APS

Medical record retrieval

Traditional Attending Physician Statements (APS) have been a part of the standard risk assessment process for decades. However, it can be cumbersome, time-consuming and costly. It’s a common pain point for both home office underwriters and life insurance agents – extending the policy issue cycle time into weeks.  It requires multiple contact points with physicians and applicants to obtain the information from the medical facility.

The frustration we hear about the APS process has resonated through our annual Customer Satisfaction Survey. Over the past three years, APS time-service and service quality continue to fall short of expectations. As a result, we have made it a priority to identify ways to improve and invest in this process, to help make it a simpler and faster solution. 

Here are 4 ways we are investing in our medical record retrievals to improve the overall process  

Real-time medical record results – Through LabPiQture™ and medical claims data, insurers can receive up to seven years of historical laboratory testing results. These results are retrieved in near real-time, allowing insurers to make decisions quickly and confidently. From physician-ordered testing results to doctor specialties, insurers receive a comprehensive report detailing past laboratory tests.

The nature of LabPiQture real-time access provides our partners the ability to incorporate medical records in an accelerated workflow or a full underwriting workflow. Recently, during the COVID-19 pandemic, insurers have adopted LabPiQture as an alternative to a paramedical exam. If the LabPiQture report does not provide sufficient information, it can be triaged into a full underwriting workflow.

Electronic Health Records (EHR) – Now with a connection to leading EHR providers, ExamOne has direct access to electronic medical records. Through this integration, physicians listed in the EHR database will be identified and the APS request will be routed to the EHR system, reducing days to weeks off the APS request wait time.

Direct connection to copy service – One critical component of the process affecting the APS turnaround times is the copy services contracted to release records on behalf of the provider. We have secured direct connections that allow us to bypass the doctor/provider and reach out directly to the copy service. This reduces the number of calls and wait time in reaching out to the physician’s office and improves the overall communication/status process.

APS Summary – Through a partnership with Aosta Insurance Services, we are leveraging their technology to provide a summary of any medical file. This tool is directly integrated into our retrieval process, eliminating extra connections and reducing turnaround times. This summary service reduces the time spent reviewing each individual APS, allowing insurers to spend their time in other areas.

A few tips that could help improve time service and overall quality of the APS orders:

  • Provide the full name and address of the physician or medical facility where records are being requested
  • Provide the HIPAA authorization at time of ordering
  • Provide the applicant email address that can be utilized should the medical facility require a special authorization. ExamOne will forward the appropriate form directly to the applicant for signature

Our goal is to help alleviate some of the pain points insurers and agents feel when it comes to an APS. Applicants are making the important decision to purchase life insurance, and we want to make the process as easy and rapid as possible, for you and for them.

Note: 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.

You trust us to handle this important step in your client’s journey to protecting their family, but how are the health data for life insurance policy collected? It’s likely that if you’re not sure of some of this terminology, neither are your clients. We’ve found that key information about the process shared by you, as their trusted agent, can help reduce anxiety and manage expectations. Eliminating unknowns can ease your client’s mind and help ensure a quicker path to an issued policy.

Collecting health data

Your life underwriter will often require a paramedical exam and additional data collection points. A paramedical examination is a personal interview with your client to collect information about their medical history. This interview may be performed over the phone, online and/or in-person at the time of their examination. The additional data points may include a Motor Vehicle Report, Attending Physician Statements (medical records) or a detailed prescription history.

The interview is a brief phone call to gather information about your client’s medical history. This can take 15-40 minutes, depending on one’s medical history (e.g. diagnoses, prescriptions). Your client can prepare for a more efficient call by compiling their prescription list, any significant health dates or surgeries and detailed contact information from their primary care provider.

The next step is typically the medical exam. The examination usually includes a recording of height, weight, blood pressure and pulse. The exam may also include the collection of blood, urine, oral fluid, and an EKG and/or X-ray, depending on the insurer’s underwriting guidelines based on a client’s age and insurance amount. If an interview was not completed, your client may be required to complete a medical history interview at the exam appointment. A checklist of do’s and don’ts can be found on our website, to help your client prepare for their exam.

When it comes to the exam appointment, we offer many options for your client’s convenience. In addition to our extensive national network of mobile examiners, we offer over 2,000 locations where the exam can be done in a medical setting. If your client is squeamish or dreading having blood drawn, you may want to encourage them to schedule a mobile exam at home where they can be most comfortable.

Additional data requirements

Although collecting Attending Physician Statements (APS or medical records) can add more time to the process, we’re here to help things go as quickly as possible. Please advise your clients that some cases may take 30-45 days (especially when a special release is required). We are implementing a special authorization tool that will allow us to collect the authorization at the time of the interview in an effort to reduce the number of days to obtain an APS. Please note that if your client has a potential diagnosis in progress, any new treatments or assessments may delay an underwriting decision as new data are created and accessed.

What happens next?

The paramedical examination and any additional requirements are forwarded to the insurance company. Any specimens obtained during the examination are sent to our laboratory or another designated laboratory and the results are forwarded to the insurance company for assessment. ExamOne professionals are not aware of the tests performed on the specimen(s) at the laboratory and do not receive the test results.

Tools to help prepare

There are many resources available from ExamOne that can help you walk through the process with your clients and prepare them for the best possible result. These include applicant brochures, a printable checklist, and short videos on our ExamOne YouTube channel. Please visit our website at MyExamOne.com to find the materials best suited for you and your clients.

If your client has health conditions or habits that may impact their insurance rating, you may be able to ease their concerns. ExamOne does not make underwriting decisions, rather we serve as an impartial third-party health data collection service. The data collected allows the insurance company to evaluate the potential risk in insuring the client. Any health information we collect is handled carefully and delivered confidentially to the insurance company. Some companies have expanded their products to include coverage for people with certain conditions, so we recommend gaining an understanding of your client’s general health before applying so you can get a head start on gathering the best product options designed to fit them.

Be sure to have a conversation with your client to help demystify the application process and help them prepare for the best possible outcome. If you have any questions or need help accessing our support resources, please contact your local ExamOne sales representative or visit our website.

Read additional articles in this series: https://blog.examone.com/learn-more-life-insurance-application/