Medicaid Plans Grievances, Appeals & Complaints

Appeals

If you are still unhappy after talking to Customer Service, you have the right to file an appeal with Quartz up to 60 days after you receive an adverse benefit determination notice. You may file a request by phone or in writing:

Quartz
Attn: Appeals Specialists
2650 Novation Parkway
Fitchburg, WI 53713

(866) 569-3426 or (608) 644-3416

If filed verbally, you will still need to send a letter stating your request to appeal.

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 were wrongly denied, limited, reduced, delayed, or stopped by Quartz. An appeal must be made no more than 90 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.

Grievances

We would like to know if you ever have concerns about our service or your claims. For help resolving your concerns, please call Quartz’s Customer Service at (800) 362-3310, or write to us if you have a grievance:

Quartz
2650 Novation Parkway
Fitchburg, WI 53713

If you want to talk to someone outside of 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. The HMO Enrollment Specialist can also help write a formal grievance to Quartz or to the BadgerCare Plus Program.

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