HSA/FSA vs. HRA
What is a Health Reimbursement Arrangement (HRA)?
This type of account is employer-owned and the funds never expire for the member, as long as they stay with the plan.
What is an EOB (Explanation of Benefits) or other documentation?
The document a client needs to provide to confirm their HRA paid for a session, often used to process a refund for a duplicate charge.
Headway currently only accepts EAPs sponsored by these two major carriers (excluding Anthem EAPs).
What are Cigna and Optum?
The required format for Cigna EAP authorization codes starting with "OP."
What is OP followed by 10 digits (12 characters total)?
The EAP authorization for this carrier can be verified via Provider Express instead of requiring a letter first.
What is Optum?
The key difference is that unused funds in this account are forfeited back to the employer, unlike an HSA.
What is a Flexible Spending Account (FSA)?
What are waived sessions?
To stop a client with an HRA from being continuously charged, you must add these to their account.
This is the minimum level of documentation required to add a Cigna EAP to a client's account.
What is an authorization letter (or equivalent documentation like an email screenshot)?
The only CPT code that is considered EAP-eligible for Cigna.
What is 99404?
An Optum EAP authorization code is composed of letters/numbers and ends with this two-character sequence.
What is a hyphen and two numbers (e.g., -01, -02, -03)?
What is a Health Savings Account (HSA)?
Funds from this type of account never expire and remain with the member, even if they change health plans or employers.
The maximum number of waived sessions that can be added to a client's Atlas account at one time.
What is five (5)?
If a client has an active EAP with remaining sessions and sends in a new one, the new EAP should be added but this is the setting it should have in Atlas.
What is "inactive"?
The two license types of providers who can see clients under a Cigna EAP.
What are Master-level clinicians and Doctoral-level psychologists (CP)?
The type of clinician that is eligible to see clients under an Optum EAP.
What is a Master-level clinician (e.g., LCSW, LPC, LMHC, etc.)?
What is an HSA-qualified health plan?
A client is generally required to have this kind of health plan to be able to use their HSA benefits.
In cases where HRA payments go through a third-party administrator, this is the specific document where details like EFT or Check number, Vendor/Payer, Amount, and Date Cleared must be filled out for a refund request.
What is the Third Party Payment Requests spreadsheet?
The number of active EAPs a client can have on file with remaining "valid" sessions.
What is one?
The process a client must follow to switch providers while still using sessions from a single Cigna EAP authorization.
What is calling Cigna to have them generate a new EAP authorization for the new provider?
The number of EAP providers a client can use a single Optum authorization with.
What are as many as the client would like?
What is an HSA?
The name of the tax-deductible contributions: Member, employer, or family can contribute to this, but only the employer contributes to an HRA.
What is adding waived sessions to their account?
The required action for a Customer Care Agent (CCA) to take after issuing a refund for double payments and the client has provided a screenshot of their current HRA balance.
What happens to EAP sessions if a client cancels an appointment?
What is they do not count against the EAP session number?
The unique Cigna EAP code that must be entered in all caps in Atlas, even if the client's insurance is mismatched with the EAP.
What is DISNEY?
The type of appointment that is not eligible for Optum EAP coverage.
What is a medication management appointment?