Common Therapy Terms
These types of therapies include ABA, Cognitive Behavioral Therapy, and Addiction Counseling
What is behavioral therapy?
This tool is used to look up vendors for therapy providers based on zip code
What is the Service Area Lookup Tool (SALT)?
This Equation which uses questioning techniques of "what, who, where, and why" is used to assist in quoting benefit coverage.
What is the coverage equation?
This website is used to check for medical necessity review coverage.
What is the ASHlink website?
This document explains the coverage and payment decisions for a submitted claim.
What is the explanation of benefits or EOB?
This type of therapy that focuses on touch by trained physical therapists or chiropractors is often not covered by insurance.
What is massage therapy?
This third party company is contracted with providers and insurance companies for the purpose of processing payments for claims for therapy services.
What is Ashlink (American Specialty Health)
We should check these alphanumeric codes for any precertification requirements.
What are CPT and HCPCS codes?
You are permitted to have 5 of most therapy visits before having to do this.
What is request pre-authorization?
These types of codes can explain why a payment was not made on a claim.
What are RNC codes?
This is when there is expected to be no further improvement from continued treatment because patient has returned to pre-injury status or is not expected to improve any further.
What is maximum therapeutic benefit?
This guide is used with Benefits Access and related processing procedures to assist the services operations team within Cigna to process claims
What is the therapy guide?
This type of code can indicate a limitation on the amount of visits and/or coverage due to its definitions within medically necessary coverage.
What are CPT or Diagnosis codes?
When this is shown in the information tab of a claim in OneView, it means that there is a need to verify the medical necessity review in AshLink.
What is code MNR?
This type of code shows the location or provider of a service.