QUANTUM HEALTH ASSESSMENT QUESTIONS WITH COMPLETE ANSWERS

QUANTUM HEALTH ASSESSMENT
QUESTIONS WITH COMPLETE
ANSWERS

Short ccAnswer ccQuestions: ccList cc3 ccpieces ccof ccinformation ccneeded ccto ccverify cca
ccmembers ccidentification ccin ccorder ccto ccdiscuss ccPHI cc- ccAnswer cc1. ccID ccNumber
2. ccName cc
3. ccDate ccof ccBirth

Short ccAnswer ccQuestions: ccWhat ccare cc3 ccplaces/ways ccto ccfind ccan ccEOB. cc-
ccAnswer cc1. ccTPA ccWebsite
2. ccMembers ccwebsite
3. ccInternal ccClaim

Short ccAnswer ccQuestions: ccDefine ccdeductible. cc- ccAnswer ccThe ccfixed ccdollar
ccamount ccthat ccis ccthe ccresponsibility ccof ccthe ccmember/family ccto ccpay ccbefore ccthe
ccplan ccstarts ccto ccpay cca cccertain ccpercentage.


Short ccAnswer ccQuestions: ccDefine ccOut ccof ccPocket ccMaximum cc- ccAnswer ccA
ccfixed ccdollar ccamount ccthat ccis ccthe ccresponsibility ccof ccthe ccmember/family ccto ccpay
ccbefore ccthe ccplan ccwill ccstart ccpaying cc100% ccof cccovered ccINN ccservices.


Short ccAnswer ccQuestions: ccWhat ccare ccthe cc3 ccpieces ccof ccbilling ccinformation
ccneeded ccto ccverify cca ccprovider ccis ccINN cc- ccAnswer cc1. ccBilling ccAddress cc
2. ccBilling ccName
3. ccBilling ccTax ccID

Short ccAnswer ccQuestions: ccWhen ccquoting ccbenefits ccfor ccOP ccsurgery. ccWho ccare
ccthe cc2 ccproviders ccwe ccshould ccbe ccchecking ccnetwork ccstatus ccon? cc- ccAnswer cc1.
ccFacility
2. ccSurgeon

Short ccAnswer ccQuestions: ccWhen cca cccaller ccis ccasking ccabout cca ccclaim. ccWhat
ccare ccthe cc3 ccpieces ccof ccinformation ccneeded ccto ccmost ccefficiently cclocate ccthat
ccclaim? cc- ccAnswer cc1. ccDate ccof ccService
2. ccTotal ccCharged ccAmount
3. ccProvider ccName

, Short ccAnswer ccQuestions: ccWhen ccbuilding cca ccpre-cert ccfor ccan ccOP ccMRI. ccWhat
ccare ccthe cc4 cckey ccitems ccneeded? cc(DO ccNOT ccINCLUDE ccDATE ccOF ccSERVICE)
cc- ccAnswer cc1. ccCPT ccCode
2. ccDiagnosis ccCode
3. ccOrdering ccProvider
4. ccFacility

Name ccof ccthe ccdocument ccthat ccoutlines ccevery ccdetail ccof ccthe ccplan. ccAlso ccknown
ccas ccthe cc"constitution ccof ccthe ccplan." cc- ccAnswer ccSPD cc(Summary ccPlan
ccDescription)


SATA: ccItems ccthat cca cccare cccoordinator cccan ccupdated ccin ccPivot. cc- ccAnswer cc1.
ccPCP
2. ccPhone ccNumber
3. ccEmail ccaddress

The ccnetwork ccthat cccovers ccmembers ccwhen ccthey ccare cctraveling ccor cctemporarily
ccoutside ccof cctheir cchome ccarea. cc- ccAnswer ccWrap ccNetwork


Who ccis ccresponsible ccfor ccmaintaining ccand cccommunicating ccmembers cceligibility
ccinformation ccto ccthe ccmembers ccof ccthe ccteam, ccsuch ccas ccQuantum ccHealth ccand
ccPBM cc- ccAnswer ccTPA


A ccgroup ccof ccdoctors, cchospitals, ccand ccother cchealthcare ccproviders ccthat ccare
cccontracted ccto ccoffer cctheir ccservices ccfor cclower ccthan cctheir ccusual ccrate. cc-
ccAnswer ccNetwork


True ccor ccFalse: ccPeople ccwho cchave ccan ccestablished cccare ccwith cca ccPCP ccon
ccaverage ccsave ccabout cc30% ccon cctheir cchealthcare. cc- ccAnswer ccTrue


The ccnetwork ccthat ccis ccgoing ccto ccgive ccthe ccmember cctheir ccBEST ccbenefit cc-
ccAnswer ccPrimary ccNetwork


A ccsavings ccaccount ccthat cccan ccbe ccfunded ccby ccboth ccemployer ccand ccemployee. cc-
ccAnswer ccHSA


A ccfixed ccdollar ccamount ccthat ccis ccthe ccresponsibility ccof ccthe ccpatient ccat ccthe cctime
ccof ccservice. cc- ccAnswer ccCo-Pay


To ccincrease cca ccmember's ccparticipation ccand ccownership ccof cctheir cchealth ccsome
ccplans ccwill ccoffer cc___________________. cc- ccAnswer ccIncentive ccManagement
ccProgram


What ccis ccit ccthat cca ccUR ccnurse ccdoes ccwhile ccthe ccmember ccis ccin-patient ccat ccthe
cchospital. cc- ccAnswer ccConcurrent ccReview