Mutual of Omaha Living Promise coverage denied

[neetsiepk]

I may be remembering incorrectly. Doesn't MoO have a Disclosure to agent form? I believe it is part of my app pac.

 

[neetsiepk]

MOO does have that disclosure and the UW will tell you what RX denied them. I had them deny my healthy client for filling her pain pills Rx 30 times over the last 5 years.

 

[Allen Trent]

MOO does have that disclosure and the UW will tell you what RX denied them. I had them deny my healthy client for filling her pain pills Rx 30 times over the last 5 years.

You should self insure her if you think you can make money on people that renew a script 30x in 5 years.

 

[jdeasy]

It's not MIB. It's RX history.

You are technically correct but real world wrong. A company cannot decline based on MIB information. But they will get MIB information that causes a decline without saying it was for an MIB hit.

Still, this was most certainly an Rx decline. But mofo is a POS company. Probably a dozen FE companies would take this case level all day long.

 

[suranceman]

You are technically correct but real world wrong. A company cannot decline based on MIB information. But they will get MIB information that causes a decline without saying it was for an MIB hit.

Still, this was most certainly an Rx decline. But mofo is a POS company. Probably a dozen FE companies would take this case level all day long.

What does "You are technically correct but real world wrong." mean?

Also, you don't know who will take this case level because you (nobody knows) don't know what's in her Rx history.

 

[jdeasy]

What does "You are technically correct but real world wrong." mean?

Also, you don't know who will take this case level because you (nobody knows) don't know what's in her Rx history.

That’s why I said “probably”. I place people every day level that mofo declines.

I explained what I meant about your being technically correct on the MIB.

A company can’t technically decline on the MIB. But when they see something on the MIB they don’t like try will find a reason to decline. And give another reason. Or refuse to give reason while hiding behind HIPAA.