| SERVICES |
Information on SISCO SISCO Benefits provides claim administration services for your medical, dental, vision, long-term disability, short-term disability, prescription drugs, flexible spending, and consumer driven health plans. We also administrate life billing, accidental death and dismemberment, PPO repricing, COBRA, and HIPAA. We are here to assist you at any time. SISCO DIVISIONAL OVERVIEW: Claims: The claims department at SISCO is responsible for processing and closing your claims. Our auditors and processing staff are in the same building, enabling us to provide you with immediate feedback on a specific claim and/or services issue. Enrollment: Enrollment is primarily responsible for enrolling all new SISCO participants and their dependents. They are also in charge of auditing all eligibility to be sure that all participants are |
eligible for enrollment. This department is also responsible for terminating participant's coverages. Subrogation: Your health plan reserves the right of subrogation if you or a covered member is injured and a third party insurance may be liable for claims. The subrogation department reviews injury reports and determines if there is third party involvement. Eligibility Audit: SISCO combines leading-edge technology with precise attention-to-detail to provide a solution to the complex (and sometimes uncomfortable) task of auditing and verifying dependent eligibility. Our enrollment professionals interface directly with participants to reduce HR workload and ask the hard questions that are absolutely critical for eligibility determinations. Click here to view the eligibility audit ROI form. Customer Service: Customer Service is primarily a part of the quality assurance area. This department of SISCO consists of 21 individuals, 13 who are service representatives that take incoming customer calls, 3 are auditors, 2 are patient advocates (appeals), One is the trainer for the service reps and claims examiners, one is in charge of provider maintenance, and the last is a service specialist who responds to emailed requests for information, and randomly monitors calls to assure quality levels. Email us at: Sisco.Service@cb-sisco.com Or by phone at: 1-800-457-4726 Ext. 7276 |