Medical Records Are The New Credit Score?

Just like an error on your credit report can affect your score, an error on your medical records can have an impact when you’re applying for insurance, according to the Wall Street Journal.

With health-care costs rising fast and insurers more closely scrutinizing potential clients, consumers need to pay closer attention to what is in their medical records.

Not only can incorrect medical information lead to ineffective or harmful treatment — the Institute of Medicine estimates that as many as 98,000 patients die each year in hospitals from medical errors — it can also affect your insurability.

“You need to make sure you know what’s in your medical records and correct any errors before you apply for insurance,” says Carolyn McClanahan, a certified financial planner in Jacksonville, Fla., and a former medical doctor.

Savvy consumers know to check their credit score before applying for a loan. What is less well known is that consumers can improve their chances of getting insured — and of paying lower premiums — by checking that medical information held by doctors, hospitals and pharmacies is accurate.

Errors in medical records aren’t uncommon. “They happen all the time,” says Joy Pritts, research associate professor at Georgetown University’s Health Policy Institute.


Patient Records Need Reviews
[WSJ via WSJ Health Blog]
(Photo:Getty)

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  1. pinkbunnyslippers says:

    I don’t understand this. There’s not some single repository for health histories like there is credit reports. This country doesn’t have a trifecta of “Health Report” Bureaus with which you can easily check your history to ensure it’s error free. So where does this article suggest starting out your search? Just call up my doctor and ask them to pass over my files?

  2. andrewsmash says:

    The only reason insurance companies even have access to medical records is so that they can maximize their profits. If we are going to continue wasting the publics’ time and money with for-profit medical insurance, this practice needs to be outlawed. Medical care in this country has become progressively less effective and more expensive as the insurance providers have been given more say in medical care. If we are not going to allow a one-payer system of medical care, we need to stop allowing these companies to cherry-pick the patients that will give them the best return on their investment. This is health-care, not accounting or finance, and if they want to keep people from getting sick, they should work to improve the health infrastructure, not just find news ways to weed out applicants that are “financially risky.”

  3. warf0x0r says:

    @andrewsmash: I agree 100%. Where is my system for identifying Items from my medical history, there is none. If, in order to keep a score on you, credit card companies have central agencies to track it there should have to be a centralized version of this for the medical industry.

  4. mindshadow says:

    This kinda reminds me of the show on Discovery channel about what we think the future will be like, and it showed future medical care. They could do amazing things to save your life, like regrow your heart and all kinds of things… if you had top of the line insurance that costs a lot. Otherwise you die. It pissed me off, not only because it’s greed costing people their lives, but because at this rate that’s where we’ll be at when 2050 rolls around.

  5. FLConsumer says:

    @pinkbunnyslippers: Uhh… actually there is a central repository with the medical histories on 90%+ of the American public. It’s a company called the MIB Group.

    They keep track of:
    “Coded information identifies medical conditions or medical tests that are reported by MIB Members to MIB under broad categories. There are also a few codes that are non-medical. Those codes report potentially hazardous avocations or hobbies, or results of a motor vehicle report showing a poor driving history.”

    Lovely, isn’t it?

  6. vildechaia says:

    Hah! About time. I found out about the MIB in 1971 through an article in New York Magazine. I suggest everyone get a copy of their medical records, sort of like you do with credit reports.

  7. timmus says:

    This is why absolutely no doctor or hospital ever gets my Social Security number when I’m paying cash. The one time a hospital insisted, I made up a fictitious one. I absolutely do not trust the system. The only time they get one is when I’m there to use insurance benefits.

  8. thunderstruck says:

    People should be very aware of the MIB. They’re the Experian, Equifax, and TransUnion of the life/health insurance business, and the info they have about you can determine if and/or how much life insurance you can get, among other things.

  9. BugMeNot2 says:


    Request Your MIB Consumer File (free once per year):
    [www.mib.com]

  10. @All Regarding MIB and Insurer’s access to it: WTF?!?!

    So what the heck is HIPPA for? Is it for fun? Just ’cause it’s fun to say HIPPA?

  11. mockingbird says:

    I was denied health insurance about ten years ago because of a mistake in my medical records. I was graduating from college, and so I had to switch from my parents’ plan to an individual one. On my parents’ plan, I had the same PCP as them, and somehow they put my dad’s sleep apnea on my medical history. It’s not a big deal to have that as a man over 65, but it’s a deal breaker on an early 20’s woman with other pre-existing conditions. Since they have to tell you why they denied coverage, I found out about the mistake and had it corrected, and went on to get a different individual plan with no real trouble. When I think about the many hells health insurance has caused me over the years, this is pretty much bottom of the list stuff.

  12. AmericaTheBrave says:

    FLConsumer is correct, there is a central repository for medical records. I’m also surprised that the Wall Street Journal article Megh referred to didn’t mention that some employers are now running medical checks along with background checks before making hiring decisions. So incorrect information can also cost you a job.

    President Clinton tried unsuccessfully to pass a law prohibiting employers from looking at your medical files.

    President Bush has sided with the AMA, who claim your medical records are the property of your doctor, who has the right to make money selling it to anyone he/she wants.

  13. Johnyq1982 says:

    Most life insurance companies will order the last 3-5 years of records from your primary doctor and also any hospital records you might have (the HIPAA release is built into the application you sign).

    You can request them yourself by sending an authorization to the facilities where you have been a patient (you can get a valid authorization for New York at [www.courts.state.ny.us] the rules and forms vary from state to state)but beware they can and usually will charge you as much as 75 cents per page.

    Hospital charts for long stays can be well over 500 pages so be sure to request what is called an “abstract” which is just the important info (dictated reports, lab work, X-Ray reports, etc… and leaves out things like the nurses notes, temp. charts, and consent forms )

  14. Auntie M. says:

    This is a good idea. I always request my records after any hospital visit. Thank goodness I caught the time the coder made a mistake, and at the top of the first page was “opiate addiction.” Farthest from the truth, BTW, but could have wreaked havoc on any insurance try.

  15. oneheadlite says:

    I want to see TV commercials for straightening out medical records and something like Triple Advantage, but for medical records instead of Credit Scores.

    Then, maybe some of the people who still say health care is better in the U. S. than in Canada will wake up to the reality of the situation.

    Sure, such businesses would be shady, but they would not inflict as much harm as the health insurance companies and the rest of the big corporate medical industry in the U. S. does.

  16. BritBoy says:

    @Rectilinear Propagation: bump…..yeah, so isnt this entirely contrary to HIPPA ??

  17. Elvisisdead says:

    @BritBoy: It is not against HIPAA regs to do this. There is a specific part of the regs that state:
    “(2) Treatment, Payment, Health Care Operations. A covered entity may use and disclose protected health information for its own treatment, payment, and health care operations activities. A covered entity also may disclose protected health information for the treatment activities of any health care provider, the payment activities of another covered entity and of any health care provider, or the health care operations of another covered entity involving either quality or competency assurance activities or fraud and abuse detection and compliance activities, if both covered entities have or had a relationship with the individual and the protected health information pertains to the relationship. See OCR “Treatment, Payment, Health Care Operations” Guidance.

    Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.

    Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.

    Health care operations are any of the following activities: (a) quality assessment and improvement activities, including case management and care coordination; (b) competency assurance activities, including provider or health plan performance evaluation, credentialing, and accreditation; (c) conducting or arranging for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs; (d) specified insurance functions, such as underwriting, risk rating, and reinsuring risk; (e) business planning, development, management, and administration; and (f) business management and general administrative activities of the entity, including but not limited to: de-identifying protected health information, creating a limited data set, and certain fundraising for the benefit of the covered entity.

    Most uses and disclosures of psychotherapy notes for treatment, payment, and health care operations purposes require an authorization as described below.

    Obtaining “consent” (written permission from individuals to use and disclose their protected health information for treatment, payment, and health care operations) is optional under the Privacy Rule for all covered entities. The content of a consent form, and the process for obtaining consent, are at the discretion of the covered entity electing to seek consent.

    [www.hhs.gov]

    So, essentially, any insurance company can request your records in order to set your rates, provided that they know who your provider is. If your provider uses an EMR system, all they have to to is request your EMR file from the system provider.

  18. Eaglerock says:

    Not only is there a central repository for medical records (MIB) but there is one for casualty insurance claims (ISO).
    Get in a fender bender and have an attorney make a case that you have serious lower back strain – that is now on file for all insurance companies to see – and may affect your health insurance rates and/or future employabilty.
    I am an insurance adjuster and cringe whenever I have to enter a diagnosis into ISO as when an attorney tries to make a claim “look better” – the diagnosis does go on your permanent record!
    Sure people really do get injured in accidents, but in minor car crashes I will get a chiropractor report with up to 20 different diagnoses sometimes vague like “insomnia”, “stress”, “Headaches”, “irritability” and so on. They all go into the database….

  19. Mr. Gunn says:

    Eaglerock – Exactly, which just reinforces the point I’ve been making a lot lately. Just when you think you’re getting one over on someone, they’re probably getting you twice as bad without you even realizing it.

    Or, as they say in the stock market, sacrificing long-term performance for short-term gains.

  20. marisatv says:

    I am a national television news producer working on a story about medical record mistakes. I am hoping to speak with some one who had a mistake on his/her medical record. If this has happened to you, please email me at mtoccin@newspronet.com.
    Thanks!