Bupa Arabia Healthcare Services

25 Questions | Total Attempts: 355

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Bupa Arabia Healthcare Services

Owning the whole


Questions and Answers
  • 1. 
    Which of the following would be the main contributor to poor quality outcome in health care systems?
    • A. 

      Distant providers

    • B. 

      Poor in-patient packaging

    • C. 

      Uncoordinated medical services among and within providers

    • D. 

      High expense of medical care

  • 2. 
    The Health care operation ( HCO ) services would ensure all of the following EXCEPT
    • A. 

      Optimal use of resources.

    • B. 

      Decreased utilization

    • C. 

      Better quality of service

    • D. 

      Overall lower prices of services

  • 3. 
    What is the main reason behind  Bupa’s will to touch 1 million members with value?
    • A. 

      To create a marketing impact

    • B. 

      To control provider abuse through enlightening of members about their rights

    • C. 

      To create loyalty and retention

    • D. 

      To reduce load on operation by coordinating

  • 4. 
    Explanation, offering, trying, and satisfying are all part of the process to :
    • A. 

      Keep a customer within his comfort zone

    • B. 

      Creation of an impulse

    • C. 

      Creation of demand

    • D. 

      Design a product

  • 5. 
    Health care operations services provide Bupa Arabia with a unique value proposition that is difficult to imitate by the competition because:
    • A. 

      They are unique

    • B. 

      They are expensive and resourceful.

    • C. 

      They are protected with extreme confidentiality.

    • D. 

      They are protected by legal obligations.

    • E. 

      They are built on core competencies and are cross functional

  • 6. 
    Ultimately customer satisfaction will lead to all of the following EXCEPT :
    • A. 

      Reduced price sensitivity

    • B. 

      Reduced switching to competitors.

    • C. 

      Increased referrals to Bupa

    • D. 

      Increased repeat purchases

    • E. 

      Better packaging of medical services

  • 7. 
    Which of the following does NOT belong  to the streams for Operational Management of Strategic Accounts?
    • A. 

      Chronic disease management

    • B. 

      Targeted outreach program

    • C. 

      Medication refill.

    • D. 

      Provider relations

    • E. 

      Doctor on phone

  • 8. 
    Which of the following is one of the tools of our health care services?
    • A. 

      Telecare system and devices for members with dementia.

    • B. 

      Fast response outbound emergency doctors

    • C. 

      Home country care treatment.

    • D. 

      Rapid Reimbursement program

  • 9. 
    The value to the member in maternity coaching is:
    • A. 

      Communication

    • B. 

      Empathy

    • C. 

      Advice on what to expect

    • D. 

      Answering queries

    • E. 

      All of the listed options are correct

  • 10. 
    In regards to maternity coaching:
    • A. 

      Both prenatal and postnatal coaching is available

    • B. 

      Mothers receiving maternity gifts do not get coaching calls

    • C. 

      The priority of the coaching call goes to mothers with emergent medical problem

    • D. 

      Group coaching presentation is not a possibility.

  • 11. 
    The stream of HCO doctor calling members admitted to hospitals involves all of the following EXCEPT :
    • A. 

      Outbound calls

    • B. 

      Asking about any issues or problems.

    • C. 

      Actively helping to solve a problem

    • D. 

      Talking only to members who are flagged to be complicated.

    • E. 

      Calling the Hospital Audit doctors to coordinate services.

  • 12. 
    Chronic disease management stream is one of our most valuable streams because of the following values :
    • A. 

      Customer satisfaction

    • B. 

      Coordination of healthcare delivery for quality outcome

    • C. 

      Potential commercial benefit

    • D. 

      All of the listed options are correct

    • E. 

      Specific, targeted medical outcomes

  • 13. 
    Which of the following is NOT an added value to the  medication refills stream  :
    • A. 

      Managing Chronic Conditions by ensuring access to medications in a timely manner

    • B. 

      Ensuring member compliance with chronic medications by having reminders

    • C. 

      Accessibility to Al –Nahdi network

    • D. 

      First Clinic will call the member about the next refills

    • E. 

      Web- based medication refill

  • 14. 
    Which of the following is a currently adopted coaching program?
    • A. 

      Diabetes coaching program

    • B. 

      Cataract prevention coaching

    • C. 

      Skin care and wellness program

    • D. 

      Coaching for cancer cervix screening

  • 15. 
    What is “Rejection recovery" service?
    • A. 

      It is a service by which a medical service rejected by PA would be re looked at in claims

    • B. 

      It is a service by which the L2 - Preauthorization team would rework a rejected service

    • C. 

      It is a service of reconciliation carried out by the Provider relations team.

    • D. 

      It is a service by which a member is called within 15 minutes of a rejected service in order to explain the reason of rejection and offer him/ her advice.

  • 16. 
    What is "Pending recovery" service?
    • A. 

      It is a service by which the L2 team would convert any pending to either an approval or a rejection

    • B. 

      It is a service by which the PA team would call the member and the hospital to facilitate completing required data.

    • C. 

      It is a new service by which CESAR would initiate an automated pending to request complete uploading of documents relevant to the diagnosis.

    • D. 

      It is a protocol initiated when needed by the PA department to prevent excessive pending when the response time drops to critical levels.

  • 17. 
    What is the Home Country Treatment service?
    • A. 

      It is giving members an exceptional discount when reimbursing certain services done at their home countries.

    • B. 

      It is a special service by which Bupa will provide tickets to the family of a terminally ill patient in order to accompany him to his home country.

    • C. 

      It is providing complete medical services to certain nationalities in their home countries in contracted hospitals.

    • D. 

      It is a service provided to VIP members to reimburse them with 100 % of their bills if treated in his home country.

  • 18. 
    The ones present at "Point of service" and facilitate outpatient operations are:
    • A. 

      Delegates

    • B. 

      Customer service

    • C. 

      Hospital audit doctors

    • D. 

      Hospital insurance officers

    • E. 

      HCO doctors

  • 19. 
    The most important value of the Clinical Excellence (roving doctor)’s visit to members admitted in Providers is all of following EXCEPT :
    • A. 

      Solving any problems.

    • B. 

      Discussing the condition with the member.

    • C. 

      Face to face interaction.

    • D. 

      Engaging with any relatives present.

    • E. 

      All of the listed options are correct

  • 20. 
    Which of the following is an indication for Home Health Care?
    • A. 

      Admission just for (IV Antibiotics, Dressing, Care of tubes)

    • B. 

      Physiotherapy (particularly for stroke and cerebral palsy patients)

    • C. 

      Terminal cases for support management only

    • D. 

      All answers are correct

  • 21. 
    Which best describes the "Doctor on phone" service?
    • A. 

      It is a service dedicated to renewing and refilling chronic medications.

    • B. 

      It is a service that can offer medical advice and referral opinion.

    • C. 

      It is a service dedicated to recover rejections for higher network members.

    • D. 

      It is a new service launched to communicate with the treating doctors to solve pending issues of the selected members.

  • 22. 
    The most valuable of our Health Care Service Streams is “Chronic disease management”. The characteristics of this stream include:
    • A. 

      It targets specific health related objectives.

    • B. 

      It is based on recognized internationally accepted scientific evidence.

    • C. 

      It is scripted and prepared for coaching

    • D. 

      It is audited.

    • E. 

      All of the listed options are correct

  • 23. 
    Chronic disease management stream includes all of the following EXCEPT:
    • A. 

      Helping patients manage their chronic conditions such as Diabetes and Hypertension by advise and coaching.

    • B. 

      It may include refilling service for chronic medications.

    • C. 

      It may include providing laboratory services at home or work.

    • D. 

      It will include arranging a home visit by a doctor every 3 months for selected members

  • 24. 
    The Strategic implementation mind-set of our HealthCare services, is that they are owned by:
    • A. 

      Core HCO team

    • B. 

      Operations Division

    • C. 

      Sales Department

    • D. 

      Every Bupa employee

    • E. 

      Quality Department

  • 25. 
    The role of the Sales Department in implementation of our HCO services includes the following:
    • A. 

      Listening carefully to members of their groups and knowing all issues

    • B. 

      Helping with getting missing member mobile numbers

    • C. 

      All of the listed options are correct

    • D. 

      Coordinating with Stream Owners to arrange for targeted inclusion of particular streams for their groups.

    • E. 

      Communicating these services - and their value - to the Groups.

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