Tips for Completing the Application How to help your customers apply

To ensure timely processing of applications, it is important that all questions on the application are completed and that supporting information such as dates and relevant details for medical conditions, medications, and physician visits are provided for all persons being covered.
When applying online, the system has controls in place to prevent an applicant from skipping required sections or questions on the application. However, some online applicants still submit incomplete applications that cause delays in the underwriting process. Many applicants provide an answer of “N/A” for date of last doctor visit and dates of treatment, or they neglect to select a primary care physician (PCP) when applying for an HMO plan. Please advise your customers that they should not do either.
Because paper applications do not have the same system controls in place, these applications tend to be incomplete more frequently. Independence Blue Cross’s process requires that paper applications be entered into our system by data-entry staff just as if they were online submissions. If the paper application is incomplete, it cannot be entered into the system until we have all of the needed information. Therefore, an incomplete application will delay the initial underwriting review. By reviewing applications prior to submission, you can ensure that all relevant information has been included and help avoid unnecessary delays in the underwriting process.

Whether you personally assist your client in completing the application, or you just provide guidance, here are some important things to remember:

A primary care physician must be selected and the HMO ID number of the medical office provided when applying for an HMO plan. You or your prospect can find participating providers by visiting our provider search website. Family members may select different primary care physicians. Hospitals and specialists may not be selected as a primary care physician.
If any applicant listed on the application is not a U.S. citizen, explain his/her status.
Applicants must have a street address. A P.O. Box is not acceptable for a residence address, and the application will be rejected if a proper address is not provided.
Dates must be provided for all conditions and medications reported.
Applicants must be specific when providing medical history. For example, if someone has a knee injury, specify the type of injury. Was it a simple strain, or was there ligament or cartilage damage? If there is a history of kidney stones, did the stones pass, or was surgery required? If there is a history of skin cancer, what type? Taking the time to ask the right questions will facilitate more efficient processing of the application.
Any altered information or answer in the paper application must be initialed by the primary applicant, regardless of who may have written the original information. If it is not initialed by the primary applicant, or if it is initialed by someone else, it will not be accepted.
Paper applications must be signed and currently dated. If the date is altered for any reason, the alteration must be initialed. If spousal coverage is requested, the spouse must also sign and date the application form.

Download a copy of the How to Apply flyer for your customers.

Sections Requiring Extra Attention

Please pay special attention to these areas of the application, which often have incomplete information.

Section G (Other Insurance) frequently has incomplete answers or no answers at all. If someone has other insurance, besides naming the company, include the termination or renewal date and indicate if it is a termination or renewal date.
Section I (Expectant Parent Information) applies to, and must be answered by all applicants.
In Section J (Health-Related Questions), applicants may not leave out dates or detailed explanations of affirmative answers. If an applicant answers “Yes” to any of the questions in Section J, answers in Sections K (Health History Questionnaire for each person applying for coverage) and L2 (Additional Detailed Medical Information) should reflect the appropriate information. For example, if your applicant answers J7 “Yes” because he/she is on blood pressure medication, then in K6, the high blood pressure question should be answered “Yes”, and Section L should include details on the person affected, medications taken, physician information, and last doctor visit for this condition.
If questions in Section K are answered affirmatively, then Section L (numbers 1 through 3) should also be answered.
Make sure question K 15 is answered. It is the most frequently unanswered question on the paper application.
Section L3, is another frequently unanswered section on both the online and paper applications. It is very unlikely that someone has never seen a physician, yet that question is often left blank, even if medical history has been reported.

Mail completed paper applications and payment information to:

If you do not use this specific address, the application may be lost or significantly delayed in reaching the Underwriting Department.