Subrogation means substituting one person or group by another in respect to an insurance claim. A subrogation vendor investigates claims to determine whether a third party may be responsible for paying for a member’s claims. Discovery Health Partners (DHP) has replaced Meridian as our subrogation vendor (although Meridian will continue to work cases they opened prior to January 1, 2017).
DHP’s subrogation solution draws on advanced mining technology, state-of-the-art case management and workflow, and sophisticated analytics and dashboards. This technology is combined with a deep expertise in the health insurance industry and a proven track record of improved recoveries.
Potential case members receive Investigation Questionnaires to complete and return to DHP.
Women’s Health and Cancer Rights Act
The Women’s Health and Cancer Rights Act of 1998 requires all health plans offering mastectomy coverage to also provide benefits for the following services –
Quartz provides breast reconstruction benefits in accordance with this law. Coverage for these services is subject to the same limitations, exclusions and cost-sharing provisions that apply to other services provided under member health insurance plan. The copayment and deductible amounts that apply to a member’s surgical benefit also apply to the mastectomy and breast reconstruction benefits. They can consult their Certificate of Coverage* and Summary of Benefits and Coverage for specific information.
If members have questions about their benefits, they can call Quartz Customer Service at (800) 362-3310.
* State of Wisconsin Health Insurance Program Participants should consult their It’s Your Choice: Reference Guide.
View List of Fall 2017 Unity Connection Articles
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Quartz Health Solutions, Inc., Unity Health Plans Insurance Corporation, Gundersen Health Plan, Inc., Gundersen Health Plan Minnesota, Physicians Plus Insurance Corporation, Gundersen Health System, UnityPoint Health and UW Health are separate legal entities. Plans are underwritten by Unity Health Plans Insurance Corporation unless otherwise noted.