Information + Forms
Quartz Self-Funded Members
Your employer has selected Quartz to administer your health plan benefits. Providing excellent customer service is a company-wide goal at Quartz. Every employee is dedicated to helping ensure that you receive the high level of service that you deserve.
We strive to:
- Provide prompt and accurate claim processing and customer service
- Keep our promises and commitments to our customers
- Exceed our customers’ expectations in everything we do
All participants 18 years of age and older are provided with access to a secure online portal, MyChart. With MyChart, you can access your health benefit information and other features. For instance, you can:
- View your plan benefit information
- Check claims status
- Check eligibility
- Review prior authorizations
- Request or print ID cards
- View your Explanation of Benefits
- Change your Primary Care Provider
- Update your demographic information
- Ask a question securely with “Send a Message”
Self-Funded Members Forms & Resources
To verify if your employer offers Appeals, please refer to your Summary Plan document.
All appeals must be submitted in writing within 180 days following the receipt of notification of an Adverse Benefit Determination. If the appeal qualifies as an Expedited case, then the appeal request can be taken verbally. Appeals Specialists will work with appropriate staff to determine if an appeal qualifies to be expedited.
Appeals Specialists will determine if an appeal is a valid appeal by verifying that Quartz has processed the issue correctly. Valid appeals will be acknowledged within five business days by a mailed letter to the participant. The appeal will be resolved within 30 days for pre-service requests and 60 days for post-service claims. Participants have the right to submit relevant testimony with the appeal.
Providers can file appeals on behalf of participants, with the participants’ permission. In order to obtain proper authorization, the Appointment of Authorized Representative form will need to be signed by the participant.
Once a decision has been reached and if it is unfavorable for the participant, you may have the option to file a request for external review. If this is an option for your appeal, the external review rights will be given to you with the final internal determination.