Core solution

Quantum Health Complete™

What does a single point of contact for all benefits needs mean? Care is streamlined, burdens are eased and outcomes are improved. We are the only healthcare navigation solution that brings together all clinical, member and provider services with a single point of contact.

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Navigation

Experience tailored healthcare navigation

When you partner with Quantum Health, you’ll have access to a dedicated group of Care Coordinators who specialize in YOU — your organization, your carriers, your people. Because the best navigation is proactive, our Care Coordinators connect with your employees and their dependents early in their journeys. They will help your team members navigate your healthcare benefits program and the healthcare ecosystem as a whole. Your employees will be guided to in-network providers and point solutions within your plan, along with helpful community resources.

  • Healthcare benefits navigation
  • Provider search and guidance
  • Claims assistance
  • Point solution and community referrals
  • Member engagement communications
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Care coordination

Personalized clinical guidance

Clinical expertise is a core part of our Quantum Health Complete™ navigation solution. From the moment members begin their medical journey, they are paired with a nurse from our in-house team. A dedicated nurse will guide your employees every step of the way, from explaining members’ complicated diagnoses to checking on the emotional wellbeing of their families. Every nurse is trained to understand your members’ unique needs, providing decision support, needs assessments, care plans and relief.

  • Utilization management
  • High-cost case review
  • Medical appeals coordination
  • Case and disease management
  • Preadmission and postdischarge planning
  • Behavioral and mental health support
  • Prescription and specialty pharmacy management
  • Transplant and oncology management
  • Referral and eligibility verification for providers
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