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MRB-13962 - USA (California) - Health Consumer Outreach and Assistance Program Service - Deadline October 10,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MRB-13962

Government authority located in California; USA based organization looking for expert vendor for health consumer outreach and assistance program service.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide health consumer outreach and assistance program service.
- Provide services free of charge to California’s diverse health care consumers needing assistance with health insurance issues, health coverage and health plan complaints and appeals, as well as
understanding the complex health care coverage system. Services will also include consumer assistance for uninsured Californians. Successful contractors will focus on equipping consumers with useful tools, guidance and assistance to meet their health care service needs.
- Demonstrate a full complement of knowledge about California health coverage programs and laws governing health coverage. The Contractor must also know grievance and appeals processes for consumers in health plans that are not DMHC regulated. - Provide direct one-on-one case management services and educate consumers about issues related to health coverage. Services will consist of:
a. Assisting consumers with filing complaints and appeals with a health plan’s internal appeal or grievance process of a group health plan or health insurance issuer.
b. Assisting consumers with filing DMHC Complaints and IMRs after, in most cases, a health plan grievance denial has been upheld.
c. Helping both uninsured and insured consumers navigate their health coverage options, including Medi-Cal, Covered California and private health plans, and providing enrollment assistance.
d. Helping consumers with health care service problems navigate their health coverage benefits and understand their health care rights.
e. Providing information about the IMR and complaint processes and providing consumer education and guidance about health care benefits and consumer health care rights.
f. Provide consumer assistance services that the DMHC, as the regulator, does not provide, such as assisting the consumer with filing a health plan grievance prior to coming to the DMHC for assistance, completing and submitting the DMHC Complaint/IMR form and advocating for the
consumer’s needs. The DMHC Complaint/IMR form must be signed and dated by the consumer and the consumer must also sign the DMHC Authorized Assistant form if they choose to authorize an individual to assist with their IMR or complaint.
(2) All question must be submitted no later than September 26, 2019.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Thursday, 10 October, 2019

Question Answer Deadline : Thursday, 26 September, 2019

Category : Marketing and Branding

Country : USA

State : California

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