Hypothetically Speaking

[jdeasy]

The MIB is going to tell everything about her medical conditions.

Not necessarily. If she paid cash then it won't be in the MIB. If VA it won't be in the MIB.

 

[WinoBlues]

Not necessarily. If she paid cash then it won't be in the MIB. If VA it won't be in the MIB.

Does the VA meds show up in the script check?

 

[jdeasy]

Does the VA meds show up in the script check?

No............................................filler

 

[scagnt83]

Not necessarily. If she paid cash then it won't be in the MIB. If VA it won't be in the MIB.

You mean it wont be in the Rx check. Not MIB.

MIB is a database used by and contributed to by insurance companies. They compile underwriting data on applicants by the insurers submiting it to them in coded form.
The insurance companies can then cross check a new applicant with the MIB database and see if they have ever been denied/approved for coverage and if so for what reasons.

Does the VA meds show up in the script check?

No............................................filler

According to intelliscripts one main resource they gather info from are PBMs (Pharmacy Benefit Managers).
Intelliscripts also states that PBMs:

In addition, PBM’s may provide prescription services for insurance companies, retail pharmacies, individual consumers and government programs.

http://www.rxhistories.com/FAQ/


So I would be careful making blanket statements like that to a client.

 

[jdeasy]

You mean it wont be in the Rx check. Not MIB.

MIB is a database used by and contributed to by insurance companies. They compile underwriting data on applicants by the insurers submiting it to them in coded form.
The insurance companies can then cross check a new applicant with the MIB database and see if they have ever been denied/approved for coverage and if so for what reasons.

If she paid cash then there is no insurance company involved to report it to the MIB. The VA does not report to the MIB. Same for the Rx.

The MIB also won't say if a person was denied coverage. maybe an expert on MIB can make an educated guess as to the outcome but it it is not reported as to whether a case was declined, approved or rated.

 

[scagnt83]

If she paid cash then there is no insurance company involved to report it to the MIB. The VA does not report to the MIB. Same for the Rx.

The MIB also won't say if a person was denied coverage. maybe an expert on MIB can make an educated guess as to the outcome but it it is not reported as to whether a case was declined, approved or rated.

Go to the MIB website and read the FAQ. Because you are misinformed. http://www.mib.com/facts_about_mib.html

Insurers do not report claims to the MIB. They report underwriting facts/decisions. And yes, they do report if a case was approved or declined.

Cinci life once declined a case due to a previous decline found via the MIB database.

Claims have nothing to do with the MIB.

 

[jdeasy]

I may be misinformed but I am misinformed by the insurance companies. Just recently Americo had me re ask about policies applied for in the last year or so on a client that told they had no insurance. Americo told me they could see that the couple had applied with 2 or 3 companies but they could see the outcome. They wanted to know if they were just not accepted, declined, rated or if they person actually had the insurance.

RNA has us read the meds on the POS because they say they cannot get those if a person pays cash or is VA. Same on conditions. I've only had one contestable case declined with RNA and it was because the guy had a procedure done at the VA that would have caused the policy to not be issued. RNA could not get that info at underwriting but they could get it after death. The widow admited later that they left that out at application.

So, while I may be misinformed, the real world practices support the misinformation that I have.

{I don't know why this is typing in bold}

Go to the MIB website and read the FAQ. Because you are misinformed. mib.com - The Facts About MIB

Insurers do not report claims to the MIB. They report underwriting facts/decisions. And yes, they do report if a case was approved or declined.

Cinci life once declined a case due to a previous decline found via the MIB database.

Claims have nothing to do with the MIB.

 

[benefits365]

I may be misinformed but I am misinformed by the insurance companies. Just recently Americo had me re ask about policies applied for in the last year or so on a client that told they had no insurance. Americo told me they could see that the couple had applied with 2 or 3 companies but they could see the outcome. They wanted to know if they were just not accepted, declined, rated or if they person actually had the insurance. RNA has us read the meds on the POS because they say they cannot get those if a person pays cash or is VA. Same on conditions. I've only had one contestable case declined with RNA and it was because the guy had a procedure done at the VA that would have caused the policy to not be issued. RNA could not get that info at underwriting but they could get it after death. The widow admited later that they left that out at application. So, while I may be misinformed, the real world practices support the misinformation that I have. {I don't know why this is typing in bold}

I was told by a carrier rep that APS are requested with some life cases. I'm almost exclusively selling health, so I figured it was true. We live and learn.
That said, you might have been given correct info based on your full explanation here...

Who knows any more?

 

[scagnt83]

I may be misinformed but I am misinformed by the insurance companies. Just recently Americo had me re ask about policies applied for in the last year or so on a client that told they had no insurance. Americo told me they could see that the couple had applied with 2 or 3 companies but they could see the outcome. They wanted to know if they were just not accepted, declined, rated or if they person actually had the insurance.

RNA has us read the meds on the POS because they say they cannot get those if a person pays cash or is VA. Same on conditions. I've only had one contestable case declined with RNA and it was because the guy had a procedure done at the VA that would have caused the policy to not be issued. RNA could not get that info at underwriting but they could get it after death. The widow admited later that they left that out at application.

So, while I may be misinformed, the real world practices support the misinformation that I have.

And real world practice has shown the contrary through my example from Cincinnati Life.


Im not saying the VA does or does not report to Intelliscripts. I only stated what intelliscripts says on their website, and it wasnt specific to the VA.


The MIB however only deals with underwriting info, not claims.


The reason we have had different experiences with the MIB is that carriers choose how much or how little info they submit. Some do not even submit to the MIB at all.

So the amount of information available will vary from carrier to carrier. Just because some dont, does not mean that all dont.

And from my experience, fully underwritten & non-FE companies tend to be more active with MIB records.