When State Health Plan (SHP) subscribers report accident-related claims, BlueCross BlueShield of South Carolina (BCBS) needs information about the event. They gather this information through an Accident Questionnaire that the subscriber completes. These Accident Questionnaires are sent to subscribers when there is a claim filed for treatment of an injury or diagnosis that has been established by BCBS's staff of physicians as likely to be accident or work-related. Accident Questionnaires are generated once per week, based on the claims that were received that week. Some subscribers receive multiple Accident Questionnaires related to the same event, which can be confusing. Below are some reasons why this might happen, along with the best way to resolve each of them.

One possibility is that BCBS may simply not have received a response to the first Accident Questionnaire they sent. Since these questionnaires are generated weekly, it is possible that a subscriber may not have sufficient time to respond to the first one they received before a second is generated. The subscriber should not receive more than one extra Accident Questionnaire if they return the first one in a timely manner. Additional questionnaires will be sent to the subscriber each week until BCBS receives a completed Accident Questionnaire. To help eliminate the extra cost and inconvenience of receiving these forms, subscribers should complete and return them in a timely manner.

Subscribers may also receive more than one Accident Questionnaire if more than one covered person in the same family receives treatment related to the same accident. In this situation, BCBS will send out a questionnaire for each covered individual being treated for injuries related to the accident. To distinguish among the different questionnaires, BCBS lists the name of the patient for whom a particular Accident Questionnaire has been generated at the top of the form.. Subscribers should answer and return promptly an Accident Questionnaire for each covered individual being treated for injuries related to the accident.

Once BCBS receives an Accident Questionnaire response, it is valid for six months. If claims meeting the established accident-related criteria are reported more than six months after the original accident date, the subscriber will receive another Accident Questionnaire. This six-month cycle helps BCBS identify any subsequent accidents that may have occurred. If claims reported more than six months after the original accident are related to that event, the subscriber should simply check the "update" space and return the questionnaire to BCBS. This will update the subscriber's file for another six months.

BCBS is working on improvements to its computer systems that will help to prevent duplicate Accident Questionnaires from being generated and sent to subscribers. In the next few months, new procedures will limit the number of Accident Questionnaires generated for each subscriber to one per month in order to give subscribers more time to respond.