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is being recorded.and welcome to the new provider.orientation my name is anna.and i'm a behavioral provider relations.representative here at cigna.i look forward to spending the next 30.minutes talking to you about working.with cigna.this orientation is geared towards.individual providers and clinics.please do not feel that you have to.write down all the contact information i.present to you today.the welcome to the network email that.you recently received includes.all the highlights that we'll cover.including phone numbers email addresses.and websites.cigna's mission is to improve the health.well-being and sense of security in the.people that we serve.because you play such a vital role in.the health and well-being of our.customers it's a priority to us to.develop long-lasting and productive.relationships with healthcare providers.my goal in this orientation is to give.you the tools you need to start working.with cigna.the provider services team is designed.to be a one-stop shop in addressing your.questions and concerns.advocates can assist you with.eligibility and benefit quotes status.inquiries.claim status checks and problem.resolution they can provide basic.information on initiatives that may be.of interest to you.joining the network information they can.also triage calls to get them to the.appropriate team members.and are serving as your initial point of.contact they can be reached at.1-800-926-2273.the provider relations team is dedicated.to improving your experience working.with cigna.we're working with you as well as behind.the scenes to make working with us.easier please contact your pr app if you.have any questions about your contract.if there's questions that an advocate.wasn't able to resolve.but you can also feel free to ask for.your pr at any time.to find the prep covering your state.please see the cigna behavioral health.key contacts flyer.in the welcome to the network email that.you recently received.our after hours team is available for.after hours crisis situations only.you can reach them by calling the.provider services number.that number again is 1-800-926-2273.this team is not available for.administrative questions.it does include advocates care.coordinators and clinical care managers.our medical management program or mmp.is where you'll find all the information.we're covering in the presentation today.the cigna behavioral medical management.program or mmp.is an extension of your contract and is.referenced in your participating.provider agreement.it's divided into two sections an.administrative guide.and a state specific section.it also includes helpful forms such as.the primary care physician.communication information form a.self-pay agreement.a coordination of benefits form amongst.others.you can access the mmp at our website.cignaforhcp.com in the resources section.mmp is updated quarterly.let's move next to the credentialing.process you're either in the middle of.that process or you just completed it.sigma verifies all information with ca.qh.please respond to any request from cigna.regarding your profile.once your caqh profile is completed and.has been attested.it will be released to cigna for review.and final credentialing.this process can take anywhere from 45.to 60 days from the credentialing date.while in the credentialing process you.are only in network for patients with.html plans.employee assistance programs and the.integrated policies.please call in to verify your in-network.status prior to seeing any signal.members.you will receive notification for any.upcoming re-credentialing at the mailing.address that we have on file for you.this notification will be sent out six.months in advance the re-credentialing.date.please note that most states require.this every three years however some.states do require re-credentialing every.two years.as a contracted provider with cigna you.are considered in network wherever you.render services.your contract with segment is specific.to you rather than to a specific.location or taxpayer identification.number or 10..if you are a contracted individual.provider who also works at a.non-contracted group practice.your services would be considered.in-network regardless of the service.location or billington.for more information on this please.review the behavioral medical management.program.on our website signat4hcp.com again it's.in the resources section.for demographic changes if there are.changes to your clinic's address.telephone number or leadership team.please contact provider services as soon.as possible to make those updates.they'll update your profile or amend.your contract accordingly.please note that addresses updated in.caqh are not sent to cigna.you must contact cigna directly with.address changes.you can call provider services at.1-800-926-2273.to add active service locations to your.file as well.cigna has a number of product offerings.including hmo.ppo or open access plus standalone.employer products.it's important to contact cigna whenever.you receive new patient to verify their.benefits.benefits will vary based on the product.type amongst other factors.the provider advocate can confirm the.correct claims payer with.for each new signed behavioral patient.cigna also maintains.alliances with other healthcare.companies that access our network.claims for alliance customers are paid.by the health company that manages the.benefits.for more information about our alliances.please refer to the behavioral medical.management program.found on cigna for hcp.com you can look.in the resources section.the last product offering that i want to.mention is cigna health.health spring hmo and ppo cigna health.spring markets are not nationwide.please refer to the mmp to see if.healthspring is offered in your state.you can tell if you're in network for.cigna health spring via your.participating provider agreement with.cigna.you can outreach our health spring.provider service team for inquiries.about the plans at 800 800-230-6138.they can help with claims and claims.revolution eligibility and status checks.billing inquiries they can provide basic.information on initiatives that may be.of interest to you.as well as serving as your initial point.of contact regarding health spring.next i want to talk about our care.advocacy process.when seeing a new cigna member please.ensure that you make a copy of the.patient's id card.call the telephone number on the back of.the id card to check eligibility and.benefits.confirm the claims address and confirm.if the patient is using their employee.assistance program or eap.you can also check eligibility benefits.and some claim status on cigna's website.cignaforhcp.com.for authorization requirements.for cigna there is no pre-authorization.required.for routine care including medication.management individual group therapy.you'll want to call the patient's.medical carrier for psych and.neuropsychological testing authorization.requirements.outpatient reviews may be required.occasionally you'll want to make sure.that you're contacting cygnus.within seven days of receiving a letter.requesting a clinical review.pressing the health spring.pre-authorization is not required for.most routine care.again things like medication management.individual and group therapy.you'll still want to contact the medical.carrier for.psych and neuropsych testing.authorization requirements.due to mental health parity requirements.it is critical that you call in to.confirm eligibility and benefits for.every patient.it's also important to call in at the.beginning of every new year for existing.patients to see if their benefits have.changed.you are all considered in network for.our routine services but i do want to.take a moment to discuss sigma's other.access levels.we have routine care which requires no.pre-authorization.intermediate care which is an.appointment within 48 hours of a request.lastly we have crisis stabilization.which is an appointment within six hours.of the request.price of stabilization is divided into.two categories.24 7 and non 24 7 options.sigma supports the concept that all.licensed behavioral health practitioners.by virtue of their license.are competent to treat most behavioral.health disorders some disorders.testing and participant groups are.better treated by practitioners with.special knowledge and skills in such.areas.in order to claim a specialty in these.designated areas.practitioners must meet one or more of.the education or experience requirements.for each of the listed specialty.disorders.treatment modalities or populations.for most specialties the practitioner.simply signs an attestation form that.they meet.their requirements signal will only.refer participants needing a specialty.service to those participants who have.listed the specialty.if you are a clinic and have clinicians.who did not notify us.of their specialty or in any of these.services they can complete a specialty.network worksheet.located in the medical management.program in appendix.f.as a participating provider with sigma.behavioral you are automatically.identified as a provider.with eap assessment and referral.specialty.unless you chose not to participate.while completing your provider.application.approximately 20 million cigna customers.nationwide have access to our standard.eap.or to a bundled solution for short-term.counseling and work-life resources.by participating in this specialty.network you can perform.eap services which include short-term.counseling that focuses on problem.identification.and resolution you can also refer to the.appropriate resource to complete the.problem resolution.medication management is not included.for eap.claims for eap services should always be.sent to cigna behavioral again.please note that eap services cannot.be offered by psychiatrists.by providing these eap services you can.potentially broaden the scope of your.practice.supplement your income with sessions.into a wider patient population.and also expand the access to behavioral.health services in your community.i want to go over some administration.tips for eap benefits.sessions are separate from the.behavioral health benefit plan.so no co-pay is required from the.customer.to utilize their eap benefit a cigna.customer must obtain an eap.authorization from.cigna and they must provide this to you.prior to their first counseling session.you should not provide eap services.unless you have an eap authorization.number.you may call provider services to verify.an authorization number.as well as the number of sessions.available.you'll want to use the cpt code 99404 to.ensure appropriate payment.each eap authorization covers one issue.per individual per plan year if the.cigna customer presents to you with a.new issue within the same year.prior to treatment please contact cigna.to obtain a new authorization number.eap is not meant for long-term treatment.or therapy claims must be submitted.promptly after each eap visit.to comply with family filing.requirements.please call provider services to check.eligibility or to request an eap.authorization.and to close the patient's eap case once.you've completed it.telehealth benefits for behavioral.telehealth sessions.are administered in accordance with the.customer's benefit plan.telehealth sessions may be used for.therapy or medication management.behavioral telehealth is available as an.alternative service method.by treatment providers who meet the.telehealth specialty requirements.visit cigna's website cignaforhcp.com.you'll go to the resources section forms.center.behavioral health forms to find the.attested specialty form to add the.telehealth specialty to your profile.when submitting claims you'll want to.use the appropriate cpt code and include.the modifier.g t in the field 24 d.of a claims form this modifier specifies.that the service is a telehealth session.you'll use your existing fee schedule to.determine the correct charge.once you're fully contracted we.encourage you to register on our website.cignaforhcp.com to verify your contract.status you can call provider services.at 1-800-926-2273.once registered you can log onto the.website and verify.benefit plans for html and ppo members.check claim status update your.information and much more.we would also like to encourage you to.check out our web tutorials.our goal is to provide you with a.positive online experience.you can find our behavioral education.and training page.at cignaforhcp.com.you can learn how to navigate the.website verify patients eligibility and.benefits.perform claims inquiries register for.eft.and much more.i want to take a few minutes to go over.some basics around claim submission.there's a detailed section in the mmp.devoted to claims payment.in addition to an appendix and helpful.claim forms.one important note about claims before.we move on is the coordination of.benefits form.this will be requested for the first.claim of the year for all signet.customers.it is the customer's responsibility to.advise advise us of any secondary.coverage but it can slow your claim.payment.process down if they're unresponsive.you may want to ask your participant or.your patients excuse me to fill out the.coordination of benefits form at the.beginning of every.year and have it on record if you have.the assigned form you can submit it to.cygnus to help ensure that your payment.is not delayed due to lack.of information about other benefits you.can find the coordination of benefits.form in appendix d.of the medical management program.you'll also want to take note of the.timely filing time frames outlined in.your contract.and they can vary state by state.our self-pay agreement is also available.for services that are rendered that are.not covered by the customer's benefit.plan.that would be things such as a missed.appointment fee.this form can be found in our mmp.you can find more information about.billing code guidance and prior.authorization.requirements in the authorization and.billing resource.on our website again cigna for hcp.com.you'll go to the resources section.behavioral resources.doing business with cigna.i want to point out a couple of common.issues when working with the cms 1500.form.in box 31 you may want to print your.name as opposed to signing it.you may also want to make sure you're.including.your claims mailing address as it's.listed on your w-9.these simple steps can help ensure that.your claim is processed quickly.i also want to go over the required.information on a claim form.please make sure to include the employee.name the patient name.the patient's date of birth an.identification number.such as their social security number or.alternative medical id number.if the patient does not want to give.either of those identifiers you can use.the signet id.and the date of birth you'll also want.to include the type of service.the date of service the charge for the.service.the diagnosis the treating provider.including license and credentials the.taxpayer identification number or tin of.the.provider clinic or facility.the provider's signature the admitting.diagnosis is required for an emergency.room claim.and an npi is required for electronic.submissions.participating in an electronic data.interchange or edi.can help ease your administrative burden.you can submit claims electronically.with less processing errors edi vendors.also allow you to receive electronic.eligibility and benefits information.working with an edi vendor may also.reduce your paperwork and generate.faster claim delivery than traditional.mail.you'll also be able to receive.electronic remittance advances.cigna's payer id for adi is 62308.you can find a list of our vendors on.our website cigna.com.edi vendors.for sigma health spring you can still.use edi.there is a different payer id 63092.you can send paper claims for health.spring using the cms 1500 form.to po box 981706.el paso texas 79998.you can also sign up for electronic.funds transfer.eft for health spring you can go to.cigna dot com.slash medicare cigna dash help spring.you'll go to solutions for health care.providers.current provider manual and then you'll.go to.eft enrollment process.eft is basically just direct deposit.it electronically deposits claim.payments directly into your bank account.some of the benefits are that it.eliminates a paper check.you have access to the funds on the same.day that they're deposited.you can view separate remittance reports.online for each deposit.and it can help easily reconcile.payments using a single remittance.tracking number.to sign up for eft for cigna you can.enroll two different ways.you can enroll directly with caqh for.multiple payers.including cigna on their website.or you can log on to cigna's website.cignaforhcp.com and log in.and sign up for eft directly with just.cigna you'll go to.working with cigna enroll in electronic.funds transfer options.lastly i want to mention our newsletter.transformations.it is a bi-monthly newsletter delivered.right to your inbox.it'll help you keep up to date with.featured industry information.administrative updates plan coverage and.other helpful tips.on behalf of cigna i want to thank you.for your interest in our network.and listening to our new provider.orientation we hope you found this.information valuable.and it will help you to administer.benefits to your sigma patients.we encourage you to refer to your.welcome to the network email.which covers the highlights we discussed.including phone numbers.email mailing addresses website.and more thank you again.

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You Asked For Easy Administration We Deliver With The Aetna Form FAQs

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Is it legal in Illinois for a potential employer to ask you to fill out and sign medical health history forms before you are hired? I was under the impression these were documents you filled out with HR after you had the job.

I’m not an attorney or at all familiar with employment laws in Illinois, so my answer is more a comment than a direct answer to the question. At the federal level, the US Equal Employment Opportunity Commmission had the following to say on the subject.[1] An employer may not ask a job applicant, for example, if he or she has a disability (or about the nature of an obvious disability). An employer also may not ask a job applicant to answer medical questions or take a medical exam before making a job offer. An employer may ask a job applicant whether they can perform the job and how they would perform the job. The law allows an employer to condition a job offer on the applicant answering certain medical questions or successfully passing a medical exam, but only if all new employees in the same job have to answer the questions or take the exam. Once a person is hired and has started work, an employer generally can only ask medical questions or require a medical exam if the employer needs medical documentation to support an employee’s request for an accommodation or if the employer has reason to believe an employee would not be able to perform a job successfully or safely because of a medical condition. There appears to be a line on exactly what type of medical related questions can or cannot be asked, but I can’t comment on permissible or forbidden questions with any authority. Footnotes [1] Pre-Employment Inquiries and Medical Questions & Examinations

The company I work for is taking taxes out of my paycheck but has not asked me to complete any paperwork or fill out any forms since day one. How are they paying taxes without my SSN?

Certain taxes are based on a flat percentage of your income (Social Security, Medicare, State wages—possibly, Local, state unemployment, etc). These taxes are collected and remitted at certain periods after a payroll ends. However, you do not need to report a Social Security number tied to amounts until certain points. For Federal taxes, this is at the end of the calendar year. For states and locals, that might be at the end of the quarter or end of the year depending on the reporting requirements. Employers are required to withhold taxes immediately, from pay regardless of paperwork. Now the qu Continue Reading

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