​Discovery Health Partners

Our New Subrogation Vendor is Discovery Health Partners

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 –

  • All stages of reconstruction of the breast on which the mastectomy was performed
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance
  • Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedema

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.