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Why are insurers using Final Expense?

Drug2Today, there are more than 35 million Americans age 65 and older. That includes 10,000 Baby Boomers who turn 65 every day and this trend will continue for at least 15 more years.[i]  Additionally, there are 95 million Americans who do not have life insurance[ii], and approximately 36 million people who do not have any savings, retirement savings or investments.[iii]

So what happens when one of these individuals with no life insurance, no savings, and no retirement savings passes away and their family is left with the expenses incurred for a funeral? Many insurance carriers offer a Final Expense product to cover this growing segment of consumers.

Final Expense is a life insurance product that can be purchased to cover funeral and burial costs as well as bills and debt. They are issued as small face amounts and most are covered under simplified issue underwriting.

How ScriptCheck can assist you in your underwriting of Final Expense

According to the LIC/CSG Final Expense 2013 survey report, 46% of Final Expense products incorporate a prescription history check. When issuing a life insurance policy to someone over the age of 65, chances are they have a greater list of prescribed medications than a younger individual.

Through ScriptCheck®, you can build a more complete profile on your applicant.* We work with some of the largest pharmacy benefit management (PBM) companies in the country and have developed exclusive relationships that help capture a more comprehensive review of your applicant’s prescription drug history. We are the only provider that represents 85% of the PBM market share. Additionally, approximately 40% of maintenance medications are mail in orders which can only be pulled through a PBM.

Benefits:

  • Saves time allowing underwriters to make faster decisions
  • Flags concerning medication
  • Eliminates costly human mistakes
  • Translates large volume of data into actionable information for an underwriter

Additionally, through our vast data product offering, we can provide additional services that will help you build your applicant profile. We can complete a health history phone interviewprovide a real-time, scored motor vehicle report, and provide a QuestCheck® and MIB report.

While Final Expense products are smaller face amount policies, it is more important than ever to accurately assess risk and to ensure fair and appropriate mortality assumption. Contact Beth Millay at Beth.A.Millay@ExamOne.com today to learn more.

*ExamOne requires prior written consent from insurance applicants, which appears in the HIPAA-compliant authorization that is part of the insurance application. The authorization must be signed and dated prior to accessing the information.


[i] US Census Bureau

[ii] www.Lifehappens.org

[iii] Social Security Administration

A prescription history (ScriptCheck®) report can provide underwriters immense detail into an applicant’s prescription drug use.* From identifying medication not disclosed in the interview to understanding prescription adherence, a prescription history report can help underwriters identify potential red flags when making underwriting decisions.

Marnie Vieselmeyer, ExamOne’s new Data Specialist Strategic Account Executive, answers some common questions about what to look for in your ScriptCheck report and how to interpret the results.

Reporting sections

Q. Which details does the ScriptCheck report include?
Your reports can be customized to fit your needs. The following components can be included under your results sections.

Prescription history report components

A few of the sections are summarized below.

Specialty summary: This summary displays a list of the providers and a high or medium score for their specialties. This view is designed to give you a summary of high-risk doctors’ specialties from the prescription fill records.

Drug summary: Underwriters can see an overview of all prescription drugs discovered for that particular applicant, including how long each prescription has been prescribed.

ScriptCheck drug summary table

Q. Is there a way to easily identify if an individual is taking opioid medication?
Yes, you can find this under the ‘Opioid Daily MME’ section. Our look-back graph will calculate a daily morphine equivalent. This calculation identifies all filled prescriptions that are classified in the opioid family of drugs and helps underwriters quickly identify chronic opioid users. 

ScriptCheck opioid MME graph
ScriptCheck opioid MME table

Q. Is there an easy way to sort reports?
Yes. This is configured during the account setup or can be changed through your Regional Account Manager after an account is already set up. The sections that can be sorted include the drug summary section (see image above) by any of the column headings, and the prescription detail section by drug name or filled date.

ScriptCheck prescriber detail

Scoring details

Prescription history report scoring

Q: What do the various colors, shapes and numbers mean in the ScriptCheck report?
Our score provides a number and a correlating colored shape for each score level. The ExamOne default scoring will display: zero (green circle) for low risk, five (yellow triangle) for medium risk, and ten (red diamond) high risk.

Q. What sections are scored?
Multiple sections may be scored within the ScriptCheck report, including the prescriber specialty and the drug summary. The drug summary scoring can be based on therapeutic class, drug level or drug rule. The client determines this and some implementation may be necessary.

Scoring is reported at the therapeutic class; customized drug-level and drug-rule scoring are available. 

Q. How do I customize the scoring for my requirements?
Customization and sorting are both handled during the account setup process. One of our specialists will walk through the sections that are available and work with the client to determine which sections should be included and which should be suppressed. Additionally, a client can request further customization through our Professional Services workflow.

We hope this answers any questions you may have regarding the prescription history reports you receive. If you have further questions, or would like to set up customized scoring, please email Marnie at Marnie.X.Vieselmeyer@ExamOne.com.

Look for our next article in this series where we will walk through our clinical laboratory history report, LabPiQture™, where you can access physician-ordered clinical test results related to preventive care, disease monitoring and diagnosis.

*ExamOne requires prior written consent from insurance applicants, which appears in the HIPAA compliant authorization that is part of the insurance application. The authorization must be signed and dated prior to accessing the information.

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