Hooper Holmes Services - Underwriting/Inspections

Hooper Holmes Services offers tele-underwriting, pharmacy database searches, APS and APS summaries, EKG interpretation, mortality data, underwriting decisions and risk assessments, Physicians Information Lines, disease state profiles, inspection services, MVR, fraud detection searches, credit checks, and more.

We also provide on-demand underwriting for any size project, from simple to complex processes. Services include: first looks, informal trial cases, quick quotes, and full underwriting from receipt to completion.

  • Underwriting Solutions Our “on demand” underwriting solutions provide experienced underwriting staff members prepared to meet any customer's unique needs.

    We have unmatched capabilities for handling traditional full and large case underwriting. We can complete a full underwriting assessment of the application from submission to final decision. 

    Our dedicated team of impaired risk underwriters is technically trained in any product line that has a deferred rate class, for any age. We provide complete full-underwriting assessment of an application from submission to the final decision.

    Contact Thomas Welch, Vice President, Underwriting, who can explain any service we provide in complete detail.
    Thomas.Welch@hooperholmes.com
    (800) 577-6020.

    Our Innovations:
    • On staff underwriters provide immediate support for volume relief due to attrition or variable staffing/seasonal (within the carrier).

    • Provide unbiased underwriting audit expertise from a neutral perspective. We bring best practices to apply to every case.

    • Offer specific skill sets for new products or new underwriting philosophy. We have backgrounds from numerous carriers and numerous types of products, such as disability, long-term care, major medical, impaired risk underwriting and financial underwriting.

    • We’ll take a new niche concept to market with a shorter lead time. Carriers interested in expanding a niche area may be told by their reinsurer that they don’t have the necessary underwriting expertise. We can provide on-demand support.

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  • Tele-Application – Part I Hooper Holmes, Dallas-based tele-underwriting staff is highly trained in the collection of Part I (or Part A) – general information based on carrier guidelines.

    Our team of licensed health and life professionals interacts directly with applicants to complete the upfront screening process of the application.

    The tele-app process reduces sales time and reduces errors. Inspection services can be ordered reflexively based on responses provided in the interview or based on age/amount requirements. Stand alone orders are also available.

    All interviews are recorded for legal and quality assurance review. Voice Signatures allow for immediate processing of applications as well as offering the ability to request medical records with a digital signed HIPAA authorization, which is being accepted by a majority of the medical facilities across the country.

    With the growing acceptance of electronic signatures some medical facilities are providing medical records more quickly; we do not have to wait for “on-paper signatures” for authorizations.

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  • Tele-Application – Part II Hooper Holmes Services is staffed for tele-application – the collection of Part II (or Part B) – when only health information is required. Asking all the right questions is an art–especially when speed and training matter. Our trained U.S.-based team of licensed health and life professionals interacts directly with applicants to complete the screening processes of an application.

     

    Our Innovations

    • Proprietary technology that allows ordering of an MIB and RX while the applicant is providing information and converts insurance company questionnaires into a tele-med with drill-down questions.
    • Ordering of an APS following underwriting guidelines at time of completion.
    • Digital recording of interview with voice authorization.
    • Our U.S.-based call center is staffed with specially trained, friendly professionals.
    • Completion – we follow the process until the exam and/or application is received back with signature.
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  • Informal Application Receive a complete built case file with recommended insurability against a customer’s standards and guidelines. Trial applications are often viewed as time consuming, diverting underwriting talent away from activities that demonstrate more immediate impact.
    We take on the responsibility for interacting with agents by building a case file and making recommendations about insurability as measured against your standards and guidelines. Customers can direct us to present only those files or applications that are of interest, which reduces overall underwriting expense.

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  • Case Management Our case management department works with a strong understanding of underwriting philosophy to provide seamless, transparent reviews of applications and supporting documents “In-Good-Order.”

    Trial applications are often viewed as time consuming, as well as a means of diverting underwriting talent. We take on the responsibility for interacting with agents by building a case file and making a recommendation about insurability as measured against set standards and guidelines. Customers can direct us to present only files or applications of interest, which reduces overall underwriting expense.

    Our Innovations:
    Hooper Holmes Services is the only company offering case management and underwriting services combined.
    Within minutes of receipt, order requests are distributed.
    Case Managers have a strong customer service and insurance background. Ongoing training occurs for underwriters, managers, and compliance departments.
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  • Attending Physician Statement (APS) An APS is a written statement or report prepared by a physician, a hospital, or other medical professional to provide information that gives underwriters a complete picture of the an applicant’s health, detailing key medical ailments.

    Our experienced and skilled APS retrieval team works to secure medical records, in record time and In Good Order. All calls are recorded including voice signature authorization; Email integration expedites special authorization requests sent directly to the applicant and reflexive additional requirements may be predetermined.

    Our Innovations

    • Credit card payments made to facilities provide greater efficiency and faster turnaround time.
    • Email integration expedites special authorization requests sent directly to the applicant.
    • Reflexive additional requirements based on predetermined guidelines may be ordered in conjunction with the APS.
    • Voice signature authorization.
    • Cycle time averages 15 days; demonstrating our commitment to continuous improvements through advanced process controls, technology initiatives, and enhanced management disciplines.
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  • APS Summary The APS Summary is a condensed version of an APS. It extracts key components from the medical records and highlights critical information for the underwriting decision. APS summaries help put focus on cases that are likely to be successfully underwritten. Cases that may be issued at a substandard rate are identified up front.

    Our Innovations

    • Outsourcing time-consuming reading of APS reports frees 25% to 40% of a home office underwriter’s time.
    • 200 pages of records take about an hour and a half to summarize.
    • Cost is less than a summary with a full underwriting assessment.
    • Underwriters generally receive information necessary to make an underwriting decision within 48 hours of the order.
    • Our assessment practices are driven by carrier underwriting standards.
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  • Physician Information Line (PIL) The PIL program is an abbreviated APS that allows the underwriter to zero in on specific areas for clarification. By helping an underwriter focus on specific medical or lifestyle conditions that affect insurability, a PIL reduces medical record fees and speeds the assessment process.

    We contact the applicant’s treating physician about health or lifestyle conditions noted on the application for insurance. Using a discussion guide and questionnaire the medically trained staff communicates with the physician to secure information about the condition; including diagnosis, plan of treatment, outcome and prognosis.

    We have developed more than 100 guides and questionnaires; including diabetes, cancer, cardiac, and hypertension. The completed questionnaire, along with interview notes, is sent to underwriters.

    PIL can be used very effectively in 30% to 40% of cases where an APS is requested for a routine situation or for the clarification of a specific impairment.

    Our Innovations

    • Average time service is 10 to 13 calendar days.
    • Our medically trained staff calls the physician’s office and obtains requested information directly.
    • Our extensive library of more than 100 PIL questionnaires can be customized.
    • Most PILs are completed on the first attempt.
    • Special authorizations required by medical facilities are reduced as physicians accept the signed and dated PIL authorization.
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  • Medical director support ECG Interpretation We have the ability to provide same-day interpretation of ECGs sent to us in the specimen collection kits by an insurance-trained medical director and coded using MIB criteria. Receive realistic direction on challenges and in reviewing ECGs/medical testing. We provide support, treadmill, ECHOs with accredited medical directors on staff.

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  • MIB Report (Medical Information Bureau) Be alerted to fraud or omission of information from an insurance application. Working as a branch office of your company, this information can be reviewed and further investigated to develop information to contest or rescind policies where material information was eliminated from the original underwriting process. This review also provides additional insight about your potential exposure in impairment, product knowledge or medical requirements lists.

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  • Motor Vehicle Report (MVR)  A detailed report that lists an applicant’s complete driving history. When requesting this report, the underwriter specifically checks to see if the applicant has any minor or major traffic violations, suspensions, or revocations. MVRs can show underwriters a future prediction of an applicant’s behavior and driving performance.

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  • Prescription History / RX database Hooper IntelliScript provides access to prescription drug histories from pharmacy benefit managers and other data suppliers. Prescription profiles are delivered in seconds directly to underwriters' and claim adjusters' desktops to uncover critical medical information, including a timeline of an applicant's prescription drug history, dosage information, prescribing physician information and medical indications for each prescription.

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  • Quick Quote We will compile a review of one or two paragraphs of a possible applicant's information submitted by a broker or agent to a direct carrier. The QQ involves providing an underwriting assessment subject to full requirements.

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