SYSTEMS
SYSTEMS
DEDUCTIBLES
TERMINOLOGY
FACETS
100
When a plan is on an amendment hold, which system do you use to quote benefits for the customer?
What is CIT
100
Where do you go to find a plans funding type?
What is Admin tab in BSBS of Facets
100
Also known as benefit level, this is the percentage of covered expenses that the plan will pay after any deductible is satisfied?
What is coinsurance
100
What does ad+d mean?
What is Accidental Death & Dismemberment
100
ID # 103661704 How many occupational therapy visits does this customer have?
What is 20
200
True or False? FileNet is used for Cigna to send out correspondence to customers?
What is False. Customers send US correspondence through FileNet. We use XNet to send correspondence to customers.
200
Where would you most likely be able to find this account : U51593880?
What is OneView 2.0
200
True or False? Non-Collective deductible is where the entire family deductible must be satisfied before benefits are available for any family member?
What is False, Collective.
200
What does ACR mean?
What is Average Contracted Rate
200
ID # 102656439 What is the previous years family deductible and OOP max?
What is 12,000 & 13,000
300
Member Dawn Ireland has an Authorization (IP0090901742) on file, what was the primary diagnosis code that was reviewed for this claim?
What is K81.9
300
PLAN ID# 191318 What is the TPA Number?
What is 800-457-4726. (using PTRACKII)
300
A 12 month period, other than January-December, in which deductible and OOP amounts accumulate is called a ____________ year?
What is a plan year.
300
What does U&C mean?
What is Usual & Customary
300
ID# 103661704 What is the reason authorization IP0089541370 was denied?
What is not medically necessary.
400
Which company/vendor would be responsible for Occupational Therapy precertification in zip code 32006?
What is ASH, using Service Area Lookup Tool
400
Go into CED and tell me what Greenbean Badhb Nightmare's Phone number is.
What is 407-273-3465
400
ID Number 102872458 How much more does this member need to meet in order to satisfy their Individual Deductible?
What is $4,815.96
400
What does SEP stand for?
What is Special Enrollment Period
400
ID# 103661704 What is the Diagnosis that was approved on 9/19/17
What is Neurosyphilis unspecified
500
What is the name/names of the website that we go to for plan booklets?
What is Cigna Select Books / Facets Online Booklet
500
Go into CPF and tell me what Dr. Charity Batman's mailing address is.
What is PO BOX 776351 Chicago, IL 60677
500
ID Number 103243086 True or false? This member's OOP max does not include their deductibles?
What is False - it does include their deductibles.
500
If a doctor chooses to be ______, then they will not show up in any of Cigna.com's directories.
What is Suppressed.
500
ID# 103171223 What is the service type and primary procedure for the requested authorization on file?
What is Surgical Inpatient for Freeing of Bowel Adhesion
M
e
n
u