september 18, 2014 … page confidential, unpublished property of allegiance benefit plan...

September 18, 2014 … Page Confidential, unpublished property of Allegiance Benefit Plan Management, Inc. Do not

duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Allegiance Benefit Plan Management, Inc.

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Information for Providers

Table of Contents



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I. Background

I. Who Is Allegiance?

II. Allegiance and Huntsville Hospital Health System

II. Working with Allegiance

I. Online Tools

II. Pre-Certification / Pre-Treatment Review

III. Submitting Claims

IV. Claims Processing and Payment

V. Claims and Benefit Questions

VI. Claim Processing Overview

III. Am I a Preferred Provider?

I. In-Network Providers

II. Enrolling with Cigna

IV. Additional Information

Who is Allegiance?



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OUR HISTORY

Originally founded in 1980, Allegiance has administered Self-Funded Health Plans for more than three decades.

• Over 100 clients across the country representing more than 166,000 lives.

• Clients include hospital systems, school districts and government organizations, insurance trusts, and MEWAs.

• Claims processing, customer service, enrollment, and all other services are coordinated from our corporate office in Missoula, MT.

Allegiance became a wholly-owned subsidiary of Cigna in 2008 enabling us to offer the flexibility and customized service of our TPA model alongside Cigna’s extensive network and analytic products.

Allegiance and Huntsville Hospital Health System



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OUR RELATIONSHIP

Effective November 1, 2014, the Huntsville Hospital Health System Health Plans will be administered by Allegiance.

HH Heath System Health Plans covers 14,000 lives throughout the Huntsville, Athens and Decatur areas.

Employees and their families will access the Cigna PPO network of providers.



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Working with Allegiance




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ONLINE TOOLS

Many of the processes discussed on the following pages can be made easier by taking advantage of Allegiance’s Online Tools for Providers.

Providers can find helpful information at: www.askallegiance.com/hhsys/forproviders.asp

http://www.askallegiance.com/hhsys/forproviders.asp





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PRE-CERTIFICATION / PRE-TREATMENT REVIEWPre-certification and Pre-treatment Review for

services will be coordinated through StarPoint Health Group, an Allegiance company.

A Pre-treatment Review list is available online at www.askallegiance.com/hhsys/forproviders.asp

StarPoint’s Nurse case managers and reviewers are available by phone at (800) 342-6510






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SUBMITTING CLAIMS

All medical claims are required to be sent to Cigna PO Box 188061Chattanooga, TN 37422-8061or Payer ID: 62308

Cigna will forward priced claims to Allegiance electronically for processing.

Claims submitted electronically will be accepted or rejected based on an eligibility match. If rejected, the provider will receive a 999 response file. If submitted via paper and there is no eligibility match, the provider will receive the claim along with a form letter stating the member could not be found.




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CLAIMS PROCESSING/PAYMENT

All claims will be processed by Allegiance at its facility in Missoula, MT.

Checks and EOBs will come from Allegiance.

Providers interested in electronic payments and ERAs should contact PayPlus Solutions for enrollment information.

(877) [email protected]

More information on PayPlus is available online at

www.askallegiance.com/hhsys/forproviders.asp

mailto:[email protected]






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BENEFITS & QUESTIONS

Online Verification of Benefits (beginning 11/1/14) is available at: www.askallegiance.com/hhsys/forproviders.asp

Allegiance Customer Service is available from 7a-7p CST, Monday through Friday at (855) 999-0294

An Automated Voice Response system (IVR) is also available 24/7/365 for claims and benefit information

Providers interested in HIPAA transactions; 270/271, 276/277 should have their clearinghouse contact Health-e-Web (877) 565-5457 www.hewedi.com/expanded-services


http://www.hewedi.com/expanded-services




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CLAIMS PROCESSING/PAYMENT OVERVIEW

Process Contact Add’l Information

Claim Submission Cigna

PO Box 188061, Chattanooga, TN

37422-8061Payer ID: 62308

Claim Processing Allegiance (855) 999-0294

Claim Status Allegiance(855) 999-0294 askallegiance.com/

hhsys

Claim Payment Allegiance(855) 999-0294 askallegiance.com/

hhsys

http://www.askallegiance.com/hhsys/







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CLAIMS PROCESSING/PAYMENT OVERVIEW

Process Contact Add’l Information

Pre-Certification / Pre-treatment

Review

StarPoint / Allegiance (800) 342-6510

Payment Refunds AllegiancePO Box 3018

Missoula, MT 59806(855) 999-0294

Benefit Verification Allegiance(855) 999-0294 askallegiance.com/

hhsys





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Am I a Preferred Provider?




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IN-NETWORK PROVIDERS FOR HUNTSVILLE HOSPITAL HEALTH SYSTEM

HH Health System employees will access the Cigna PPO Network.

Providers not currently contracted with Cigna are encouraged to enroll with Cigna prior to implementation on November 1, 2014 to avoid potential service disruption for HH Health System members.




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ENROLLING WITH CIGNA

Providers who wish to enroll with Cigna can do so online

www.cigna.com/healthcare-professionalsor by phone

(800) 882-4462

http://www.cigna.com/healthcare-professionals

http://www.cigna.com/healthcare-professionals



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Additional Information

New Member Identification Cards



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SAMPLE ID CARD (FRONT)

New Member Identification Cards



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SAMPLE ID CARD (BACK)

september 18, 2014 … page confidential, unpublished property of allegiance benefit plan...

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