Helps solve problems to ensure that members receive all medically necessary covered services for which plans are contractually responsible.

Services offered:

• Serves as an objective resource to resolve issues between Medi-Cal managed care members and managed care health plans.
• Helps members with urgent enrollment and disenrollment problems.
• Offers information and referrals.
• Identifies ways to improve the effectiveness of the Medi-Cal managed care program.
• Educates members on how to effectively navigate through the Medi-Cal managed care system.
• Help members find information to access appropriate mental health services.
• Connects members with the right person/department to help resolve a problem.
• Connect members with patient’s rights services.