As business intelligence increases to find out every stick of information about individuals, so goes the MIB, the Medical Insurance Bureau.  What is alarming as far as information contained is the fact that it can and does go beyond just claim information.  Your credit report may be in here as well as your driving records.  If you read below there’s a little additional information quoted that could be here.  image

The collection of algorithms mined though various sources provide the decision making information on computer screens.  I have covered a bit about the MIB a while back at the link below. 

What is the MIB - Medical Insurance Bureau - and how does it affect qualifying for insurance?

The drive for behavioral underwriting has increased tremendously with employer provided health insurance, in other words how big of a risk are you and add on information found in files as such at the MIB, well you could have a huge history of mined data that you are not aware of.  Yes you are in fact “guilty” of all kinds of issues and it is up to you, the consumer to prove yourself “innocent” here.  The non profit organization has been around for years and now with adapting to Web 2.0 technologies, the collection process of information has accelerated for them too. 

Wellpoint Enters Contract Agreement with Red Brick for Behavioral Underwriting

With many companies exploring and using both biometric monitoring and behavioral underwriting today, I might guess the files could in fact get much thicker pretty quickly, it’s all about the data and the algorithms they use for collection and sharing.  I have a friend of mine here that has been fighting for years to get his record corrected to no avail. 

Behavioral Underwriting With Biometric Employee Screenings – Red Brick Secures 3 More Clients

It does make one wonder how an agency for health insurers that uses information as such gets categorized as a “consumer reporting agency” as this is not for the benefit of the consumer, it’s for the underwriters and the fact that a consumer can get a copy of what is on file seems to be a side lines interest here to keep things “legally” but perhaps not “morally” correct. 

Here’s some additional information quoted from Know Your Health

With some of this information some may think twice about hooking up devices like wireless bottles that remembers your prescriptions and reminds you, it reminds and notifies a few other sources too as well as other devices on the market, just be aware of the privacy factors, or lack of sometimes when finding out as a consumer what is the “right” decision for you. 

“Ingenix, Inc. is a wholly-owned subsidiary of UnitedHealth Group, Inc. and sells the MedPoint prescription profiling data product.  Consumers should be aware that Ingenix, Inc. has contractual relationships to acquire data from Pharmacy Benefit Managers (“PBM”), which maintain records of individuals’ prescription drug histories.  Ingenix, through MedPoint, obtains an insurance applicant’s five-year prescription drug history from the PBMs and creates a prescription medical profile on the applicant for the insurance company.

The medical profile generated by MedPoint includes, but is not limited to, prescription drugs, including dosage and number of refills filled by the insurance applicant for the previous five years. It also includes for each drug, the name and address of the dispensing pharmacy, as well as the name and address of the prescribing doctor, including specialty medical practice.  The medical profile generated by MedPoint analyzes the individual’s prescription drug history, and provides, based on that analysis, potential medical conditions that may be present and predictive scores for the individual.  (Source, Federal Trade Commission Complaint, February 2008).

According to the Washington Post, Ingenix, Inc. reported corporate revenues of $1.3 billion in 2008.  In addition to Ingenix MedPoint Prescription Profiling, Ingenix Inc.’s other “underwriting and actuarial solutions” include Impact Pro for Underwriting, Ingenix Health Technology Pipeline, Ingenix StepWise Automated Rating, StepWise Medical Underwriter, and Symmetry Pharmacy Risk Groups.”

Rescission rates on the brochure helped one satisfied client disqualify applicants from the start…strange marketing for consumers to see by far in my estimation when they need care.  It’s all about keeping the underwriters happy and not about care it appears. 

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MIB Inc Medical Information Bureau Fact Sheet

The MIB offers software called Audit Focus and Security Alert Services. 

You can read more here:

“With Audit Focus you can:

  • Look at every new policy from every ceding company
  • See which cases are outside of your risk tolerances
  • Quickly identify risk concentrations and prevalence of unexpected medical conditions
  • Identify high-risk cases by ceding company to prioritize audits
  • Monitor those companies you are unable to audit
  • View reports by your most important metrics
  • Better manage risk for improved financial performance

A Security Alert search is automatically performed on every applicant run through the MIB Checking Service data base – this offering is a useful adjunct to check name assignments beyond underwriting such as policyholder and beneficiary changes, claims, etc. Both our web-based Transactional Service and outsourced Portfolio Sweeps use MIB’s precise name search technology. Security Alert Services gives companies the flexibility they require to meet their unique needs.”

If you have read this far, do you maybe think what I say about us fighting healthcare battles with “swords and daggers” and going up against those with “machine guns” has some merit here? 

When I say “machine guns” I mean “data machine guns”, aka “The Algorithms”.  This exists today all over Wall Street too as they are the partners of healthcare for profit and make sure the dividends are paid out accordingly and shareholders are kept happy.  From what I read here with the various intelligence companies owned by United, they appear to have money rolling in from all sides, even from other insurance carriers.  BD 

The Medical Information Bureau Inc. (a/k/a, MIB Group, Inc., a/k/a, MIB, Inc., a/k/a, MIB Solutions, Inc.) collects and furnishes information on consumers to all Medical Information Bureau (MIB) member corporations for use in the insurance underwriting process.  According to MIB, Inc. marketing materials,

“MIB, Inc. is the premiere provider of fraud detection information for individually underwritten life, disability income, long term care and critical illness insurance.  MIB member companies rely on its Checking Service for the fast, secure aggregation and  exchange of data to combat fraud, improve underwriting effectiveness and increase product line profitability while ensuring fair pricing for all applicants.”

In addition to an individual’s credit history, data collected by the Medical Information Bureau (MIB) may include medical conditions, driving records, criminal activity, drug use, participation in hazardous sports, and personal or family genetic history, among other facts.

The Insurance Industry Shares Intelligence through the MIB, Inc. | AnnualMedicalReport.com

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