Healthy Today Card
How long does it take for a member to receiv their helath today card once it has been mailed?
What is 10 business days.
Member switched to another MCO during AEP and wishes to come back to Cigna.
What is transfer to sales 1-800-870-2169 to complete a new application.
How does a member get a copy of their total OOP for 2022 that they paid for prescriptions?
What is request a full rx EOB material request in QNXT. Assign to .CSADMIN
What does OEP stand for?
What is Open Enrollment Period
Are implants covered?
What is only under the dental allowance. Implants are not covered under the DHMO.
The vendor that will be handling the healthy today card
Who is Convey 1-866-851-1579.
The member has decided to return back to traditional Medicare and would like to enroll in a PDP plan.
What is transfer to PDP sales 1-800-222-6700
Member has received a denial for a narcotic prescription at the pharmacy.
What is the member can request to get a 7 day fill or the member can request a CD for the full month ahead.
What are the dates of OEP?
1/1/2023-3/31/2023
How to determine a DHMO copay?
What is pull up the member's account in webster and locate the charge schedule number. Then go to the KX ARTICLE 000064170 to locate the charge schedule. NOTE: This only applies if you are dental trained if not, please transfer to the dental queue.
Can a member increase or add a benefit offered through the health today card?
What is no, however you can offer to do a search of plans in that members area that may include that particular benefit/allowance.
Member is calling in to change from a preferred HMO plan to a true choice PPO.
What is transfer to plan change 1-800-619-8111
Where do find how much a specific cost of a drug?
What is you can run a test claim to determine the cost or you can search the tier of the drug and then look at the tier under the health plan id.
If a member makes a plan change request during OEP, when will it take effect?
What is the 1st of the following month.
A member calls in to locate a provider.
If dental trained, you would utilize webster for DHMO plans kx 000011399. If you are not trained, please transfer to the dental queue.
Where can the member use their utility allowance?
The member can use their utility only directly through the utility company via online, customer service or IVR system.
A member from Arizona is calling in to complete a plan change.
What is transfer plan change 1-800-619-8111
A prescription has been denied due to a refill too soon.
What is outreach to pharmacy resource to get a waiver 877-376-7104
What are the hours of operation during OEP
7am-10pm CST, 7 days a week
you are unable to locate the DMR claim the member has sent in.
you would need to check oneview as well as dentaque under claim correspondence tab.
Where can the member find what items are eligible to purchase with their OTC allowance?
What is OTC catalog.
Member recently qualified for Medicaid and would like to change to a totalcare plan.
What is transfer to Plan change 1-800-619-8111
A member calls in to get a replacement glucose meter.
What is educate on the CD process and warm transfer to Coverage Determination 877-508-0310
All D-SNP/ Dual eligible members qualify to use this to change plan once each quarter of the year except for 4th quarter.
What is a Special Election Period (SEP)
What happens if a member using their max dental allowance for the year?
What is the member will be responsible for anything of the dental allowance amount 100%