Systems
Products
EAP
Eligibility
HIPAA

100

This system houses member information such as their eligibility and benefits

CAMS

100

This product is offered as an add-on to traditional benefits and includes anywhere from 3 to 12 free sessions for patients and household members

EAP

100

This EAP product type offers a limit of 3 visits per authorization 

AS/Assessment

100

Where do we receive eligibility and demographic information from?
The employer

100

This cannot be released until both the provider and the member have been HIPAA validated over the phone

PHI/Protected Health Information

200

This system houses information about health care professionals such as addresses, phone numbers and network status

PMRS

200

This product is offered as an add-on to traditional benefits and includes 3 free sessions for members on the plan

MAP

200

This EAP product offers up to 12 visits per authorization

STC/Short Term Counseling

200

If benefits or eligibility cannot be confirmed or quoted you would send this type of request

REGIS

200

Before leaving your desk, you need to do this step 

Lock your screen!

Windows + L

or Ctrl + Alt + Del & log off

300

This system allows us to view account exceptions for groups who have Cigna insurance for their employees

OLAM

300

This product is considered a "carve-in" products, claims are handled at CHC and most use the Guaranteed Cost funding mechanism

PPO

300

This is the CPT code that must be billed for EAP services

99404

300

How can we determine eligibility for a member with a TruCare pop up?

Transfer to Claims!

300

This information is required to HIPAA validate a provider

TIN/NPI & provider's name

400

This system allows us to check deductible & out of pocket max accumulations, other insurance and check parity for HMO and Employer Group Plans

DG

400

This product often does not offer out of network benefits and is considered a "carve-in" product

HMO

400

This is the system used to determine if the member is eligible for EAP and how many visits they're eligible for

OLAM

400

This icon is the shape of a computer in CAMS and can help clarify eligibility discrepancies and is updated whenever a REGIS is sent

PC comments

400

This information is required to validate HIPAA for a patient

Member ID

First & last name

DOB

Address

Phone Number

500

This system allows us to check deductible & out of pocket max accumulations, other insurance and check parity for PPO plans

OneView

500

This funding mechanism allows Cigna access to the employer's back account in order to reimburse provider for services rendered

ASO/Self Funded

500

This criteria needs to be met for a provider to be eligible to receive payment for EAP services: the patients account must offer EAP, the provider has to be INN and ________

Be a masters or psychologist level provider

500

Name the 3 types of registrations we see in CAMS

Managed

EAP

Integrated

500

How do you HIPAA validate a caller from a non-Cigna insurer? 

Get their callback number, put them on hold and make a call out to that number to verify they're calling from that insurance company