MIB and coding

Posted by Jack Cotlar on Mon, Feb 27, 2012 @ 04:55 AM

MIB is as important to the insurance underwriting process as it is misunderstood. What MIB is, what it does and what it does not do was the?topic of my most recent blog, “What you need to know about MIB and how it functions It generated several emails from life insurance agents.

Their main concern was that if a test is "coded" because of being abnormal, an adverse underwriting decision will necessarily?happen. This is not the case. Often the abnormal test result does not have underwriting significance and because, by MIB rules an adverse underwriting decision is not to be based solely?upon an MIB code. In addition, a subsequent test that was coded normal might negate the significance of the earlier abnormally coded test. Case in point ... as the Medical Director of?an insurance company I was asked to interpret an EKG done in February 2012, which was normal. We are aware that there is an abnormal MIB EKG?code from January 2011. The underwriter will "code" the current EKG as being normal so that another underwriter seeing the case in the future?will have a more complete and accurate picture of the EKG information.

Topics: Strategic Medical Consulting, MIB, Life insurance medical underwriting, Insurance medical underwriting, Dr. Jack Cotlar, Underwriting