Your health plan, our quality standards
Making informed decisions about your health starts with clear, accessible information.
At Quartz, we’re committed to offering the tools and resources you need to feel confident in the care you receive. We continuously review how we’re doing against rigorous quality standards and look for ways to improve, so your experience reflects the high-quality care you deserve.
Common questions
What is a Certificate of Coverage (COC) and where can I find it?
A Certificate of Coverage (COC) is a detailed guide to your health plan. It includes information about covered and excluded benefits and services, restrictions for care received outside Quartz’s service area, and how to submit a claim. You can find your COC in your Member Guide in your Quartz MyChart.
If you’re covered under the State of Wisconsin 2025 Plan, your COC is included in the State of Wisconsin Plan Guide.
What is a Summary of Benefits and Coverage (SBC) and where can I find it?
A Summary of Benefits (SOB), sometimes called a Schedule of Benefits, provides an overview of your health plan costs, including copayments, deductibles, and coinsurance, and what you may pay when receiving care. You can find your SOB in your Quartz MyChart within your Member Guide.
If you’re covered under the State of Wisconsin health insurance program, this information is included in your State of Wisconsin Plan Guide.
What is a Schedule of Benefits (SOB), and where can I find it?
A Summary of Benefits (SOB), sometimes called a Schedule of Benefits, provides an overview of your health plan costs, including copayments, deductibles, and coinsurance, and what you may pay when receiving care. You can find your SOB in your Quartz MyChart within your Member Guide.
If you’re covered under the State of Wisconsin health insurance program, this information is included in your State of Wisconsin Plan Guide.
How can I appeal a coverage decision and what are my appeal rights?
Your right to appeal
Every member has the right to file a complaint or appeal a decision made by Quartz. We believe in the importance of a fair and prompt review process, ensuring that your voice is heard. If you feel that a decision regarding your health care or services isn’t right, you have the power to appeal.
External review options
In addition to appealing directly to Quartz, certain situations may allow for external review. This means that you can have Quartz’s decision evaluated by an independent review organization.
Learn more about your appeal rights
To navigate the appeals and grievances process effectively, we encourage you to visit our dedicated pages:
How does Quartz decide on the coverage of new technology?
We often look at new technologies to potentially include as a covered service. We will consider coverage when all the following criteria is met:
- The technology must be non-experimental and non-investigational.
- The new technology must be approved by the appropriate regulatory body.
- Research and review of evidence-based medicine must demonstrate that the new technology has a positive effect on health and is safe.
- 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.
What is Care Management and how can they help me navigate my care?
As a Quartz member, you have access to tailored support for your health and well-being. Care Management, a team of trained health professionals, is here to help, whether you’re navigating a new diagnosis or managing life changes.
Call us at (866) 884-4601 or fill out our request form to get started. You can also learn more on our Care Management page.
How does the Women’s Health and Cancer Rights Act (WHCRA) protect my breast reconstruction rights?
The Women’s Health and Cancer Rights Act of 1998 (WHCRA) is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy. If you have had or are going to have a mastectomy, you may be entitled to certain benefits under WHCRA. You can learn more about it in our article.
What is advance care planning and what should I know about it?
Advance care planning ensures your wishes are known by your family, friends and doctors. This becomes especially important if you ever have a serious illness or injury and are unable to communicate. You can read more about how advance care planning can help you in our article.
How can I authorize the release of my health information?
We’ve made the process simple if you would like us to share your health information with someone other than yourself. By completing the Authorization for Disclosure of Protected Health Information form, you can specify what information we share and with whom. You can learn more about the process to release your health information and understand why that might be important for you on this page. (add link to new page created with this article copy).
What is considered health information?
Definition coming from Laura and Phong
Contact us
Quartz is committed to providing superior customer service. That’s one reason we offer so many ways to reach us.