Quantum Health- Final Exam QUESTIONS AND ANSWERS 100% SOLVED (Newest 2025) How long does it take for pharmacy claims to process? - Correct Answers ✅Immediately (Real Time) Why would a PCP's name in PIVIT be highlighted yellow? - Correct Answers ✅needs updating or verification A member calls and tells you that they were just diagnosed with a serious medical condition that will require surgery and a lot of rehab. They just want to make sure that is the best and only option that they have. What kind of point solution would you suggest for them? - Correct Answers ✅Second opinion What do you call a group of doctors, hospitals, and other healthcare providers that are contracted to offer their services for a lower than usual rate - Correct Answers ✅Specialty/Narrow Network What section of Smart Benefit Search would you go to in order to quote a sick office visit with a pediatrician - Correct Answers ✅PCP- Office Visit What does DME stand for? - Correct Answers ✅durable medical equipment 1 / 2
Quantum Health- Final Exam QUESTIONS AND ANSWERS 100% SOLVED (Newest 2025) 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? - Correct Answers ✅Incentive Management Program People who have an established relationship with a PCP spend on average ____ less on healthcare - Correct Answers ✅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? - Correct Answers ✅Doctor's name, Facility ( Billing address), and Tax ID What 3 pieces of information do we need to properly look up a claim - Correct Answers ✅date of service, amount of claim, and provider name What are the two main functions of a TPA - Correct Answers ✅Administer the plan and pay claims Why does an employer hire a network for their plan - Correct Answers ✅To save money and provide services at discounted (contracted) rate
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