FREQUENTLY ASKED QUESTIONS
How do clients access your services?
How do patients access your services?
What is your proprietary network called?
Who is responsible for paying claims?
Does QHM determine what is covered under a benefit plan?
What role does QHM have in the benefit plan?
How do I check if my doctor/hospital is part of the network?
How do patients access your services?
What is your proprietary network called?
Who is responsible for paying claims?
Does QHM determine what is covered under a benefit plan?
What role does QHM have in the benefit plan?
How do I check if my doctor/hospital is part of the network?
How do clients access your services?
QHM staff is available to assist clients via Internet Web viewer, e-mail telephone, and fax. Whether you are an insurance company, self-funded employer group, foreign government, consultant or broker, you may call us directly to find out more about our services. Our Sales Department is ready to assist clients in tailoring a network that meets the needs of your members and your budget. Contact a Sales & Marketing Executive to assist you at 305-821-8430.
How do patients access your services?
Patients may contact the Member Services Department to request assistance with coordination of medical care or via web site request form. QHM representatives are available to schedule and coordinate care with participating providers.
What is your proprietary network called?
QHM’s proprietary networks are called "QHM Select" and "QHM International". Both networks are comprised of hospitals and physicians directly contracted with QHM.
Who is responsible for paying claims?
QHM processes claims but the insurance company or employer listed on the insurance card is responsible for payment.
Does QHM determine what is covered under a benefit plan?
No, the benefit structure is determined by the insurance plan or employer.
What role does QHM have in the benefit plan?
QHM provides a network of providers. QHM processes claims to determine if a preferred provider was used and to apply the contractual discount to the bill. We forward claims to insurance carrier or employer for benefit determination and adjudication.
How do I check if my doctor/hospital is part of the network?
You may search your network directory or contact a QHM customer service representative via telephone, e-mail or fax to assist you with your search.
New strategies of oncology risk management connect patients, physicians and payers while improving care and cost.