Care Coordination
For those who elect Medical/Rx coverage, Quantum Health will be available every step of the way to help you navigate the healthcare system. Quantum Health will be your one stop shop for navigating your medical plan benefits.
When in doubt, call Quantum.
For all benefit eligible employees, Quantum’s Care Coordinators will be your primary contact for all benefit related questions.
They are here to simplify your healthcare experience by replacing ID cards, finding in-network providers and so much more. Your Care Coordinators are with you every step of your healthcare journey, from navigating medical claims, check-ups and pre-certifications. Your Care Coordinators can organize and simplify your benefits to provide you with a better experience when you need care. Depending on your healthcare needs, there are nurses, clinicians and benefit specialist ready to advocate for you and your family. Make Quantum your first call before scheduling your visit or procedure to ensure you get the best value for your care. They will assist you will all the following and so much more:
- Explain Clario's benefits
- Find in-network providers
- Manage chronic conditions
- Contant providers to discuss treatment
- Health with claims and billing
- Create health improvement plans and wellness goals
- Help avoid unnecessary out-of-pocket spending
Lower quality medical care can lead to higher complications, unnecessary procedures and a higher change of misdiagnosis-costing you more time and money.
For those enrolled in the Highmark BCBS Core or HDHP – when your providers office asks “Who is your health insurance carrier?" Simply reply your coverage is through Highmark BCBS with the Blue Cross Blue Shield Network. Claims are submitted to Highmark BCBS with instructions on the back of your ID for your provider. When in doubt, providers should contact Quantum's Provider Customer Service at 1.866.920.1952.
Prescription drugs are administered through CVS Caremark. Your ID card has the needed information for your pharmacy to process your prescription drug claim. When in doubt, pharmacies should contact the CVS Caremark number on the back of your ID card, or call Quantum member services
Quantum Health is available every step of the way to help you navigate the health care system. Together they all work behind the scenes to ensure your best overall member experience.
Quantum may contact you... for certain items only if it's important including:
- You could save on your out-of-pocket costs
- There is an issue with your prescriptions
- Insurance information is needed
- You qualify for a coaching program
- They need to follow up on a procedure or discharge
