Medical Reports


 

There are several large companies that gather information about individuals with insurance. Two of the largest groups are MIB Group, Inc. (formerly the Medical Information Bureau), and OptumInsight (formerly Ingenix, a wholly owned subsidiary of UnitedHealth Group). Optum has access to a database of medical records to make analyses and projections about the health care industry, while MIB uses information exchanged during medical transactions to determine eligibility for underwriting. Many individuals may be unaware that the data transmitted through health care transactions, such as claims and contact information entry are sent to Optum for statistical and filing use. MIB uses personal medical information when verifying an individual’s medical history in the underwriting process, to ensure they are not withholding information about their health. If you wish to find out if you have been included in their database, it is best to contact the companies directly and ask for your medical report.

OptumInsight’s National Provider Database collects from over 600 sources including commercial, public, and proprietary sources, which they screen for accuracy before entry into the database. MIB Group collects the information of those who have applied for health insurance, life insurance, disability insurance, long-term care and critical illness insurance from member companies and private sources. However, MIB does not use everyone who has applied for insurance in their database. Optum is affiliated with the federal government, health insurance companies, doctors, and hospitals. MIB Group, Inc. gets its information only through MIB member companies, which include private health insurance companies and providers. Though these companies both gather information and make files for individuals, their agendas are separate.

The most important part of knowing these companies exist is making sure your information is current and accurate, so that you do not get denied or overcharged for health insurance, or added as a false statistic. When your information is in their system it is safe from identity theft, and is being used only for professional medical research or health insurance purposes. Because these business entities are working hand-in-hand with health insurance companies and providers, they must abide by HIPAA law to protect your information and inform you when it is being shared by any party.

About MIB

MIB collects information from individuals who have applied for individual health insurance in the last seven years. The insurance company they applied with must be an MIB member, and you must have a significantly health or life-threatening condition to be on file. An MIB file contains the codes used to identify medical procedures or conditions, as dictated by the insurance company that gives them the file. Your health status and history will be outlined in codes, as well as some non-medical information like activities that put your health at risk or results of a motor vehicle report that proves a poor driving record. If you have an MIB report and it is going to be checked when you apply for insurance, the insurance company (who must be an MIB member) has to give you an MIB Pre-Notice to sign for disclosure. Insurance companies use MIB files to assess an applicant’s eligibility for a health plan to compare to the information provided by the applicant. Underwriting decisions cannot be based upon what the MIB report says, but they require further verification from the insurance company and make the process longer.

To find out if you have an MIB file, you can contact MIB and ask for a copy of your medical report for no cost. You will have to disclose some personal information in order to properly identify yourself, give them accurate current information, and they should mail you a response within 15 days as to whether you have a report or not. For more information on what MIB does with your information, read their consumer guide.

  • Request Your Information from MIB: 866-692-6901 or use their online form.

 

About OptumInsight

OptumInsight collects, licenses, and sells information about a patient through their provider, for the purpose of keeping contact information current, improving the claims system, and validating provider identity. Like many companies with electronic personal information, Optum has a commercial database of healthcare providers that they license to organizations related to health care. They collect, license, and publish your personal information, so you may wish to opt out and not be included in the database.

In order to opt-out, or remove your information from being active in the database, they first want you to verify your identity by providing current personal information. Optum warns against this, because it threatens the accuracy of information given when you see a health care provider. So basically, the next time you go in for a visit, your name will be placed back into the database. Your information is safe in the database, protected from identity theft and fraud. If you are an insured individual and want to know if you are in the database, change your information, or remove yourself from their database, contact the Optum headquarters. Before you do so, it is important you know their privacy policy.

  • Contact OptumInsight: 888-445-8745 or email inform@optum.com

 

Sources:

1. MIB.com, “MIB Group, Inc. Consumer Guide”. http://www.mib.com/html/consumer_guide.html

2. OptumInsight.com, “About Us”. http://www.optuminsight.com/about/

3. OptumInsight.com, “Optum Provider Profile FAQs”. http://www.optuminsight.com/providerprofiles/