Some services and supplies covered by your insurance plan must have prior authorization. This means that you, your doctor or nurse must fill out a Prior Authorization Request Form before you can have the treatment to determine if it will be covered.

The services that need Prior Authorization are based on the type of insurance plan you have.  Check your Quartz ID card to see what plan you have.  It’s printed at the top of the card.


View  your health plan's prior authorization list –

If you need one of the services on your plan’s Prior Authorization list, contact your doctor. Ask your doctor to fill out Quartz’s Prior Authorization Request Form.


Before you schedule your treatment, check to see if Quartz has approved the Prior Authorization. Just login to MyChartMyChart link or contact Customer Service at 800.362.3310.  


Medication Prior Authorization

Certain medications require a Medication Prior Authorization


HMO Members

Use only in-network services and supplies. All out-of-network services and supplies must have Prior Authorization.

  • Quartz checks out-of-network Prior Authorization requests to see if the service is needed based on medical review
  • Insurance plans have a range of limitations and services or products that are excluded

If Quartz approves a Prior Authorization, services are covered up to the usual, customary and reasonable charge (UCR). You may be responsible for paying charges that are above the UCR and other out-of-pocket costs.


POS, Choice, Choice Plus, My Choice and PPO Members

POS and PPO plans members can get services or supplies in-network or out-of-network. See Information for POS Members or Information for PPO Members.