Placement Issue

[HoosierLife]

Ok so initially I placed this lady with 5 star. She got approved graded cause of the depression, bipola, schizo question.

So I run her through with Americo. They rate her UP3 because of her scripts. I checked her scripts and didnt understand. She's in a few that don't matter but she's on methadone for fibro pain, spiranalactone for potassium, I know I know, but she's also on potassium so I beleive her (this is the med I think got her UP3 cause it can be used to treat CHF), and she used to be on Serequel for depression/anxiety/help with sleeping. I called UW before placement and they said methadone was fine, so other than the spiranalactone, cause all the other crazy pills shes on they're ok with.

So this time I decide to use a carrier that has a phi so I can listen in. I use Oxford cause it was the next cheapest one up and I know they run the script check right there and will ask questions about those scripts. They decline her because of the Serequel (could be for bipolar/schizo) and methadone. They sent it to UW for a review (while my client is in tears ) and Oxford calls me back and says I would need something from her doc explaining those two meds before they could approve her.

I plan on calling Settlers tmw morning and see where theyre at on these meds and Monumental is my last choice before I try AmCon. This is a replacement and her current rate is $47. Americo was $35, Oxford $37, Settlers $38, Mon $40 and AmCon $46.

All in all this has been a great learning experience. Americo will take all the crazy meds, so I'm not sure if its a combo of meds or just the spiranalactone that is for potassium but could be for CHF that's the problem.

Oxford has no problem with spiranalactone after they asked but didn't like the crazy meds or methadone.

Anybody have any suggestions other than the way I'm going?

 

[Rearden]

Monumental is the Preferred Solution.

 

[Newby]

Doesn't Oxford still decline them if they have been declined or rated up by any other carrier?

 

[HoosierLife]

Doesn't Oxford still decline them if they have been declined or rated up by any other carrier?

Well the question is declined or postponed. I'm pulling a JD here on that question. To me postponed means that the ins co said, "hold on, lets wait 2 months and then we'll approve this."

I could be wrong...

 

[moonlightandmargaritas]

I'm pulling a JD here on that question. To me postponed means that the ins co said, "hold on, lets wait 2 months and then we'll approve this."

I could be wrong...

You are.

It's "let's wait XX months and then we'll consider this."

 

[HoosierLife]

Well either way that doesn't mean graded, right?

 

[jdeasy]

Well the question is declined or postponed. I'm pulling a JD here on that question. To me postponed means that the ins co said, "hold on, lets wait 2 months and then we'll approve this."

I could be wrong...

You are not pulling a JD there. A postpone means it's declined. I would not place that person with Oxford or any other company that asks that question.

 

[VolAgent]

You are not pulling a JD there. A postpone means it's declined. I would not place that person with Oxford or any other company that asks that question.

No, a postpone is a different than a decline. A postpone means give it some time and we'll think about it if nothing else happens between now and then. A decline means they want nothing to do with it and are unlikely to reconsider at a future date.

 

[jdeasy]

No, a postpone is a different than a decline. A postpone means give it some time and we'll think about it if nothing else happens between now and then. A decline means they want nothing to do with it and are unlikely to reconsider at a future date.

I suppose you are right technically. But for me in writing life for 10 years now every postpone has been a decline. The letters sent to clients also said "decline" in them. They usually say something the possibility of a re-open but the cleint doesn't have insurance with the postponing company.

 

[HoosierLife]

You are not pulling a JD there. A postpone means it's declined. I would not place that person with Oxford or any other company that asks that question.

The JD move I was referring to was not calling the company and asking but just going by the app.