Benefits
Micellaneous
Vendor
Systems
Micellaneous
100

2022 member is in cigna true choice PPO North Carolina (7849-046-000) how much would the monthly premium be 

what is $ 0

100

Member calls in to start a referral or prior authorization what is that called?

What is Orginzation Determination

100

For 2022 who is the Preferred Mail Order Pharmacy?

What is Express Scripts 

100

In oneView once you get to the 360 view what button must you hit before you can move on?

What is the Validate button

100

Member calls in for a prior authorzation for medicaition?

What is called a Coverage Determination

200

2022 member in Cigna Preferred medicare HMO Southern Illinois (H7389-004-000) wants to know how much it would be to go to the ER?

What is 120 dollars?

200

Member are able to complete a yearly checkup up to get a gift card what is this called?

What is a 360 exam

200

2022 this is a subrogation and a third party liability recovery provider 

What is the Rawlings Group

200

With this system you can check on the status of a referral 

What is MHK or Medhok 

200

As a CRS for MAPD can we see Arizona plans?

What is No

300

2022 Member in Dallas county is in the Preferred Medicare  (H7787-001-000) how much will they pay for skilled nursing facility for days 21-100?

What is $188 copayment per day

300

2022 Cigna offer a new benefit that can be used to pay bills and cover prescription drug costs, as long as the vendor accept visa?

What is Cigna Cash Card

300

For the Post Hospital meal who would you contact if member has not recieved their meals frothe the acute hospital stay 

What is GA Foods 

300
In order to help member find a Dr who is in network what system can we use?

What is Qnxt providers

300

2022 member in plan (H5410-013-000) wants to know how much they get for Cigna healthy food?

What is 25 allowance 

400

2022 member in Henderson. Cigna Premier Medicare HMO POS Tennessee (H4513-036-000) is calling in to see what their copayment for out of network DME

What is 30% coinsurance 

400

In Qnxt member, to find a providers network where would you look?

What is Providers tab

400

In 2022 who is the one who handles authorizaitons for Radiology 

What is Evicore 

400

If a member calls in with cpt codes and wants to know if that code requires a prior authorizations what can we use 

What is Shrpa 

400

Member is requesting material request, what is the time frame for mailing out material request 

What is 7-14 business days 

500

2022 Member wants to know if their plan (H7020-004-000) requires a referral to see a specialist?

What is no referral required for in network provider

500

Member's Daughter is verbal hippa consent and is upset with how doctor treated her mother, can Verbal hippa consent file a grievance

Yes, but a AOR form will be sent out
500

Name ONE thing that is offered in the 2022 cigna Medicare Exclusive Discount Program

What is Weight and Nutrition, Wellness Products, Alternative medicine, lasik 

500

Where can you quote a benefit in oneview 

What is eligilibity 

500

How many hippa pieces are required to be verifed but assistance member 

what is 3