Scan Medical Insurance

can health insurance companies request medical records from other health insurance companies?

When I was in college I was in a relationship that made me really depressed, and the psychologist on campus referred me to an outside therapist with a diagnosis of "major depression"--the outside therapist corrected it and said she believed i had circumstantially-related depression, but she told me she coded the claim with the referring guy's "major depression" label so the insurance company wouldn't hassle me about the paying the claim. I worked with her for a 6 months --no medication, just got out the relationship--and am happy and healthy :) Now I'm reading all kinds of scary stuff about MIB, retroactive declining of coverage, etc and I currently have new individual (underwritten) coverage--I can ask her to correct the claim with my old company, but it seems like any action might rock the boat and I'm scared--if they didn't notice it, should i leave it be? or is there a chance that if i (god forbid) get something serious down the road that my current insurer will dig up my records from my old insurer to look for a reason to not pay? she was trying to do something to make my life easier but this whole thing has turned into such a mess! So it sounds like this may not be a good thing to leave be-- what's the best recourse to fix it? Contact my old company? New company? MIB? I asked for a copy of my MIB report and they said they don't have a file on me, which is even more confusing...

Public Comments

1. Insurance companies do not report health related claims to the MIB, the providers do. Insurance companies report applications and declines.
2. Not exactly. They can ask YOU to release permission for medical records to be sent to them, or they can check with the Medical Information Bureau (MIB). Yes, there's a chance that what you're describing, could happen. She committed insurance fraud, with your consent. Likely, eventually, some way, this WILL come back to bite you.
3. Since you have an individual health insurance policy, you had to complete an application. In this application it asked you specifically on certain questions about your prior health, treatment etc. It also most likely had you give doctor names of who treated you. When you completed that application, you also signed that you will allow them to get your medical records. The coding itself if not the issue, but what is in your medical reports. Everytime you go to a doctor, you fill out a form and a lot of them will ask if you have seen other doctors for other reasons. They may ask you the reason for seeing those doctors or if you are still treating with them. It then becomes a part of your file and if the health insurance company suspects that you did not disclose everything on your application and then pulls your medical records and see doctor so and so, then will request doctor so and so for their records etc. Did you get this insurance thu an agent or yourself online? If with an agent, ask the agent for their advice if this would be relevant or not.