Quartz is seeing an increase of the number of providers that simply send medical records with no correct claim information and and no explanation as to why the records are being sent. It is likely that the providers are requesting an appeal of a denied claim. To make sure your appeal is handled in a timely fashion, please follow these steps –
When this information is provided, Quartz will review the case and determine if the original denial can be overturned.
For those records that have already been submitted without the Claim Adjustment Form or Explanation: the records have been scanned and filed under the member number (available). No processing will occur until the Form and Explanation are provided.
Changes to the ICD-10 diagnosis codes for 2019 will go into effect on October 1st.
Nearly 300 new codes have been created, from codes that address current social issues to codes that more accurately describe surgical wound location and depth.
Look for “Coding Alert” the Fall Quartz Communicator (September) for an exploration of these new codes and what they mean for your facility.