Complaints or Grievances

We would like to know if you ever have concerns about our service or your claims. Please call Quartz Customer Service at (800) 362-3310, or write to us if you have a complaint –

Quartz
840 Carolina Street
Sauk City, WI 53583-1374

If you want to talk to someone outside Quartz about the problem, call the HMO Enrollment Specialist at (800) 291-2002. The HMO Enrollment Specialist may be able to help you solve the problem. HMO Enrollment Specialist can also help write a formal grievance to Quartz or to the BadgerCare Plus program.

To file a complaint with the BadgerCare Plus program, send your concern to –

BadgerCare Plus
Managed Care Ombuds
P.O. Box 6470
Madison, WI 53716-0470
(800) 760-0001

If your complaint or grievance needs action right away because a delay in treatment would greatly increase a risk to your health, please call Quartz as soon as possible at (800) 362-3310.

You will not be treated differently from other members because you file a complaint or grievance. Your health care benefits will not be affected.

Appeals

You have the right to appeal to the State of Wisconsin, Division of Hearings and Appeals (DHA), for a fair hearing if you believe your benefits are wrongly denied, limited, reduced, delayed, or stopped by Quartz.An appeal must be made no more than 45 days after the date of the decision being appealed. If you make an appeal before the effective date, the service may continue. You may need to pay for the cost of services if the hearing decision is not in your favor.

If you want a fair hearing, send a written request to –

Department of Administration
Division of Hearings and Appeals
P.O. Box 7875
Madison, WI 53707-7875

The hearing will be held with an administrative law judge in the county where you live. You have the right to be represented at the hearing or you can bring a friend for support. If you need a special arrangement for a disability or for language translation, please call (608) 266.3096 (voice) or (608) 264-9853 (hearing impaired).

You will not be treated differently from other members because you request a fair hearing. Your health care benefits will not be affected.

If you need help writing a request for a fair hearing, please call either the BadgerCare Plus Ombuds at (800) 760-0001 or the HMO Enrollment Specialist at (800) 291-2002.