CONSUMER ASSISTANCE Sample Clauses

CONSUMER ASSISTANCE. Experian will perform the consumer assistance function for consumers located in the Affiliate Leased Zip Code Area. Affiliate will refer all such consumers to Experian's National Consumer Assistance Center for assistance.

CONSUMER ASSISTANCE. In addition, to the core requirement to provide seamless, “no wrong door,” multi-portal consumer assistance and support related to Exchange eligibility and enrollment activities, federal law and regulations require that exchanges have an accessible consumer assistance service function and tools that provide for a toll-free consumer assistance call center, Internet web site with specified information and functionality, including information about and access to navigators, and referrals to appropriate and available consumer assistance programs in the state. The basic program goals of the Exchange consumer assistance function will be to help consumers navigate health coverage and delivery systems, secure access to needed services, guarantee consumer protections and consumer rights, and resolve problems that arise post-enrollment. As a foundation, the Exchange will build outreach, consumer engagement, and accountability processes with its contracted health plans to ensure that consumers get timely assistance with eligibility questions and plan enrollment issues, and, once enrolled, access to needed services and assistance with problem resolution. The work to ensure effective and timely consumer assistance from issuers participating in the Exchange will build on and need to be coordinated with existing state law on health plan appeals and grievance and oversight by state insurance regulators, CDI and DMHC. In addition, the Exchange will establish processes to ensure that individuals enrolled in Exchange programs who have problems at any point in the process get timely resolution to their concerns, and have appropriate support. Complaint and problem monitoring systems will also be important sources of information for the Exchange to identify systemic problems and build a culture of continuous quality improvement. During the period of the Level I grant (1.2) , the California Exchange will work with state partners and stakeholders to accomplish these goals. Coordination will be essential to the design and implementation of a consumer assistance function which builds on and coordinates with existing state, regional and local consumer assistance programs but is not duplicative. The California Exchange will work with CHHS, CDI and DMHC, and with other state agencies involved with consumer assistance, including DHCS, MRMIB, the Office of the Patient Advocate, and stakeholders, to analyze data from existing programs, including data from the federally-funded Consumer As...