Consumer Problem Resolution & NOA: 19-01 Policy 19-01

SUPERSEDES:  04-10 Notice of Action, 03-03 Consumer Problem Resolution System

New Policy June 2019, Technical edits and Translated attachments added, October 10, 2019; Technical Revision January 9, 2020
Attachment A: Technical Edit January 9, 2020; Amended May 4,
2023, Amended July 15, 2024

Attachment B:  TTechnical Edit March 12, 2021, Technical Edit and
name change March 14, 2021; Technical Edit September 24, 2021

ATTACHMENTS:         

1. Consumer Problem Resolution (Grievance) and Notice of Adverse Benefits Determination (NOABD) User Manual Manual

2.  NOABD Quick Guide & FAQs PDF

3. NOABD Denial Notice  English Spanish Tagalog Cantonese Mandarin

4. NOABD Modification Notice  English Spanish Tagalog Cantonese Mandarin

5. NOABD Termination Notice  English Spanish Tagalog Cantonese Mandarin

6. NOABD Delivery System Notice   English Spanish Tagalog Cantonese Mandarin

7. NOABD Authorization Delay English Spanish Tagalog Cantonese Mandarin

8. NOABD Timely Access Notice English Spanish Tagalog Cantonese Mandarin

9. NOABD Financial Liability Notice  English Spanish Tagalog Cantonese Mandarin

10. NOABD Payment Denial Notice  English Spanish Tagalog Cantonese Mandarin

11. NOABD Grievance and Appeal Timely Resolution Notice  English Spanish Tagalog Cantonese | Mandarin

12. NAR (Notice of Appeals Resolution) NOABD Overturned Notice                           OCFA: English Spanish Tagalog Cantonese  Mandarin QM: English Spanish Tagalog  MandarinCantonese

13. NAR (Notice of Appeals Resolution) NOABD Upheld      OCFA English SpanishTagalog Cantonese Mandarin  QM English Spanish Tagalog Cantonese Mandarin

14. Notice of Grievance Resolution OCFA English Spanish Tagalog Cantonese Mandarin QM English Spanish Tagalog  Cantonese Mandarin

15. NOABD Your RightsEnglish Spanish Tagalog Cantonese Mandarin

16. NAR (Notice of Appeals Resolution) Your Rights  English Spanish Tagalog Cantonese Mandarin

17. Language Assistance Taglines 

18. Beneficiary Non-Discrimination Notice English Spanish Tagalog Cantonese Mandarin 

19. Grievance and Appeals Resolution Poster English Spanish  Chinese  Tagalog Russian  

20. Grievance and Appeals Resolution Brochure English Spanish Chinese Tagalog

Resources: Templates for reason for issuing NOABD, Why we denied your request.  |  Guide to Using the AVATAR NOABD / NAR Form