Knowing the value of improved fasting guidelines

by ExamOne on February 13, 2017

In our continued effort to improve the applicant experience while adhering to the latest medical standards, we have updated our fasting guidelines for life insurance exams. Our recommendation to clients and applicants is that fasting is no longer necessary before a life insurance blood or urine collection. This recommendation is based on evidence that shows the minimal impact that fasting plays on the standard life insurance laboratory panels. This update not only allows greater flexibility for applicants to complete exams throughout the day, it also follows the medical community’s guidelines for fasting.

Historically, the insurance industry required fasting because it was believed to produce more accurate glucose and lipid tests. When we switched to A1c testing on all specimens in 2016, this eliminated the need for fasting because A1c is not impacted by a recent meal, as glucose is a more reliable determination of long-term glucose control. Additionally, clinical research as well as our own internal fasting studies show that triglyceride is the only other analyte affected by a recent meal. Armed with the “hours fasted” information, underwriters can make a sound decision on each applicant.

For any additional clinical support of this recommendation, see below references and sources.

“Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary.”

Source: Davinder Sidhu, Christopher Naugler. Fasting Time and Lipid Levels in a Community-Based Population.  Archives of Internal Medicine. 2012; 172(22): 1707-1710.

“The exceedingly small gain of information from a fasting blood test likely does not offset the logistical constraints put on patients, laboratories, and doctors for the procedure.”

Source: (Editorial) Dr. J. Michael Gaziano. Comparison of a Novel Method vs the Friedewald Equation for Estimating Low-Density Lipoprotein Cholesterol Levels From the standard Lipid Profile.  Archives of Internal Medicine. 2012; 172(22): 1705-1706.

“Most lipid levels differed minimally when measurements were performed nonfasting or fasting, with clinically insignificant changes; negligible changes for high-density lipoprotein (HDL) cholesterol, slight changes (up to 8 mg/dL) for total cholesterol, LDL cholesterol, and non-HDL cholesterol; and modest changes (up to 25mg/dL) for triglycerides.”

Source: Samia Mora. Nonfasting for Routine Lipid Testing From Evidence to Action. JAMA Internal Medicine. July 2016; Volume 176 Number 7, 1005.

“Lipid levels at most change minimally in response to normal food intake in individuals in the general population. Furthermore, nonfasting lipid profiles predicted increased risk of cardiovascular events.”

Source: Ann Langsted, Jacob J. Freiberg, Borge G. Nordestgaard. Fasting and Nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation. 2008; 118: 2047-2056.

“Measurements of hemoglobin A1c [HbA1c] more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose.”

Source: Hemoglobin A1c Outperforms Fasting Glucose for Risk Prediction. John Hopkins Bloomberg School of Public Health ,,. March 4, 2010.

For additional support for this decision, please see our “To Fast or Not to Fast” white paper or contact Betsy Sears, Executive Vice President, Laboratory Strategy and Sales, at, or Dr. Jim Palmier, Medical Director at with additional questions.

Flexible contact center solutions

by Jessica Wahaus on February 6, 2017

Electronic data collectionYou need answers. Literally.

ExamOne’s contact center solution has specialized in collecting consumer information for nearly 20 years in an efficient and quality-controlled environment. From complex surveys and questionnaires to friendly reminders, our experienced team and advanced technology can get you answers.

Some industries require a more comprehensive contact center partner to create customized calling scripts. ExamOne collaborates with you to tailor the conversation to fit your business requirements and workflows. Our five North American contact centers offer both inbound and outbound services, as well as warm transfers for real-time communication.

For life insurance clients, our contact center can enhance our other data product offerings. We can identify opportunities to reflex Attending Physician Statements, add additional exam/lab requirements, and include prescription history results for condition association during the interview. These opportunities help improve the applicant experience by eliminating the number of touches they receive throughout the process, and increase the comfort level of answering personal questions over the phone rather than face-to-face. Our staffing and technology capabilities also make us the ideal partner to outsource other outreach needs including policy renewal reminders, appointment scheduling, and satisfaction surveys.

Our extensive experience with medical and technical terminology gives our staff the ability and expertise to handle complex question sets for surveys or questionnaire data gathering. These skills also benefit other industries that require a higher level of call staff quality and knowledge. If your business utilizes electronic signatures, we are fully integrated with DocuSign® to obtain signatures with voice authorization.

With 1.5 million orders completed each year, our contact center specialists are committed to gathering the information you need while providing your audience with a pleasant experience.

For more information, email

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