While it’s not an official term that patients often hear, a “health credit report” is something that is used constantly as a tool by health and life insurance companies when they assess someone’s risk and determine their premiums and coverage options.
Similar to a financial credit report, a health report builds on data related to someone’s medical history, prescription drug usage and other health-related factors to create a profile.
Understanding and monitoring that report is important, according to industry experts.
“It works just like a regular credit report,” said Christian Gitersonke, the CEO of AR Rescue, a Nevada-based company that provides medical billing services for health care providers. “It follows you around just like a credit report does, but for your health.”
In the same way someone would keep a close eye on their credit score to make sure that everything is correct, Gitersonke said people should make a point to check their health credit report for any mistakes.
Such mistakes may include an incorrect diagnosis or outdated information.
If an insurer uses incorrect data to assess someone’s health risk, the person may end up paying higher premiums or even be denied coverage.
“If the provider’s office does it wrong, or the insurance company processes it wrong, then there’s a mark on your health credit report,” said Gitersonke. “Just because the claim got paid doesn’t mean it’s correct.”
Gitersonke’s advice for everyone is to request their medical histories from their health insurance companies, past and present.
Even if someone has gone through multiple companies over the years, they can formally ask each one to send the records they have.
If mistakes are discovered, insurance companies are typically willing to fix them, according to Gitersonke.
“If you pulled all of your health information, you’d probably find that you got rated a lot sicker than you actually were,” said Gitersonke. “I think the biggest takeaway is to be your own advocate as a patient and to know what’s actually happening.”
In some cases, fixing a mistake may mean an insurance company realizes that it overpaid for a particular service, meaning there is extra incentive to correct the error as it could allow the company to request money back from a health care provider.
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