Medical Disclosure

Provides Stop Loss Carriers and MGUs with timely, comprehensive clinical assessments on an individual member regarding expected treatment plan, potential costs for the next 12 months, diagnosis, and prognosis

/>American Health's role in the Medical Disclosure process is to:</p> <ul> <li>Project potential medical and high-dollar pharmaceutical claims a member could accumulate over a 12-month period</li> <li>Project the potential for re-hospitalizations</li> <li>Provide a clinical prognosis</li> <li>Provide history and clinical status reports</li> <li>Review proposed the treatment plan and determine if it is within accepted standards of practice for disease and condition processes</li> <li>Identify experimental and/or investigational treatments and medications, including FDA approval status<br /></li> </ul> <h3><img src=

  • Prompt acknowledgment of request and response
  • Utilizes experienced Registered Nurse Case Managers
  • Detailed reports identifying potential risk to assist underwriting in setting rates


To learn more about American Health's Medical Disclosure Program, please contact us by phone at 866.614.4244 or by Email at .