What changes did CIGNA HealthCare make to Provider Self-Service (PSS)?
In July 2003, PSS was changed to support eligibility and benefit inquiries and response (270/271), as well as claim status inquiries and response (276/277). Here are some of the changes you’ll notice: Claim Status: • The status field now shows whether the claim is pending or in process. • Explanation of Payment — Remark codes, now called “Additional Information,” are now HIPAA-compliant. These codes are used only for electronic transactions (PSS). On a single inquiry you are now able to inquire about services provided within a 180-day date range. Eligibility and Benefits: • Product Type The screen now shows additional information when applicable: • Medical Group/Risk Group Name • PCP phone number • Outpatient hospital out-of-pocket expense • MRI/Lab/X-ray copayments • The coinsurance percentage CIGNA HealthCare applies to a covered expense (instead of the percentage the member must pay).
