1.
Which tool can you use to find out who the Claims Examiner (CE) is for a member account?
A
F7>08>02 Menu in Luminx
B
Rep Lookup
C
Group Notes
2.
What is our standard claims processing time?
A
30 Business Days
B
30 Calendar Days
C
30-45 Days
3.
Which telephone Aux code should you use when taking your lunch break?
A
01
B
02
C
06
4.
Which of these forms would an inpatient hospital most likely use to submit their facility claims?
A
HCFA Form
B
UB Form
C
Group specific claim form
5.
How can a CSR determine which network a particular health plan uses?
A
Check the back of the ID card.
B
Check group notes.
C
Both of these are correct.
6.
A provider is looking for eligibility information on a dependent. From the main account screen, what key sequence will you use in Luminx to find this info?
A
F7 > 04
B
F7 > 01
C
F7 > 08 > 06 > F3 > F3
7.
A member's plan requires that providers submit their claims to Cigna. What is the electronic payer ID # claims should be submitted to?
A
62308
B
81040
C
188061
8.
What is the correct PO Box where appeals should be sent?
A
PO Box 3018
B
PO Box 188061
C
PO Box 1269
9.
How long does a provider have to submit a corrected claim?
A
180 days from the day we processed the claim.
B
No later than 30 days after the error on the claim is discovered.
C
365 days from the date of service.
10.
A husband and wife are the only 2 people on an account. What is the correct enrollment level for this account?
A
P01
B
F00
C
F99
11.
If a provider calls to check claim status and the CSR is unable to locate a claim on file, what should the CSR do?
A
Advise the provider to re-submit the claim using an alternate method.
B
Send a follow-up to the CE to attempt to locate the claim.
C
Transfer the call to Provider Relations.
12.
Every provider directly contracted with Allegiance is located inside of which state?
A
Montana
B
Florida
C
Texas
13.
Which abbreviation will you often see in Luminx to refer to the Cigna network?
A
CHP
B
GWL
C
MP/264
14.
If a provider has questions about an electronic funds transfer (EFT) payment on a claim, who should they contact?
A
Cigna Provider Solutions
B
Zelis
C
MultiPlan
15.
In what claim statuses are you able to provide a claim breakdown to the caller?
