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 Chinese

4. NOABD Modification Notice  English Spanish Tagalog Chinese

5. NOABD Termination Notice  English Spanish Tagalog Chinese

6. NOABD Delivery System Notice  English Spanish Tagalog Chinese

7. NOABD Authorization Delay English Spanish Tagalog Chinese

8. NOABD Timely Access Notice English Spanish Tagalog Chinese

9. NOABD Financial Liability Notice  [English Spanish Tagalog Chinese

10. NOABD Payment Denial Notice  English Spanish Tagalog Chinese

11. NOABD Grievance and Appeal Timely Resolution Notice  English Spanish Tagalog Chinese

12. NAR (Notice of Appeals Resolution) NOABD Overturned Notice   English Spanish TagalogChinese

13. NAR (Notice of Appeals Resolution) NOABD Upheld  EnglishSpanish Tagalog Chinese

14. Notice of Grievance Resolution   English Spanish Tagalog Chinese

15. NOABD Your RightsEnglish Spanish Tagalog Chinese

16. NAR (Notice of Appeals Resolution) Your Rights EnglishSpanish Tagalog Chinese

17. Language Assistance Taglines 

18. Beneficiary Non-Discrimination Notice English Spanish  ChineseTagalog

19. Grievance and Appeals Resolution Poster English Spanish  Chinese  Tagalog 

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