Prior Authorization List

Contact Quartz Customer Service with specific code information to determine if an item or service requires prior authorization.

The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. Providers are encouraged to review the Prior Authorization List frequently for changes. Prior authorization is not a guarantee of payment.

Behavioral Health Services 

Durable Medical Equipment

Any purchase items in excess of $500 in billed charges, and all equipment rental, require prior authorization.

Inpatient Admissions

Note: Urgent/emergent hospital admissions require notification at the time of admission. Elective hospital admissions require prior authorization before admission and notification when admitted.

Other Services

Out-of-Network Services or Supplies

Surgical Procedures

Note: The following procedures must be prior authorized before they are scheduled.