How Ansel Used Data to Help Ashley through Her Treatment

Rhea Manwani
October 11, 2022

When health issues pop up, people shouldn’t be worried about whether or not their insurance plan will show up for them. 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 facing a health hardship can be scary, that’s why we created a streamlined way for employees to file claims and receive meaningful support every step of the way. And now, we’re leveraging the power of readily available medical data to make a member’s experience at the time of a claim even better. 

Here’s a real-life example of a member who received benefits with Ansel—

Meet Ashley, a Ansel Member

Ashley is currently battling breast cancer. Her employer has provided Ansel with access to their employees medical claims data on a quarterly basis. Armed with Ashley’s data, Ansel was easily able to identify that she was eligible for a catastrophic benefit of $2000, which Ashley immediately received to her bank account. 

Ashley’s member care representative knew that the cancer diagnosis was particularly difficult, and would likely require ongoing treatment that could result in her incurring high out-of-pocket costs. After reaching out and speaking with Ashley, she quickly identified that Ashley was eligible for an additional catastrophic benefit after satisfying a benefit separation period under her Ansel coverage. She informed Ashley that instead of waiting until the end of the quarter when Ansel would review her group’s next claims feed, she could receive a benefit sooner by filing a claim directly to help alleviate any financial strain.

Because the member representative had access to Ashley's data, she was able to complete the entire claim process on Ashley’s behalf without requiring her to gather and upload any additional photos or documents. Ashley received her second catastrophic benefit payment within 24 hours of her member care representative filing the claim. 

Later, when Ashley’s cancer metastasized to her brain, she became eligible for three severe benefit payouts of $1000 each, which Ansel paid upon receiving her group’s third quarterly claims feed. In total, she received five benefit payouts totaling $7000, allowing her to focus on her treatment in her time of need. 

In Ashley’s words: “I’ve never seen a company doing anything like this and just how incredible and helpful it is to take the additional stress off my shoulders through this diagnosis.”

How Ansel Helped Ashley

“When groups choose to provide Ansel with their medical data, we can make their lives easier. But even as processes are automated, we know we can’t forget that people might need dedicated support along the way. That’s because in cases like Ashley’s, receiving a benefit sooner when facing a difficult diagnosis can make all of the difference.” — 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.