Quartz has partnered with Claritev to help ensure claims are reviewed accurately and reimbursement methodologies are applied consistently. This partnership improves the quality of claim reviews and reduces the need for rework or post-payment corrections.
Claritev will conduct select reviews on behalf of Quartz, including itemized bill (IBR) reviews and diagnosis-related group (DRG) validation. Providers may be asked to submit documentation such as itemized bills, medical records, or discharge notes. Timely submission is important and claims may be denied until the requested information is received and reviewed. Starting this summer, Claritev will also perform secondary reviews of certain coding edits through their ACE system.
Remittance advice will indicate when a claim has been reviewed for IBR, DRG validation, or ACE coding edits. Providers can access the Claritev provider portal (ACE) or contact them directly. Claritev will be able to assist you on behalf of Quartz.
This partnership helps make claim reviews more efficient and consistent while supplying providers with direct support. If you want to learn more about how Claritev reviews may affect your claims, you may contact Claritev.
