Howdy nerv,
Kaiser Permanente is not a health insurance company, but
rather a "health maintenance organization" (HMO), an
important distinction when it comes to the following answer.
From the Kaiser Permanente "Fast Facts" web page.
http://www.kaiserpermanente.org/newsroom/fastfacts.html
"Nation's largest HMO: Kaiser Permanente is America's
leading integrated health care organization. Founded in
1945, it is a nonprofit, group-practice health maintenance
organization (HMO) ..."
The membership of the Medical Information Bureau (MIB) is made
of life insurance companies, according to the MIB website.
http://www.mib.com/html/about_us.html
"MIB Group, Inc. ('MIB') is an association of over 500 U.S.
and Canadian life insurance companies providing information
and database management services to the financial services
industry."
Because of this, and as explained in the article entitled
"Dispelling myths about insurance industry files" By Jacques
Chambers, taken from APLA's Positive Living Newsletter and
viewable at The Body website, Kaiser can't join, etc. the MIB.
http://www.thebody.com/apla/sep98/myths.html
"Only insurance companies may join this co-op so health service
plans such as Blue Cross, Blue Shield and HMOs like Kaiser are
not members. They neither supply information to it or can they
receive data from it."
This is backed up by this AccessMedNet article.
http://www.accessmednet.com/news/insurance-vs-private-payment.html
"Remember that your MIB report only contains information forwarded
to the organization by insurance companies."
You can recive a copy of your MIB file, if one exists, for the
cost of $9.00. Forms and more information can be found on the
MIB website.
http://www.mib.com/html/request_your_record.html
"MIB is committed to the philosophy that every consumer should
be entitled to know the contents of his or her record maintained
by MIB, and to correct any inaccurate or incomplete information
in the record. This benefits both the consumer and MIB by
insuring that MIB record information is as accurate as possible."
If you need any clarification, feel free to ask.
Search Strategy
Google Search on keywords: MIB "health insurance" Kaiser
://www.google.com/search?&q=MIB+%22health+insurance%22+Kaiser
Looking Forward, denco-ga |
Request for Answer Clarification by
nerv-ga
on
14 Aug 2003 13:09 PDT
Thanks denco-ga for a very complete answer. One question comes to
mind regarding your answer: You said, "Only insurance companies may
join this co-op so health service plans such as Blue Cross, Blue
Shield and HMOs like Kaiser are not members. They neither supply
information to it or can they receive data from it." So...what if the
health plan one applies for is not an HMO, but is a PPO such as those
offered by Blue Cross, Pacificare, Cigna, Aetna, CareAmerica and
others. Would a denial by any of these be listed?
Thanks
|
Clarification of Answer by
denco-ga
on
14 Aug 2003 19:43 PDT
Howdy nerv!
Even though Preferred Provider Organizations (PPOs) are
often compared to Health Maintenance Organizations (HMOs),
some PPOs are underwritten by insurance companies, and
thus some might be MIB members, directly or indirectly.
As this National Academy of Sciences article outlines,
when an insurance company is involved, so might the MIB.
http://www.nap.edu/readingroom/books/ftr/52fa.html
"For the Record: Protecting Electronic Health Information"
...
"The life insurance company will pay for the examination,
but she must sign a release permitting the results of the
examination to be forwarded to the Medical Information
Bureau (MIB). The life insurance company decides to accept
the risk of insuring her but forwards the hypertension
results to the MIB in accordance with the industrys
practices because her hypertension, although under control,
may potentially affect her longevity."
You will need the free Adobe Acrobat Reader to view
the documents referenced below. If you do not have
it, you can download it from the Adobe website.
http://www.adobe.com/products/acrobat/readstep2.html
Beale Professional Services (and others) offers a PPO
plan that the New York Life Insurance Company underwrites,
and MIB is mentioned in this PDF file.
http://www.bealepro.com/apps/OBA_PPO_1000or2500_Ded.pdf
"OBA $1000 or $2500 DEDUCTIBLE PPO NETWORK PROGRAM"
...
"We may make a brief report to MIB; however, we will not
disclose our underwriting decision."
A subpage on the Princeton University website speaks to
Blue Cross/Blue Shield companies not belonging to MIB.
http://www.wws.princeton.edu/cgi-bin/byteserv.prl/~ota/disk1/1992/9208/920809.PDF
"BC/BS companies are not members of MIB, and therefore do
not use its data ..."
So, it probably depends on the PPO, and if it's underwritten
by an insurance company, and their individual policies. Best
to ask the PPO provider if they are MIB members, and certainly
make sure to read their forms very carefully for any mention
of MIB.
Hope this helps!
Search Strategy:
Google search on the keywords: PPO MIB
://www.google.com/search?q=PPO+MIB
Looking Forward, denco-ga
|
