Evaluating the Use of New Technology. Is it Covered?

  • June 19, 2019
  • |Quartz
|
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NCQA New Technology
New technologies that positively benefit health could potentially become a covered service.

We often look at new technologies to potentially include as a covered service. We will consider coverage when all the following criteria is met –

  1. The technology must be non-experimental and non-investigational.
  2. The new technology must be approved by the appropriate regulatory body.
  3. Research and review of evidence-based medicine must demonstrate that the new technology has a positive effect on health and is safe.
  4. The new technology must be more beneficial or less expensive than current alternative treatments.

If your provider asks Quartz to cover a treatment or service that requires new technology, we will make a coverage decision within five business days after receiving all the information needed to complete our evaluation. If coverage is denied, we will communicate the reason for the denial to your provider, as well as an explanation of our grievance process.

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