easier to use
We developed a new brand standard for our forms. We have also simplified our forms and made them electronically fillable so they are easier to complete and submit. Also, refreshed disability income plan booklets are available online here
 
• Getting in touch with plan members right away
We are now using an “initial expectations call” to serve plan members better. When we receive the first notification of a claim, the Benefit Services team calls the applicant to explain the disability claim process and to answer any questions the plan member may have.
 
• Getting a better understanding of plan members’ claims
Since September, the adjudicators call all long-term disability applicants to better understand their current situation. The target is to complete a C.A.R.E. (collaboration, assessment, relationship-building, and expectation-setting) call on 100 per cent of long-term disability claims within three business days.
 
• Promptly advising of the decision
The adjudicators call every plan member to advise them of the claim decision and to answer any questions they may have.
 
• Developing the case management plan
Together with our stakeholders, we designed a case management checklist based on one that the World Health Organization uses. The checklist will ensure a consistent experience with every claim.
 
• Building bonds
3sHealth hosted two well-attended Physician Education Sessions in December 2019.
 
Work has already started for year two of Path to Health.
 
3sHealth welcomes your feedback. We want to hear your experience applying for and receiving disability benefits. Please submit feedback by emailing EBP@3sHealth.ca or by filling out the customer survey online here.

 


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