Who is responsible for paying my claims?
The Third Party Administrator (TPA) or your Insurance Company which is listed on the back of your insurance card.

Does QHCM determine what is covered under a benefit plan?
No, the benefit structure is determined by the employer. For Blessing Hospital and Quincy Medical Group members, QHCM will quote benefits. For all other members, the TPA or Insurance Carrier can provide this information.

What role does QHCM have in my benefit plan?
QHCM provides a network of providers your TPA or Insurance Carrier has selected for your plan.  QHCM pre-processes your claims to determine if a preferred provider was used and to apply the contractual discount to the bill.  We then forward the claim to the TPA or Insurance Carrier for benefit determination and adjudication.

How do I check if my doctor/hospital is part of the Plan?
You may look in your network directory or use the website directory, but remember to call the QHCM Customer Service Center for final verification.