Q: What is Quince?
A: Quince is a cash pay program offered by employer health plans that allows select doctors and hospitals the option to receive full payment at the time of service instead of filing insurance claims. This eliminates provider cost burdens caused by lengthy claims processing, billing and collections. Quince Care Advisors help patients identify the highest quality doctors and hospitals within their medical provider network and assist with care coordination, information flow and referral management, expanding the volume and profitability opportunity for contracted doctors and hospitals.
Q: What is the advantage of contracting with Quince?
A: Only a select group of the highest quality doctors and hospitals in the medical community are offered the opportunity to contract with Quince. Contracting with Quince will allow you to collect full payments at the time of service, including the patient’s portion. Quince provides upfront payment without requiring you to submit a claim. The payment includes the patient’s portion and is credited toward their deductible and out-of-pocket maximums. Our Care Advisors also will assist you and your patients with care coordination, information flow and referral management, which expands the practice volume and profitability opportunity.
Q: Who can I speak to if I have questions regarding completing a provider contract with Quince?
A: We are happy to answer your questions. Please contact our Quince Community Design representatives at 1-833-4QUINCE for assistance.
Q: Do my patients still have health insurance?
Q: Why is this a different process than I normally follow for insurance payment?
A: Quince optimizes the patient’s existing health insurance by helping them identify the most outstanding doctors and hospitals within their medical provider network. Quince allows full payments at the time of service to your practice instead of filing an insurance claim.
Q: What is a Medical Neighborhood?
A: Quince utilizes a leading set of proprietary algorithms to identify doctors and hospitals in the community who have the best outcomes, least amount of complications and the highest quality of care. We call this select group of doctors and hospitals the “Quince Medical Neighborhood.”
Q: Who are Care Advisors?
A: Care Advisors work closely with patients to help them identify the highest quality doctors and hospitals in their area and assist with care coordination. Care Advisors’ services include:
- connecting patients to a Medical Home Provider (Primary Care Physician) within their Quince Medical Neighborhood
- providing patients and Medical Home doctors with the volume critical, clinical quality outcome and appropriateness information for patient’s specific procedure or condition
- assisting patients and Medical Home doctors in scheduling care with a Medical Neighborhood Provider
- helping patients navigate all aspects of healthcare related to their procedure or condition
- eliminating claims, billing and collections by helping the patient, health plan and provider arrange for payment at the time of service
Q: What is a Medical Home Provider?
A: Medical Home Providers are primary care doctors designated by Quince, who offer patient-centered, comprehensive and coordinated primary health care to members. They use Care Advisors to refer patients within the Quince Medical Neighborhood.
Q: How will I identify Quince patients?
A: Patients will provide a payment voucher with Quince contact information, along with their health plan identification card. If a patient arrives at the office without a payment voucher, contact us at 1-833-4QUINCE for assistance.
Q: Do I have to file a claim after I am paid?
A: Quince will prepay for services covered by the health plan. The provider is not required to submit a claim, but instead will be asked to provide the essential information needed for prepayment including ICD-10 and CPT. Exceptions may occur if a patient or plan requests a claim, or if a claim is needed to pay services that are Urgent or Emergency Medical Services that cannot be prepaid.
Q: Is precertification or prior authorization required?
A: Precertification or prior authorization may be required per the health plan. The provider will need to contact the health plan in advance of services in order to confirm requirements. The health plan will follow their existing policies and procedures. Precertification or prior authorization numbers are then shared with Quince staff who will help facilitate the cash payment.
Q: Will services I am paid for be applied to the patient’s deductible?
Q: How do I obtain my payment? What information is needed to request payment?
A: Quince can provide payment via electronic ACH deposit or credit card depending on your preference. We use a healthcare payment platform to facilitate ACH payment. Enrollment steps can easily be found on our website if you are interested in setting up ACH payment in advance in order to expedite your payment. There are no enrollment or transaction fees for ACH payments made to the provider.
Q: How many doctors and hospitals are currently participating?
A: The total number of doctors and hospitals identified in the Medical Neighborhood can vary, but generally are the top 10% of participating doctors and hospitals within the health plan’s medical provider network.
Q: What happens if I need to perform or refer my patient for additional services that weren’t included in my payment?
A: In this case please contact Quince at 1-833-4QUINCE for assistance. Whenever possible, Quince will arrange for prompt payment on a cash basis and the provider will not be required to submit a claim.
Q: What happens if I receive payment for a service in advance and the procedure or appointment is unexpectedly cancelled?
A: Please contact Quince at 1-833-4QUINCE as soon as possible should this occur. They will work with the patient and provider’s office to assist with rescheduling the service or facilitate refund options as required.