how often does the diagnosis of "osteopenia" result in denial of
medical insurance as a pre-existing condition? |
Request for Question Clarification by
jbf777-ga
on
04 Mar 2005 10:12 PST
Hello -
Acceptance or rejection is predicated on several variables.
Are you looking for statistics on this, or a general number as it
applies to your locale? If the latter, can you supply more detail,
such as state (if in the USA), age, sex, whether using medication or
not (and type), whether it's crippling, etc.
Thank you,
jbf777
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Clarification of Question by
osteopenia-ga
on
05 Mar 2005 15:07 PST
I am a physician who cares for patients with osteoporosis. Many
patients of mine have a bone density test, and turn out to have
"osteopenia" which is the intermittent category between Normal and
Osteoporotic bone. "Osteopenia" is not necessarily a disease
(statistically, 16% of the normal population lies in this lower
percentage of the normal bell-shaped curve of bone density). However,
many of this are being denied insurance on this basis.
I live in Arizona, but if possible, I would like to find out the
statistics on this nationwide (which may be difficult to get from
insurance companies) in order to organize opposition to this practice
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Request for Question Clarification by
pafalafa-ga
on
05 Mar 2005 17:18 PST
Dr. O,
Can you explain a bit about how the insurance companies know about the
patient's prior assessment of osteopenia? Are they requiring
submission of this information as part of their application process?
The more we know of the context, the better we can research this question for you.
Thanks.
pafalafa-ga
|
Request for Question Clarification by
pafalafa-ga
on
05 Mar 2005 19:43 PST
And the converse as well...how do the patients know that the reason
they have been turned down is due to osteopenia?
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Clarification of Question by
osteopenia-ga
on
06 Mar 2005 06:53 PST
The ways that the insurance companies know about the diagnosis of
osteopenia is both that they require submission by the applicatant of
any known medical diagnoses by the patient, but also, I believe they
can obtain information on any past claims for doctor or hospital bills
where they can see the reason (code) submitted by that provider for a
visit. For example, if I see a patient or do a bone density test and
submit a bill to their insurance, I must submit a code (reason) for
the visit such as "733.00 osteopenia". I believe that future potential
insurers have access to this information, but am not 100% sure. The
patient may or may not know they were given this diagnosis, but in the
case of people I know who have been turned down for insurance, they
were aware they were given this diagnosis.
I am looking for any literature, documentation or statistics on how
often this is done.
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Clarification of Question by
osteopenia-ga
on
11 Mar 2005 04:22 PST
I live in the state of Arizona. Thanks for your answer. You have hit
exactly on my question. "Osteopenia" is in many ways similar to being
overweight where neither have been traditionally considered
"diseases", but there is a continuum of risk for future adverse
outcomes compared to people who are "more normal". I understand the
rationale for insurance companies choosing to elminate this higher
riskpool when possible. I would just like to get some statistics or
numbers on of how often this is done
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