Humana is no different from any other carrier engaging in post-issue underwriting. They will request doctors records depending on diagnosis when a claim is submitted.
I have probably half a dozen going on now. Half involve significant claims (xs of $100k) and the others are minor. The most recent one involved an anxiety med prescribed but never filled following one doctor visit.
The guy was stressed over some issues at work, went to see his doc. Doc gave him a sample of Xanax and wrote a script which was never filled.
That was a year ago.
More recently he went to the doc for a checkup. H1 requested records and discovered the anxiety issue. Since the med was never filled it did not show up on the Rx history.
The situation was within the lookback period so they sent him an amendment to sign, increasing the premium $12 per month retroactive to the eff date.
He asked my advice. I told him to sign it and move on.
He did and we did.
Blue & Coventry are notorious for post-issue underwriting. I understand Time is as well but since I haven't written anything with them in 2 yrs I wouldn't know.
The only ones (so far) that haven't been as diligent in conducting post issue underwriting are GR and Aetna.
I have a 4 yr track record with GR and no issues. My time for writing with Aetna is really a little more than a year so I can't say. Only issue so far with Aetna was requesting a letter of creditable coverage. We provided it, they paid the claim, end of story.
I have probably half a dozen going on now. Half involve significant claims (xs of $100k) and the others are minor. The most recent one involved an anxiety med prescribed but never filled following one doctor visit.
The guy was stressed over some issues at work, went to see his doc. Doc gave him a sample of Xanax and wrote a script which was never filled.
That was a year ago.
More recently he went to the doc for a checkup. H1 requested records and discovered the anxiety issue. Since the med was never filled it did not show up on the Rx history.
The situation was within the lookback period so they sent him an amendment to sign, increasing the premium $12 per month retroactive to the eff date.
He asked my advice. I told him to sign it and move on.
He did and we did.
Blue & Coventry are notorious for post-issue underwriting. I understand Time is as well but since I haven't written anything with them in 2 yrs I wouldn't know.
The only ones (so far) that haven't been as diligent in conducting post issue underwriting are GR and Aetna.
I have a 4 yr track record with GR and no issues. My time for writing with Aetna is really a little more than a year so I can't say. Only issue so far with Aetna was requesting a letter of creditable coverage. We provided it, they paid the claim, end of story.