Another BCBS Challenge

[mzubek]

You guys are sharp.Please let me know what you would do with this case. I got a turn down from BCBS FL and the main reason is fatty liver without current lipid or liver enyzmes labwork results know. My client states Her Doctor orded ran MRI on her liver and He said their was a fatty spot on her liver and nothing to be concerned.about. She claims her liver enzymes are normal.

I don't have time to challenge with BCBS due to the fact She and her husband are trying to come of a group plan that is in open enrollment till 5/1.

Would you guys try a different carrier and how would you approach it?

 

[somarco]

No way to challenge it without the additional testing. A fatty liver is not something to be dismissed. Get the requested test results, try again.

 

[YouGotMyMoney]

Did you note anything on the application about her Liver?

If you did and this wasn't an issue of client omission or agent ineptitude, you should know that Blue Cross(Any carrier really), it's going to want to hear about Liver issues.

Like the Guru himself said, get some further lab testing.

I had an app like this, never spoke to the husband--only dealt with the wife, husband had liver enzyme issues too---he was like 5'6 225 or something and CHL reading of about 300 or so(Of course, according to his wife he was perfectly healthy, the liver enzymes came up in a paramed)...DECLINED...lol......though I did get a life application out of the deal, so not a total loss.

 

[mzubek]

Never said anything to me because their is no diagnosis as put to them by their doctor. Enzyme levels are normal. Doctor did an MRI, stated that the liver has a fatty spot on it. Don't worry about. Cirrhosis never came up. I was informed of this after the decline

 

[moonlightandmargaritas]

I got a turn down from BCBS FL and the main reason is fatty liver without current lipid or liver enyzmes labwork results know.

If she's age 50+, BCBSFL would have turned her down if they thought she might get a cold in the next 10 years. Brutal underwriting...why bother?

My client states Her Doctor orded ran MRI on her liver and He said their was a fatty spot on her liver and nothing to be concerned.about.

When I hear this from a prospect, I tell them it might be a good idea to ask their doc for a letter saying that they are willing to provide free treatment for any problems that may arise...

She claims her liver enzymes are normal.

Of course she does. If I had a nickel for every time I've heard this...

I don't have time to challenge with BCBS due to the fact She and her husband are trying to come of a group plan that is in open enrollment till 5/1.

If she's "coming off" a 2-50ee group plan, and the group is still intact, Florida Statutes say they she is not eligible for an individual plan until she's been uninsured for six consecutive months.

Don't get yourself into trouble.

 

[somarco]

Like the Guru himself said,

Guru doesn't have the cachet it once did now that everyone is a guru. However, there are a select few in the mile high club which makes it nice to get away from the riff-raff.

 

[moonlightandmargaritas]

However, there are a select few in the mile high club which makes it nice to get away from the riff-raff.

somarco, you are an animal.

 

[somarco]

somarco, you are an animal.

I will take that as a compliment.