Provider Medical Policies

At Quartz, we strive to keep you informed. That’s why we make it convenient for you to access the medical guidelines Quartz utilizes to make medical necessity determinations on the MCG Cite Transparency Portal.

Follow these simple steps to view our medical policies on the portal.

1. Disclaimer – Check the Accept Terms and Conditions box and click Accept and Proceed
2. User Information – Fill in your first name, last name, and what type of category best fits your interest in the guidelines
3. Contact Information – Select your preferred way of receiving a verification code
4. Access Code – Enter the access code you received

Expand the guideline categories to see the full list of medical policies. These medical policies do not constitute medical advice.

During the medical review, we will reference the terms of the enrollee’s plan and any applicable laws in the decision-making process.

The terms of an enrollee’s plan may differ from these medical policies. In the event of a conflict, the terms of the enrollee’s plan supersede the medical policy.

To review the terms of the enrollee’s plan, please see the Certificates of Coverage, Benefit Riders, and Summary Plan Descriptions using the Summary of Benefits & Coverage lookup.

The Quartz Behavioral Health Care Management team also utilizes The ASAM Criteria, which is not in the MCG Cite Transparency Portal. For detailed information on The ASAM Criteria, please refer to An Introduction to The ASAM Criteria for Patients and Families.

For Quartz Medicare Advantage related medical policies, the Quartz Utilization Management team utilizes CMS National Coverage Determinations and Local Coverage Determinations. These policies are not available within the MCG Cite Transparency Portal. To access them please use the Medicare Coverage Database.