Week 4 day 1

1. As per art. Art. Call Quoting benefits, When quoting benefits the template “Once either out-of-pocket has been met Cigna will pay 100% of the Maximum Reimbursable Charge for the remaining (calendar/contract) year based on Medical Necessity” is for in network benefits?

• NO

• YES

As per Art. Call Quoting benefits We do not need to say benefits are based on contracted rates for INN copays.

• true

• false

3. As per Art.  When to offer to provide and quote benefits to a customer in your call. / Do we need to provide benefits when the customer mentions they have an upcoming appointment?

• no

• yes

 

4. As per Art. What do we need to include when quoting coverage / Required information when quoting Medical Coverage Call Guide If Medical coverage provided and the customer has not met their out of pocket maximum we need to tell the caller that the provider may bill upfront for the copay, deductible and/or coinsurance amounts up to the out of pocket maximum for services received.

• True

• False

5. Do we used 1Cloud for FSA?

• no

• yes

6. Do we used C-fund to see H SA ?

• yes

• no

7. Are we available to see INN deductible and INN OOP in the Additional Accumulators?

• Yes, they are in Additional Accumulators

• No, they are in the demographic part

• No, they are in Benefits accumulator

• No, they are in interaction history.

8. Please select the types of FSA

• Health Care FSA

  Limited Purpose FSA

  Dependent Care FSA

• FSA medical, FSA pharmacy, FSA dental.

• Health Care, Vision, Dental.

9. If doctor is in network with Cigna, and charge the amount of $100.00 , but based on the contract with cigna the allow amount is $50.00 and member has a Copay of $25.00, how much is the patient responsibility

• $100.00

• $25.00

• $50.00

10. On the following claim, what is the specialty of the doctor?

• Otolaryngology

• pathologist

• urologist

• Neurotologist