Bupa Arabia Healthcare Services
Owning the whole
- 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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