Know the Cigna Business
Systems/KCS
Privacy
Coverage/Codes
MISC
100

What is Cigna's Mission

To Improve the health, Wellbeing, and peace of mind to those we serve.

100

What is Knowledge Centered Service? (KCS)

(There is more than one answer here)

Provides Answers just in time, exactly when you need it.

Allows you to share what you already know and helping your coworkers with those tough to answer questions.

provides customers with current answers.

100

What is HIPPA?


Health Insurance Portability and Accountability Act

100

What is the Coverage Equation?

What- Service being done

Why-Medically Necessary?

Where- place of service, place the service is taking place

Who-Who is completeing the service.

100

This is a tool that we can mirror and use to assist the customer with their digital experience. 

MyCigna.com or the My Cigna Mobile App. 

Note we can only mirror their My Cigna.com account.

200

What is our Role? 

To be champions of our customers and  our communities.


200

We use this system everyday, This is the system we use for calling taking and call tracking.

What is One View

200

What Is PHI?

Protected Heath Information?


200

What is Call Flow? How do we establish call flow?


Every call is unique and should be tailored to the needs of each individual customer you serve. 


Catering to caller, and their needs.

Greeting, Probing questions, Resolution statement or question.

200

This is a tool we use to access Plan booklets, Template and forms for our IFP customers and IFP accounts.

The IFP sharepoint

300

Who is the President and CEO of Cigna, Corp?

David Cordani

300
When talking about KCS what does UFFA mean with regards to the various roles within KCS?


Use It

Flag it

Fix it

Add it.

300

What are some examples of PHI?


  • Names.
  • Dates, except year.
  • Telephone numbers.
  • Geographic data.
  • FAX numbers.
  • Social Security numbers.
  • Email addresses.
  • Medical record numbers.
300

Name the types of codes we have disucssed.

CPT

DX

HCPC

REV codes

300

Define the following Terminolgy:

Art+T+Eye+_____ or that

Car+Sin+o+ma

Tack+E+Car+DIA

Art+Throw+s+Cops+Y

Card+IO+Meg+Ally

Gas+T+Eye+Tis

Rhino+P+Last+E

Arthritis

Carsinoma


Tachycardia

Arthroscopy

Cardiomegally

Gastritis

Rhinoplasty

400

Who is the executive Vice President, Human Resources and Services for Cigna Cooperation?


John Murabito

400

What are the Various Roles within KCS?


Explorer

Pioneer

Advisor

Publisher

Author

Publisher Mentor

Knowledge Mentor

\

400
What pieces of Information do we need to properly HIPPA validate a customer caller? 
  1. Look at the verification information populated by Computer Telephony Integration (CTI) or on your phone, and ask the caller to give you the information that was not populated.

  • Alternate Medical Identifier (AMI). Employee Identification Number (EIN) or Employee's Social Security Number (SSN)

  • Caller first and last name

  • Customer first and last name

  • Customer date of birth

  • Zip code if date of birth is incorrect

400

What is the definition of CPT code 26100

Biopsy hand joint lining

400

This is our claims processing platform and is used as a back end system for us.

what is facets

500

These are Cigna's Core Values.

What is:

We Care Deeply about our customers, patients, and Coworkers.

We create a better future together

We innovate and adapt

We partner, Collaborate, and Keep our Brand promise.

We Act with Speed and purpose.

500

This role Allows you to Use, Flag and Add,  knowledge. and puts you in the driver seat.

What is Knowledge Pioneer

500

How do we properly validate a Providers call?

  1. Look at the verification information populated by Computer Telephony Integration (CTI)  or on your phone, and ask the caller to give you the information that was not populated.
  • Alternate Medical Identifier (AMI). Employee Identification Number (EIN) or Employee's Social Security Number (SSN)

  • Caller name

  • Customer name

  • Customer date of birth

  • Zip code if date of birth is incorrect


    1. Ask the caller for the providers or Facility name.

    2. Ask the caller to verify using the information below.


    • Provider Tax Identification Number (TIN)

    • Pharmacy NABP number

    • Pharmacy only: National Provider Identifier (NPI) 

500

What is the Revenue Code for Magnetic Res Imag-Gen

Rev Code 610


500

what is an Alliance and why does Cigna Form Alliances.

As a bonus what are the different roles in an alliance (there are 2)

An Alliance is an agreement between Cigna and another Health Insurance Carrier to access networks in each others specific Geographical Area.

We form alliances to bring more Helath Care providers in network to our cusotmers.

Coordinating and supporting parties bonus answers


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