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Page Updated On 09/21/2021

Medicare Advantage Provider Resources

Forms + Links

Prior Authorization

Therapy Forms

Benefit Denial Forms

Quartz Medicare Advantage Benefit Denial Form Instructions

Dental Services (English | Spanish)

DME & Supplies (English | Spanish)

General Use (English | Spanish)

Benefit Plan Exclusion Lists

Swedish American Medicare Advantage (HMO) from Quartz

Elite & Value Exclusion List

Elite D, Value D, & Core D Exclusion List

Aurora Health Care Medicare Advantage (HMO) from Quartz

Elite & Value Exclusion List

Elite D, Value D, & Core D Exclusion List

Gundersen Medicare Advantage (HMO) from Quartz

Elite & Value Exclusion List

Elite D, Value D, & Core D Exclusion List

Gundersen Minnesota Medicare Advantage (HMO) from Quartz

Elite & Value Exclusion List

Elite D, Value D, & Core D Exclusion List

UW Health Medicare Advantage (HMO) from Quartz 

Elite & Value Exclusion List

Elite D, Value D, & Core D Exclusion List

Manuals & Programs

Welcome. We're Happy You're Here!

Thank you for choosing Quartz Medicare Advantage. We are honored that you have entrusted us with your health insurance needs, and we are committed to making your experience be the best it can be.