Validation
What can you see in Finesse which tells you the highlighted customer is validated?
The # / hashtag
What probing question is important when quoting lab work?
Identifying Place of Service
When did the CAA / No Surprises Act go into effect?
1/1/2022
What system is considered the core system for IFP Eligibility questions?
ServiceLink
Name 3 ways I can send a customer information which includes PHI?
Fileshare through myCigna, mail to address on record or fax if customer is at the fax able to receive the information immediately
What 2 things allow me to talk to caller who is not on the plan?
Verbal authorization from the validated customer or a current HIPPA Authorization to Provide Protected Health Information form
What benefit would I quote for an wheelchair?
Durable Medical Expense (DME)
What must I provide if I give provider status on a specific provider?
Provider Network Status letter or email
Name 2 places I can determine the enrollment source of an IFP Plan?
OneView Eligibility tab and Facets Enrollment Source under Member
Can a Tennessee customer be balance billed on a ER claim with a DOS of 12/10/2021?
Yes
What can be completed to authorize someone not on the plan to discuss PHI of a customer and where can I find it?
HIPPA Authorization to Release Protected Information form found under Find Forms on Cigna.com or myCigna.com
Verbally demonstrate how to quote Advanced Imaging for a CT scan at an OP Facility with coverage of CYD / 70%
Must include contracted rate, INN provider and medical necessity.
Can a customer be balance billed for an ER visit in 2022?
No
Where do I refer a customer if their plan terminated for non-payment of premium and they want to reactive their account within 30 days?
HPS / Billing team responsible for their enrollment source
Can a Missouri customer be balance billed for an ER doctor on a claim with a DOS of 5/12/2021?
No
Can I release PHI to a parent of a child dependent over the age of 18 years of age? If so, what do I need?
Yes but only with a verbal authorization from the child dependent over the age of 18.
What information do I need to include when I am quoting Physical Therapy benefits?
Number of Visits and, if ASH, the Medical Necessity Review following the 5th visit
If a specific provider is OON, I must provide 3 what?
INN Providers on the Network Status letter or email
Where can I transfer a customer to if they need to update their address?
Enrollment source
What disclaimer must I provide if I quote deductible or out of pocket accumulator totals to a customer?
"Based on claims processed to date."
What KCS article outlines what information on can disclose to different types of callers?
Article 4959 - Disclosure of Information Grid
What benefit am I going to quote for an annual check-up with my primary care provider
Preventive
CAA / No Surprises Act establishes requirements to what?
Protect patients against balance billing for involuntary out-of-network services
Where can I find the transfer codes or phone numbers for a customer's enrollment source?
Transfer Facets Call Overview article under Individual and Family Plans
What must I say when I make an outbound call?
"This call is being recorded for quality and training purposes."