Description: Helps solve problems from a neutral standpoint to ensure that members receive all medically necessary covered services for which plans are contractually responsible.The Mental Health Ombudsman is designed to create a bridge between the Mental Health Plan system and individuals, family members and friends of individuals, in need of mental health services by providing information and assistance in navigating through the system.The Office of the Ombudsman:Helps solve problems between Medi-Cal managed care members and managed care plansHelps solve problems between Medi-Cal members and county mental health plansHelps members with urgent enrollment and disenrollment problemsHelps Medi-Cal members access Medi-Cal specialty mental health servicesOffers information and referralsIdentifies ways to make the Medi-Cal managed care program more effectiveEducates members on how to navigate the Medi-Cal managed care and specialty mental health systemConnect you with the right person or department to help solve a problemConnect you with local resources in your county who can help youConnect you with patients' rights servicesThe office of the Ombudsman does not conduct formal investigations; does not change rules, policies, or procedures, nor does it participate in any formal hearing or grievance process
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