The MIB – Health Insurance Bureau Business Intelligence Mining May Go Beyond Just Healthcare Information
Posted Apr 08 2010 10:29am
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.
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.
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.
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.
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.
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.
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).
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.
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
“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.