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Every Breath You Take – How Insurance Companies Know Everything About You

By now in the twenty first century most of the American public at large has grown aware of a non profit fraternal organization directly responsible for the decision making process a health insurance company will make regarding your acceptance into a major medical healthcare plan. The entity is known as The Medical Information Bureau, an industry trade association membership corporation owned by approximately 750 member insurance companies who exchange applicant information to each other in the form of unique and internally recognized codes. Some of the data collected and disseminated among its member partners are indicators of health impairments, dangerous lifestyles, adverse driving records, hazardous sports, and even characteristics of sexual deviance such as homosexuality. But how exactly does this enterprise receive their information? Where does the source come from? And how can you stop the insurance carriers from invading your privacy or at least limit the amount of knowledge they have on you?

How They Receive Your Information.

In many ways the emergence of information within modern industrial civilization today can be attributed to a medium described as Electronic Data Interchange, a computer application commonly known as EDI developed by The American National Standards Institute. EDI is the exchange of electronically transmitted documents in a structured format between organizations, in an automated manner, directly from one computerized terminal to another without human intervention or use of carbon copy for mediating its message. In healthcare this medpoint management address automation is the primary messaging system responsible for transmitting everything about your utilization of health services including prescription consumption, diagnostic testing, evaluation and screening, as well as hospital admission or discharge. As a matter of fact, an entire paradigm of rules or a set of specific instructions was constructed to address the informational architecture in which this logical framework would be built for optimal communication. This protocol for communicating everything about your health is called ANSI (ASC) X12N, and in many ways came to be pioneered in whole or in part by Healthcare Data Interchange Corporation, a Aetna insurance company.

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Where does the information come from?

To be fair Aetna is not the only health insurance company responsible for monopolizing healthcare information databases. Conglomerates such as United Health Group own Ingenix who markets Medpoint a pharmaceutical prescription tracking system keeping records of your medication drug purchases. There are also players like Blue Cross Blue Shield and Cigna who own National Electronic Information Corporation, a clearinghouse for remitting medical claims on your behalf. There are hierarchies deployed by the health insurance companies with an agenda to know everything about you and EDI is how they transmit your records to each other.

An example of how it works.

Healthcare Data Interchange Corporation has one of the more successful business models for exchanging your medical records between associated partners utilizing EDI. The hierarchy of Healthcare Data Interchange Corporation is broken down into several subcomponents or subsidiary companies managing a very integrated circuit of knowledge acquisition. For example; If you apply for health insurance after a lapse of 63 days without prior creditable coverage, Equifax (The Credit Reporting Company) will request that a paramedical examination be performed from their subsidiary, Physical Measurements, inc. who in turn will send the results to sister company Smith Kline Laboratories who will process the results and send the batch to Physician Computer Network, an American Medical Association database shared by general practitioners whose computerized entry order terminals are all owned by National Data Corporation, subsidiary to Envoy Corporation, parent company of Aetna, who in turn will share some of the results indexed only by code to the Medical Information Bureau, all through EDI. Sounds complicated, doesn’t it? But there is something you can do about managing your privacy.

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What You Can Do.

A paramedical examination for entry into a health insurance plan is somewhat unavoidable if you had more than 63 days without prior coverage, however once insured there are a couple of things you could do to limit the use of EDI topologies transmitting you medical records into the hierarchy of The Healthcare Data Interchange Corporation Network. Discuss your confidentiality concerns with your doctor. If you want a specific condition to be held in confidence by your personal physician, bring a written request to the appointment that revokes your consent to release medical information to the insurance company and/or to your employer for that visit. You must also pay for the visit yourself in cash rather than obtain reimbursement from the insurance company, in other words do not use your medical insurance card. To be especially certain of confidentiality, you may need to see a different physician altogether. Realize that under HIPAA, your attempts to restrict the sharing of specific records can be denied by the health care provider. Keep in mind also that certain elective procedures such as a lap band surgery, tubal reversal, or being prescribed certain medications may get you prematurely denied coverage by an insurance company if they have that information on record. In those cases where you are considering certain treatment and have a clean bill of health it might not be such a bad idea to put your medical insurance card back into your wallet and pay cash.

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