The benefit name when the initial office visit is billed, IP maternity physician charges, 48 & 98 hour rule apply, and ultrasounds and labs are billed separately.
What is Global maternity?
100
This lab processes paternity diagnostics.
What is Solstas Lab Partners.
100
When Cigna insures the product and funds the money to pay claims. Cigna must follow state and federal guidelines.
What is Fully Insured or (traditional)
100
62308
What is the Cigna Payor ID?
200
A program that when activated will keep preventative services from going towards the maximum.
What is waiver saver?
200
The Therapies tab in the BSBS under medical specialty drug benefit is for this type of code.
What is a J= code (ex: J12345)
200
This company takes care of sleep study precerts.
What is CareCentrix
200
70000-79999
What is the code range for radiology?
200
PO Box 188061
Chattanooga TN 37422
What is the Claims address?
300
Preventative, Basic, Major, Ortho
What are general benefits?
300
When reviewing a customers eligibility you may see single letter codes of M, D, R, and or V. These stand for what?
What is the plan type?
300
After completing a provider search this is the next step in finding a fee schedule in facets for a physician.
What is access the medical agreement configurator?
300
When more than one person is listed on a plan, both the individual and family deductible apply and benefits are based on whichever is met first.
What is non-collective?
300
P.O Box 188037
Chattanooga, TN 37422
What is the Dental claims address?
400
A single x-ray that shows upper and lower teeth in a select area on the same film.
What is a bite-wing?
400
MRI, PET & CT Scans all fall in this category.
What is advanced radiology?
400
These are the standard claim forms that HCPs use to submit their claims.
What is HCFA 1500, CMS 1500, UB-04, ADA, and EDI (or 837)
400
A procedure that is conducted on patients who are aged 50 and over unless based on medical necessity.
What is a colonoscopy?
400
Name, email, address, physical mailing address, telephone or fax numbers, birth date, SSN, license, or medical account numbers, & financial information.
What are examples of personal identifiable information?
500
The only condition when occlusal guards are allowed.
What is bruxism?
500
Sleep studies regardless of the way they are billed fall into this benefit category.
What is OP Diagnostics?
500
This is the dollar amount that was paid on claim #1503910298.
What is $28.67
500
When the employer pays Cigna to cover administrative costs. The employer funds the money to pay claims.
What is ASO or (self funded)?
500
ID number, DOB, patients name & DOB if different than caller.