What information does the MIB have access to in looking into patient history?

[Joe Cochran]

Can they access all doctors that the patient has visited and what they entailed? Is there just a large database that they have at their disposal?

 

[somarco]

I suggest you order an MIB on yourself. Then you will know how to answer the question when/if it comes up again

mib.com - Request Your Consumer File

 

[leevena]

Can they access all doctors that the patient has visited and what they entailed? Is there just a large database that they have at their disposal?

MIB only has information if you have applied for an individual policy, such as life, DI, etc. It does not go past 7 or 8 years. Suggest you take Somarco advise and order yours.

 

[WinoBlues]

It has been a while since. However, I seem to remember that Kaiser reported on a client's drug rehab. Not as a n APS but as an MIB hit. When I questioned it I was told they are an insurance company that subscribes to MIB.

 

[somarco]

It has been a while since. However, I seem to remember that Kaiser reported on a client's drug rehab. Not as a n APS but as an MIB hit. When I questioned it I was told they are an insurance company that subscribes to MIB.

Must be new. Last time I did anything with KP they did not participate in MIB (punting or receiving).

Unless MIB has changed (which is another reason why I suggested OP pull his own records) they only reported apps denied, postponed or rated. Did not give a reason (such as rehab). Only the course of action.

 

[WinoBlues]

Must be new. Last time I did anything with KP they did not participate in MIB (punting or receiving).

Unless MIB has changed (which is another reason why I suggested OP pull his own records) they only reported apps denied, postponed or rated. Did not give a reason (such as rehab). Only the course of action.

That would have been my thinking also. Now the company is the one that said something coded on MIB so that may not be a reliable source. I remember questioning it and was told that it had to do with KP being an insurance company. Did not seem correct to me.

 

[somarco]

That would have been my thinking also. Now the company is the one that said something coded on MIB so that may not be a reliable source. I remember questioning it and was told that it had to do with KP being an insurance company. Did not seem correct to me.

In Georgia (and probably other states as well) they have the Kaiser "Foundation" (or whatever they call the HMO) with members, but they also have an insurance carrier for things like group life insurance. The carrier has policyholders.

Pretty sure the Foundation is a NFP company similar to what most of the Blue's were for many years. A NFP organization has separate rules and requirements. I think they are subject to 501(c)(3) guidelines.

But we are getting WAY off track here.

 

[Joe Cochran]

So in the process of determining whether to approve or deny coverage of a major illness does the agent simply give a quick glance at the MIB or does he call all doctors that the patient has been to? And if so how would he know what doctors the patient has been to? If it's not in some information database?

 

[somarco]

So in the process of determining whether to approve or deny coverage of a major illness does the agent simply give a quick glance at the MIB or does he call all doctors that the patient has been to? And if so how would he know what doctors the patient has been to? If it's not in some information database?

It's not the agents job to conduct background checks, call the clients mother or minister, run credit reports, etc.

You assume they are being honest and fill out the app as best you can.

Certainly if you feel your client is not being honest you should ask more probing questions. But you have no legal right to access their MIB file, credit history, drug history (Intelliscripts), CLUE (P&C), etc. It is the carriers responsibility to underwrite by using tools at their disposal.

When a carrier pulls MIB or Intelliscripts records that is the truth serum. They use the data from those sources to determine if the applicant was honest about their health history. In some cases (depending on the risk) they will request an APS or order a physical exam.

Underwriters do this, not agents.

 

[Joe Cochran]

It's not the agents job to conduct background checks, call the clients mother or minister, run credit reports, etc.

You assume they are being honest and fill out the app as best you can.

Certainly if you feel your client is not being honest you should ask more probing questions. But you have no legal right to access their MIB file, credit history, drug history (Intelliscripts), CLUE (P&C), etc. It is the carriers responsibility to underwrite by using tools at their disposal.

When a carrier pulls MIB or Intelliscripts records that is the truth serum. They use the data from those sources to determine if the applicant was honest about their health history. In some cases (depending on the risk) they will request an APS or order a physical exam.

Underwriters do this, not agents.

Intelliscript?? APS? What do those do?