Group & Employer Plans: Iowa Member Appeals

Quartz’s mission is to investigate all grievances and appeals appropriately and work to resolve them within the required time period. There is no time limit for filing appeals or grievances. Expedited appeals will be resolved in 72 hours and standard appeals will be resolved in 30 days.

You or your provider can file an appeal in writing by faxing, emailing, or mailing a letter to the Appeals Specialists. If your provider is appealing, Quartz will need your approval. Approval can be submitted on the Appointment of Authorized Representative form.

Once an appeal begins, you will be contacted by an Appeals Specialist and an invitation will be mailed to attend a Reconsideration Meeting. At this meeting, you will be able to make a statement about why you feel the appeal should be approved.

The State of Iowa gives members the ability to file an external review. The review is conducted by a company independent from Quartz. You may file an external review request simultaneously as an appeal if it is an expedited situation. Otherwise, the request must be filed within 60 days of the internal appeal decision.

To file an external review, send notification and a $25 filing fee to:

Division of Insurance
330 Maple Street
Des Moines, IA 50319

• Appointment of Authorized Representative Form
• Appeal Filing Form
• Formulary Exception Request Form