Navigating the health care claim process can be challenging for employees, and delayed claim payments and denied claims make it even harder for employees to manage their health care. Employees often lack the knowledge or experience to handle these hurdles in the claims process; for instance, many employees don’t think to follow up when their claim is unexpectedly denied, yet erroneous claims denials happen more often than they may think.

Your HR department can be a valuable resource for employees in this situation, but your company should consider how much of a role your HR department should play in helping employees sort through problem claims. This article offers benefits and drawbacks, plus easy fixes for common causes of late or rejected claims.

There are some cons to your HR department helping employees with claims. Some HR professionals feel that helping employees sort through the claims process is an unnecessary drain on their time. One risk is that employees start turning to HR as their first point of contact with a claim issue, rather than trying to call the insurer and solve the problem themselves.

In addition, some employers fear the potential liability involved with helping employees with health care claims. There is a concern that helping employees with claims exposes an employer to discrimination charges under the American Disabilities Act, or liability related to privacy laws. Many lawyers maintain that this risk is minimal; however, it would be a good idea to consult legal counsel. As a precautionary measure, some employers require employees to sign privacy waivers before helping with any health care claim issues.

Despite the drawbacks, many employers feel that helping employees handle problematic health care claims makes good business sense for several reasons:

• Employees often use company time to handle insurance-related problems, which cuts into productivity. If an HR representative can help the employee solve the issue quicker, it may translate into less company time wasted.
• Helping employees resolve claim problems offers a great opportunity for HR to monitor the performance of the insurer.
• Frequently late or mistakenly denied claims can be a sign that your carrier is underperforming, and it is time to make a change.

When employees are struggling and frustrated with their insurance plan, it can lower overall satisfaction with the company. Employers may find it in their best interest to help employees with these issues, to maintain employee morale and become a trusted go-to resource.

While it’s up to you to balance how involved your HR department is in the health care claims of your employees, we think there are some great insights you can find in the rest of this article. This article also reviews a lot of what was covered in the above text and give even further detail into just how you can help your employees feel supported in a process that is often difficult to manage. Check out this article for a deeper dive in the complexities of the HR departments involvement in employee claims.