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Systems We Use

Across
Logs you in for the day; clocks breaks and aids in phone use
___ policies: used to determine how cigna will cover certain procedures
___ provider files (CPF)
Service ___ code guide: main system that feeds CSA lookup
Service area lookup tool: used to determine who does pre-auth for ARI/PT/OT/CHIRO
Main benefit system; feeds BA
Medicare ___ navigator: used to determine who is primary when customer has medicare
Used to determine if pre-auth is needed for procedure
Used to view correspondence and paper claims submitted to Cigna
Used for pre-enrollment calls; houses client's benefits and cover letters
IEX/____: system for looking @ daily schedules
View checks and coordinating claims
Used for training purposes
Code ___: used to view diagnosis codes and procedure codes and give additional info such as TYP and cause codes
___ maintenance: used to verify if provider is INN or OON
State laws are housed in this system
Down
Procedure to ___: PXDX used of procedure says pxdx in CSA lookup
Used to find EOB's, original electronic claim submissions and DDAR's
Used on all class for eligibility, claims, interaction history
Cigna choice funds system for HRA/FSA accounts
___ ___ management system: used to record follow up calls to customers
____ quick reference: used to find "lost" claim if not in Oneview or Proclaim
Used to find overpayment/refund requests sent to providers and customers
Used to pull up CED, CPF, Group and Vipr
Benefit ___ (BA): database w/customer's benefits
Cigna's knowledge database
Used to clock in daily and for approving time sheets
Used for locating additional tools and resources used daily for your job
Used to process claims and make sure all edits are correct
Central ____ database: CED
Used to lookup precert status
___ care code guide: used to determine if a code is considered preventive
Primacy ___: used to determine who is primary when customer has other ins and Cigna
___ guide: used to determine if therapy will be covered
Used to lookup additional HIPAA verification and personal rep