Quantum Health Assessment Perfectly Answered

Quantum Health Assessment Perfectly
Answered
Short cAnswer cQuestions: cList c3 cpieces cof cinformation cneeded cto cverify ca cmembers
cidentification cin corder cto cdiscuss cPHI c- ccorrect canswers✔✔1. cID cNumber
2. cName c
3. cDate cof cBirth

Short cAnswer cQuestions: cWhat care c3 cplaces/ways cto cfind can cEOB. c- ccorrect
canswers✔✔1. cTPA cWebsite
2. cMembers cwebsite
3. cInternal cClaim

Short cAnswer cQuestions: cDefine cdeductible. c- ccorrect canswers✔✔The cfixed cdollar
camount cthat cis cthe cresponsibility cof cthe cmember/family cto cpay cbefore cthe cplan
cstarts cto cpay ca ccertain cpercentage.


Short cAnswer cQuestions: cDefine cOut cof cPocket cMaximum c- ccorrect canswers✔✔A
cfixed cdollar camount cthat cis cthe cresponsibility cof cthe cmember/family cto cpay cbefore
cthe cplan cwill cstart cpaying c100% cof ccovered cINN cservices.


Short cAnswer cQuestions: cWhat care cthe c3 cpieces cof cbilling cinformation cneeded cto
cverify ca cprovider cis cINN c- ccorrect canswers✔✔1. cBilling cAddress c
2. cBilling cName
3. cBilling cTax cID

Short cAnswer cQuestions: cWhen cquoting cbenefits cfor cOP csurgery. cWho care cthe c2
cproviders cwe cshould cbe cchecking cnetwork cstatus con? c- ccorrect canswers✔✔1.
cFacility
2. cSurgeon

Short cAnswer cQuestions: cWhen ca ccaller cis casking cabout ca cclaim. cWhat care cthe c3
cpieces cof cinformation cneeded cto cmost cefficiently clocate cthat cclaim? c- ccorrect
canswers✔✔1. cDate cof cService
2. cTotal cCharged cAmount
3. cProvider cName

Short cAnswer cQuestions: cWhen cbuilding ca cpre-cert cfor can cOP cMRI. cWhat care cthe
c4 ckey citems cneeded? c(DO cNOT cINCLUDE cDATE cOF cSERVICE) c- ccorrect
canswers✔✔1. cCPT cCode
2. cDiagnosis cCode
3. cOrdering cProvider

, 4. cFacility

Name cof cthe cdocument cthat coutlines cevery cdetail cof cthe cplan. cAlso cknown cas cthe
c"constitution cof cthe cplan." c- ccorrect canswers✔✔SPD c(Summary cPlan cDescription)


SATA: cItems cthat ca ccare ccoordinator ccan cupdated cin cPivot. c- ccorrect canswers✔✔1.
cPCP
2. cPhone cNumber
3. cEmail caddress

The cnetwork cthat ccovers cmembers cwhen cthey care ctraveling cor ctemporarily coutside
cof ctheir chome carea. c- ccorrect canswers✔✔Wrap cNetwork


Who cis cresponsible cfor cmaintaining cand ccommunicating cmembers celigibility
cinformation cto cthe cmembers cof cthe cteam, csuch cas cQuantum cHealth cand cPBM c-
ccorrect canswers✔✔TPA


A cgroup cof cdoctors, chospitals, cand cother chealthcare cproviders cthat care ccontracted
cto coffer ctheir cservices cfor clower cthan ctheir cusual crate. c- ccorrect
canswers✔✔Network


True cor cFalse: cPeople cwho chave can cestablished ccare cwith ca cPCP con caverage
csave cabout c30% con ctheir chealthcare. c- ccorrect canswers✔✔True


The cnetwork cthat cis cgoing cto cgive cthe cmember ctheir cBEST cbenefit c- ccorrect
canswers✔✔Primary cNetwork


A csavings caccount cthat ccan cbe cfunded cby cboth cemployer cand cemployee. c- ccorrect
canswers✔✔HSA


A cfixed cdollar camount cthat cis cthe cresponsibility cof cthe cpatient cat cthe ctime cof
cservice. c- ccorrect canswers✔✔Co-Pay


To cincrease ca cmember's cparticipation cand cownership cof ctheir chealth csome cplans
cwill coffer c___________________. c- ccorrect canswers✔✔Incentive cManagement
cProgram


What cis cit cthat ca cUR cnurse cdoes cwhile cthe cmember cis cin-patient cat cthe chospital. c-
ccorrect canswers✔✔Concurrent cReview


An cinstance cwhere cthe cplan cwould cdo cOut cof cNetwork cPay cas cIn c(OONPAI). c-
ccorrect canswers✔✔When cthe cmember cneeds ca cdoctor cor ca cservice cthat's cnot
coffered cwithin ctheir cnetwork.


At cQuantum chow cmany cpieces cof cinformation care cyou crequired cto cget cfrom ca
ccaller cprior cto cdiscussing cPHI? c- ccorrect canswers✔✔3