Doctors Notes Disqualified from Coverage

[ksigmtsu]

I have a client where apparently a doctor she visited 1 time wrote in his notes that he suspected possible bipolar disorder. She was declined with Humana for bipolar because of the doctor writing this in his notes when they got a copy of the APS, although she has never been diagnosed or treated for the condition.

What is the solution or recourse for this situation? I'm frankly pretty sure that a 1 time doctor visit with a 20 minute appointment and a guy writing he thinks possible bipolar in notes is not an actual diagnosis, but at this point I just need a way to fix the issue so the client can get insurance. The fear being, any company that pulls the APS and sees the notes may treat this the same way.

 

[dgoldenz]

Have her call the doctor and get him to dispute it.

 

[somarco]

Things like this are tough. I had a similar situation where a casual note in a toddler's file indicated, among other things, the child may have a mild form of autism.

That one thing was enough to warrant a decline.

The parents had to spend $2000 on follow up testing to prove the child was simply hyper-sensitive to some clothing textures.

Some of the underwriting is way over the line. Seems almost like they are doing everything they can to clean up their block prior to Obamacrap.

 

[bluemarlin08]

Another reason we should all have copies of our medical records. Unbelievable how often the applicant is unaware what is in their records.

 

[Justin Bilyj]

Can you just ask for it??

 

[somarco]

You can. Most will charge you around $75 or so. Since it is not covered by insurance many will say they can't afford it . . .

 

[briko3]

I had the same problem and tried multiple things (because at this point it was on the MIB). The only thing that worked is to get the doctor's note (on his letter head) stating that the patient does NOT have bipolar.

 

[HealthGuy]

Getting a Dr. to undiagnose something is akin to pulling out a healthy tooth without anesthetic. I like it when people think they are going to get a Dr. to do this so they can get medical insurance. Yea right. Will only happen in about 1 in 10 cases. People think they can bully Dr.s and insurance companies to push an application through. Never happens. Even with broker assistance.

 

[briko3]

HealthGuy, I think you misread the posts. According to the OP, the dr. wrote it down as a possibility...that's not a diagnosed issue. The doctor just needs to write a note clarifying that fact and it usually solves the problem.

 

[Crabcake Johnny]

Carriers do not deal with "maybe." They will likely demand a doctor's letter stating that she does or does not have bipolar disorder.

Carriers also don't deal with "borderline." If someone's a borderline diabetic that = decline.