SHS Part 1

Intake

100

People who live in Oregon

I live in Oregon and I want to file a claim... What is different about my claims process?

200

Medical Records are for...

I'm filing a wellness claim, do I need to send medical records regarding my wellness visit?

300

I want to be proactive. 

I'm currently in the hospital, can I file my hospital care claim?

400

Naming Convention

My name is Gabby Doyle, my employer is the Cigna group, my claim number is 123456. Use the naming convention for the ACK and CF. First to post in the chat, WINS!

500

Unknown Claim

You are unable to find the employer, but we never turn away a claim. What steps will you take?

Benefits

100

Wellness

Will all policies have the wellness/healthscreening/preventative care benefit?

200

Follow up

If I went for a follow up for Occupational Therapy, does that count as Physical Therapy?

300

Disclaimer

After you quote benefits, you should say....

400

Sports Injury

I have the sports injury benefit and it says I get 50% of the Initial Care and Emergency Care Benefits. The emergency room benefit is $200, How much would I get?

500

Common Denial

Explain why a newborn doesn't met the definition of active service.

Inspro

100

Searching

How do you search for a claim in InsPro?

200

Dependents

Who will add a child's demographics into InsPro?

300

Documentation

Where should you document the call if you were able to locate the account but unable to register the claim in InsPro?

400

Base Plan Code

What does the base plan code AIENHLOW mean?

500

Registering a claim

PTD is 3/1/2023 and DOS is 5/29/2023. Can you register the claim in InsPro?

Majesco

100

Troubleshooting

What should I do when Majesco is not loading?

200

Make It Easy

What can you offer to me that you wouldn't be able to offer to a customer you found in Inspro?

300

Additional Information

What additional information questions are always completed for a Majesco Intake?

400

Migration

When did Ferragamo migrate to Majesco?

500

Two Questions

What do these two questions remind you to complete?

• Claimant Authorization: Specify the Authorization By and Claim Info Certified fields. The signed date is auto populated with the Claim Received Date; update if necessary.
• Health Information Disclosure Information: Specify the Authorization By and Claim Info Certified fields. The signed date is auto populated with the Claim Received Date; update if necessary.

KnowledgeXchange

100

MyCigna.com

The customer is in Majesco, their demographics are correct but they are still having issues registering on mycigna.com. What phone number do you transfer the caller to?

200

EFT

How do I set up EFT on mycigna.com?

300

Hospital Care

What documents need to be submitted to process my claim?

400

Accidental Injury

I was a driver in a car accident, what documents need to be submitted with my claim?

500

Critical Illness

I was diagnosed with End Stage Renal Failure. What documents do I need to submit with my claim?