Med Supp Underwriting

[Medicare bro]

That would be considered a HIPAA violation . . . but they should be willing to tell you client/prospect.

I thought they would take almost anyone who could fog a mirror . . . as long as they were willing to pay the level 2 premium rates

Every carrier has there own interpretation of HIPPA. Half won't tell you the other half will.

 

[annon123]

I have a client who was just rejected by UHC for a Med Supp in Florida and I was wondering if anyone has any ideas on which company might have more liberal underwriting guidelines that I can go to for this client.

They won't tell me the specific reason for rejection.

They probably report it to Milliman. I have had to go that route with carriers that are squirrely about discusing the reason for the denial.

Your person may have to wait a couple of weeks until the report is updated, but you can be amazed (and sometimes shocked) at what is in there. It isn't unusual to find bogus claims and diagnosis coding or upcoding "errors"

They should tell the client the reason(s). Takes about 2 weeks for the letter to come which also states why although the finer details of why was skimpy in the case I just dealt with (in this case date of visit they were using the diagnosis code from to deny, and the diagnosis code used for the cancer where a different, acceptable one, could have been used - agent over the phone told us that) . As others have suggested you call medical underwriting in a 3 way call they should tell the client (direct line 888-200-0310).

A client and I called twice and got new information on the second call. Turns out she was rejected for two wrong diagnosis codes. He had given me permission to ask questions and so I asked questions that got me answers that were NOT in the letter that came. I was told the one question that was failed it was because of a diagnosis code in a last January apt - except the client had not gone to see that specialist for that reason. The other reason was that for the cancer a diagnosis code for active cancer was used at the annual check up even though he was in remission and had been so for longer than the UHC question had asked for (eg 5 years for blood cancers and 3 years for the others). The records were sent and a letter from the oncologist stating the patient continued to be in remission and were just having an annual check up.

Got letters from the MD's, they also wanted 5 years of her PCP medical records, and 3 and 5 years of the appropriate specialities for the wrong diagnosis codes. He was then accepted. The client can NOT send the visit notes. They have to be faxed from a doctor's office. The catch for the client is that then the medical records aren't free - although in this case the PCP, after hearing that, told the patient to print all required visit notes (EPIC/mychart), bring them in and he'd have his staff fax them for free.

Fax 888-836-3985 attention United Health Care underwriting department, include their AARP number (so even though they can drop AARP after they sign up, for this we were told they needed it so they might have to join again if they dropped) and if they have a UNC supp or MAP then include that number as well.

 

[goillini52]

Are there any carriers, generally speaking, that you would consider to be easier to get clients accepted? I don't do med supps that often...

What are the health problems? Meds? Height/weight?

 

[goillini52]

The short answer is yes but without the specific condition we can't tell you which one.

The best way to learn which company is more lenient is to study the application. Make copies of each carrier's application and put them in a 3-ring binder. Just the pages that have the medical questions. And learn them.

MS and FE underwriting is pretty simple. If the applicant can pass the questions he's usually going to get approved. There will be times he won't. Things like forgotten scripts or lying and such.

The first underwriter to see the application is going to be you.

Or you can do it the easy way and use Toolkit.

 

[goillini52]

Try United American have no idea what their rates are in FL. Their health questions haven't changed in 40 years. Old simple questions.

I think they have. They didn't used to ask about diabetes.

 

[Chazm]

I have a client who was just rejected by UHC for a Med Supp in Florida and I was wondering if anyone has any ideas on which company might have more liberal underwriting guidelines that I can go to for this client.

They won't tell me the specific reason for rejection.

Try Humana. Uhc used to have 2 or three questions but not anymore. Humana doesn't have as many IMO

 

[Medicare bro]

Anyone have a carrier for diabetes and pacemaker implanted?

 

[annon123]

Try Humana. Uhc used to have 2 or three questions but not anymore. Humana doesn't have as many IMO

Appeal it. If you have the client call (and have it a 3 way) you can find out far more information than what is in the letter (see my post earlier in this thread).

 

[Ron Van D]

Don't tell anybody, but the past year or so, I've really had to do some work for my clients and... underwrite.

Man, that sucks! I'll send you a Red Bull.

 

[Fisher]

Try United American have no idea what their rates are in FL. Their health questions haven't changed in 40 years. Old simple questions.

Way back in the day - early 90s - UA would take O2 use. That was helpful.