Quantum Health- Final Exam Questions With Correct Answers
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Course
Quantum Health
Institution
Quantum Health
Quantum Health- Final Exam Questions
With Correct Answers
How long does it take for pharmacy claims to process? - answerImmediately (Real Time)
Why would a PCP's name in PIVIT be highlighted yellow? - answerneeds updating or
verification
A member calls and tells you that they were just diagnos...
In which section of SBS would you look for information on specific requirements an employee
would need to satisfy in order to get a lower premium? - answer✔Incentive Management
Program
People who have an established relationship with a PCP spend on average ____ less on
healthcare - answer✔30
When calling the network to verify whether a provider participates to not, what are the 3 pieces
of information you need to obtain before calling? - answer✔Doctor's name, Facility ( Billing
address), and Tax ID
What 3 pieces of information do we need to properly look up a claim - answer✔date of service,
amount of claim, and provider name
What are the two main functions of a TPA - answer✔Administer the plan and pay claims
Why does an employer hire a network for their plan - answer✔To save money and provide
services at discounted (contracted) rate
When building a Pre-Determination for an office procedure, what provider will you input in the
top right hand corner of the Pre-D? (Physician/Facility field of the form) - answer✔NPI for
Preforming Facility
What Benefit would you quote for Botox Injections - answer✔Office Surgery
what kind of nurse preforms daily concurrent for inpatient members? - answer✔UR Nurse
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