Dear Revdex.com of Hawaii, I am following up on complaint #[redacted]. On March 13, 2017 I made a complaint against Kaiser Permanente for quoting me a price for a service, then overcharging me for that service despite verbal confirmation from [redacted], RN at the time of service that the amount I was stating was due, was the correct amount that she quoted me. [redacted], RN works for KP in their “Breast Care Team” on Oahu to help patients understand their bill before scheduling services. I had a conversation with [redacted], RN prior to making my mammogram appt. She told me that the SCREENING mammogram would result in no deductible to be met on my plan as it was a ‘fully covered benefit’ and was not subject to any deductible. She was well aware of my plan, my member number, and that I was a new patient and had not accrued any money whatsoever towards my deductible. We spoke at length about how much was my responsibility at the time of service and she told me that ‘deductibles’ would be due in the amount of $237 for the Ultrasound and $210 for the diagnostic. I was told there would be ‘no deductible due’ for the screening mammogram as it was a ‘totally covered benefit’. AFTER my services, I was told my ‘deductible’ would be $237 for the Ultrasound and $348 for the diagnostic. (No mention of a deductible being due for the screening mammogram was mentioned at the time of service.) I said I was told by [redacted], RN in the Breast Care Team dept. that my ‘deductible’ would be $237 for the Ultrasound and $210 for the diagnostic. [redacted], RN said she was not aware of such a high deductible of $237 for the diagnostic. This conversation between the receptionist and [redacted], RN was in my presence where I could overhear their conversation. [redacted], RN confirmed the numbers I was stating to the receptionist. The receptionist told [redacted], RN that ‘there had been a recent price increase’ and ‘did she not get it’. Celeste said that as of ‘today’ (3/13/17) she was still quoting the $210 as the correct ‘deductible’ amount. Receptionist finished the conversation with [redacted], RN and said I was responsible for the $348 despite confirmation by [redacted], RN that $210 was her quote to me prior to scheduling the appt. I then asked to speak with a manager of the clinic and he repeated that it was still my responsibility to pay the higher rate despite being quoted a much lower rate. Again, at the time of service, only these two charges were discussed. Thus, I paid $447 on my charge card that covered the full quote from [redacted], RN. On 4/24/17 I received a bill from KP. There was a line item for TWO radiology services and no line item on the bill for the ultrasound. No line item for the Ultrasound bill nor my payment of $237 towards that Ultrasound bill. On top of my diagnostic mammogram, there was a bill for the SCREENING mammogram for $585.48 with $181.50 ‘deductible’ due. Once again, my previous conversation with [redacted], RN in the Breast Care Team dept. that my ‘deductible’ would be $237 for the Ultrasound and $210 for the diagnostic for a total of only $447 due for services I was requesting. After two different conversations with Patient Financial Services, I understood that they still hold me responsible for the $181.50 despite [redacted], RN informing me PRIOR to scheduling the appt that my plan coverage would take care of the screening service ‘in full’ with ‘no deductible’. Now, on 3/25/17 I have received a letter from the grievance dept of Kaiser Permanente, signed by James G. A[redacted], that I was “granted a waiver for the $138” and that it would take ‘6-8 weeks to process’. This was the resolution letter to my complaint #[redacted]. It has been 11 weeks and no credit has been ever credited to my account as promised in letter dated 3/25/17 I received from the grievance dept of Kaiser Permanente, signed by James ** A[redacted]. I have had two very long conversations with Patient Financial Services (one on 4/24/17 and one today 6/8/17) because I am still being billed for the $138 ‘waived’ amount. And also being billed $181.50 for the screening mammogram. On 4/24/17 Jamie in Patient Financial Services dept sent in a request to the grievance dept for confirmation of the waived $138. She has not received a response from that department, and it has been 6 weeks since her request. I then spoke with Mel in Patient Financial Services today 6/8/17, then got escalated to speaking with her ‘lead’ Aloha in Patient Financial Services. Neither of them were able to reach the grievance department on the phone today. I am writing a complaint to the Revdex.com because my complaint # [redacted] has NOT been resolved and since then, another bill has popped up beyond my quote from their breast department employee [redacted], RN. No other industry can treat people so poorly as the health care industry. Official documents from KP ask their members to “Know Before you Go” and “Get a Cost Estimate” before scheduling your appt. I did this as requested as I was planning an ELECTIVE procedure. I was directed to [redacted], RN in the Breast Care Team department and we spoke at length. She spent detailed time understanding my plan and gave me a quote of $447 for the services I was requesting: A screening mammogram on my Right breast, and a diagnostic mammogram for my Left breast, and an ultrasound for my left breast. I ask, how can one department of KP give me a quote, confirm that quote with a receptionist in a different department, then 6 weeks later send a bill for a third deductible due when the third charge was never mentioned at the time of service, nor ever mentioned during my “Know Before you Go” lengthy conversation with [redacted], RN? With premiums soaring, and services plummeting, members deserve ACCURATE quotes prior to service. If quotes are made, they should be honored. I am asking that my original complaint # [redacted] be honored and fulfilled and that the second unmentioned deductible of $181.50 also be waived. No other industry would stay in business treating their members so poorly!Desired Outcome: I am asking that my original complaint # [redacted] be honored and fulfilled and that the second unmentioned deductible of $181.50 also be waived.
This is in response to your inquiry dated April 18, 2016 to Mr. [redacted] of Kaiser Permanente regarding the above referenced matter.The issues raised in Mr. [redacted]'s March 19, 2016 correspondence were reviewed by our Member Administration department, who verified that Mr. [redacted]'s...
membership is current, and his coverage was reinstated effective February 1, 2016.Any further questions or concerns Mr. [redacted] may have regarding his membership can be directed to our Member Administration department at [redacted].In addition, our Members may call the Customer Services Department from 8:00 a.m. to 5:00p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at [redacted] with general questions or for help with benefits or coverage issues. For TTY users, please call [redacted]. For free language interpretation services, please call [redacted].We appreciate your giving us the opportunity to respond to these concerns.
This is in response to your inquiry dated July 19, 2017 to Kaiser Permanente regarding the above referenced matter.After a review of Ms. [redacted]’s submission, we have changed the address we have on file to match that of her daughter’s. Since this issue is now a matter of public record, and out of...
respect for Ms. [redacted]’s privacy, we will not advise as to what our records reflect as Ms. [redacted]’s address. However, she is welcome to call our Member Service Contact Center at 1-800-966-5955 to ensure we have the correct address on file.Any further questions or concerns Ms. [redacted] may have regarding benefits or coverage issues can also be directed to our Member Service Contact Center from 8:00 a.m. to 5:00 p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at [redacted] For TTY users, please call [redacted]. For free language interpretation services, please call [redacted].We appreciate your giving us the opportunity to respond to these concerns.
This is in response to your inquiry dated April 27, 2016 addressed to the Manager of Kaiser Permanente regarding the above referenced matter.The issues raised in Ms. [redacted]' "Statement of the Problem" dated April 27, 2016 were reviewed by the Director of our Provider Contracting & Resource...
Planning department, who contacted [redacted]' billing department on April 27, 2016. During this conversation, [redacted] were reminded of their contractual obligations to our Members in billing matters between Kaiser Permanente and external providers such as themselves.Additionally, [redacted] confirmed that they wHI be taking the appropriate measures to rectify the billing matter with Kaiser Permanente directly, will be suspending any collection action taken against Ms. [redacted] in relation to this instant matter, and intend to send a revised statement to Ms. [redacted]. [redacted] advised that this process should take them 7-10 business days from the date of the conversation.Any further questions or concerns Ms. [redacted] may have regarding external billing inquiries can be directed to our Member Service Contact Center at [redacted].In addition, our Members may call the Customer Services Department from 8:00 a.m. to 5:00p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at ###-###-#### with general questions or for help with benefits or coverage issues. For TTY users, please call ###-###-#### . For free language interpretation services, please call ###-###-#### .We appreciate your giving us the opportunity to respond to these concerns
Dear Revdex.com of Hawaii, I am following up on complaint #[redacted]. On March 13, 2017 I made a complaint against Kaiser Permanente for quoting me a price for a service, then overcharging me for that service despite verbal confirmation from [redacted], RN at the time of service that the amount I was stating was due, was the correct amount that she quoted me. [redacted], RN works for KP in their “Breast Care Team” on Oahu to help patients understand their bill before scheduling services. I had a conversation with [redacted], RN prior to making my mammogram appt. She told me that the SCREENING mammogram would result in no deductible to be met on my plan as it was a ‘fully covered benefit’ and was not subject to any deductible. She was well aware of my plan, my member number, and that I was a new patient and had not accrued any money whatsoever towards my deductible. We spoke at length about how much was my responsibility at the time of service and she told me that ‘deductibles’ would be due in the amount of $237 for the Ultrasound and $210 for the diagnostic. I was told there would be ‘no deductible due’ for the screening mammogram as it was a ‘totally covered benefit’. AFTER my services, I was told my ‘deductible’ would be $237 for the Ultrasound and $348 for the diagnostic. (No mention of a deductible being due for the screening mammogram was mentioned at the time of service.) I said I was told by [redacted], RN in the Breast Care Team dept. that my ‘deductible’ would be $237 for the Ultrasound and $210 for the diagnostic. [redacted], RN said she was not aware of such a high deductible of $237 for the diagnostic. This conversation between the receptionist and [redacted], RN was in my presence where I could overhear their conversation. [redacted], RN confirmed the numbers I was stating to the receptionist. The receptionist told [redacted], RN that ‘there had been a recent price increase’ and ‘did she not get it’. Celeste said that as of ‘today’ (3/13/17) she was still quoting the $210 as the correct ‘deductible’ amount. Receptionist finished the conversation with [redacted], RN and said I was responsible for the $348 despite confirmation by [redacted], RN that $210 was her quote to me prior to scheduling the appt. I then asked to speak with a manager of the clinic and he repeated that it was still my responsibility to pay the higher rate despite being quoted a much lower rate. Again, at the time of service, only these two charges were discussed. Thus, I paid $447 on my charge card that covered the full quote from [redacted], RN. On 4/24/17 I received a bill from KP. There was a line item for TWO radiology services and no line item on the bill for the ultrasound. No line item for the Ultrasound bill nor my payment of $237 towards that Ultrasound bill. On top of my diagnostic mammogram, there was a bill for the SCREENING mammogram for $585.48 with $181.50 ‘deductible’ due. Once again, my previous conversation with [redacted], RN in the Breast Care Team dept. that my ‘deductible’ would be $237 for the Ultrasound and $210 for the diagnostic for a total of only $447 due for services I was requesting. After two different conversations with Patient Financial Services, I understood that they still hold me responsible for the $181.50 despite [redacted], RN informing me PRIOR to scheduling the appt that my plan coverage would take care of the screening service ‘in full’ with ‘no deductible’. Now, on 3/25/17 I have received a letter from the grievance dept of Kaiser Permanente, signed by James G. A[redacted], that I was “granted a waiver for the $138” and that it would take ‘6-8 weeks to process’. This was the resolution letter to my complaint #[redacted]. It has been 11 weeks and no credit has been ever credited to my account as promised in letter dated 3/25/17 I received from the grievance dept of Kaiser Permanente, signed by James ** A[redacted]. I have had two very long conversations with Patient Financial Services (one on 4/24/17 and one today 6/8/17) because I am still being billed for the $138 ‘waived’ amount. And also being billed $181.50 for the screening mammogram. On 4/24/17 Jamie in Patient Financial Services dept sent in a request to the grievance dept for confirmation of the waived $138. She has not received a response from that department, and it has been 6 weeks since her request. I then spoke with Mel in Patient Financial Services today 6/8/17, then got escalated to speaking with her ‘lead’ Aloha in Patient Financial Services. Neither of them were able to reach the grievance department on the phone today. I am writing a complaint to the Revdex.com because my complaint # [redacted] has NOT been resolved and since then, another bill has popped up beyond my quote from their breast department employee [redacted], RN. No other industry can treat people so poorly as the health care industry. Official documents from KP ask their members to “Know Before you Go” and “Get a Cost Estimate” before scheduling your appt. I did this as requested as I was planning an ELECTIVE procedure. I was directed to [redacted], RN in the Breast Care Team department and we spoke at length. She spent detailed time understanding my plan and gave me a quote of $447 for the services I was requesting: A screening mammogram on my Right breast, and a diagnostic mammogram for my Left breast, and an ultrasound for my left breast. I ask, how can one department of KP give me a quote, confirm that quote with a receptionist in a different department, then 6 weeks later send a bill for a third deductible due when the third charge was never mentioned at the time of service, nor ever mentioned during my “Know Before you Go” lengthy conversation with [redacted], RN? With premiums soaring, and services plummeting, members deserve ACCURATE quotes prior to service. If quotes are made, they should be honored. I am asking that my original complaint # [redacted] be honored and fulfilled and that the second unmentioned deductible of $181.50 also be waived. No other industry would stay in business treating their members so poorly!Desired Outcome: I am asking that my original complaint # [redacted] be honored and fulfilled and that the second unmentioned deductible of $181.50 also be waived.
This is in response to your inquiry dated April 18, 2016 to Mr. [redacted] of Kaiser Permanente regarding the above referenced matter.The issues raised in Mr. [redacted]'s March 19, 2016 correspondence were reviewed by our Member Administration department, who verified that Mr. [redacted]'s...
membership is current, and his coverage was reinstated effective February 1, 2016.Any further questions or concerns Mr. [redacted] may have regarding his membership can be directed to our Member Administration department at [redacted].In addition, our Members may call the Customer Services Department from 8:00 a.m. to 5:00p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at [redacted] with general questions or for help with benefits or coverage issues. For TTY users, please call [redacted]. For free language interpretation services, please call [redacted].We appreciate your giving us the opportunity to respond to these concerns.
This is in response to your inquiry dated July 19, 2017 to Kaiser Permanente regarding the above referenced matter.After a review of Ms. [redacted]’s submission, we have changed the address we have on file to match that of her daughter’s. Since this issue is now a matter of public record, and out of...
respect for Ms. [redacted]’s privacy, we will not advise as to what our records reflect as Ms. [redacted]’s address. However, she is welcome to call our Member Service Contact Center at 1-800-966-5955 to ensure we have the correct address on file.Any further questions or concerns Ms. [redacted] may have regarding benefits or coverage issues can also be directed to our Member Service Contact Center from 8:00 a.m. to 5:00 p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at [redacted] For TTY users, please call [redacted]. For free language interpretation services, please call [redacted].We appreciate your giving us the opportunity to respond to these concerns.
This is in response to your inquiry dated April 27, 2016 addressed to the Manager of Kaiser Permanente regarding the above referenced matter.The issues raised in Ms. [redacted]' "Statement of the Problem" dated April 27, 2016 were reviewed by the Director of our Provider Contracting & Resource...
Planning department, who contacted [redacted]' billing department on April 27, 2016. During this conversation, [redacted] were reminded of their contractual obligations to our Members in billing matters between Kaiser Permanente and external providers such as themselves.Additionally, [redacted] confirmed that they wHI be taking the appropriate measures to rectify the billing matter with Kaiser Permanente directly, will be suspending any collection action taken against Ms. [redacted] in relation to this instant matter, and intend to send a revised statement to Ms. [redacted]. [redacted] advised that this process should take them 7-10 business days from the date of the conversation.Any further questions or concerns Ms. [redacted] may have regarding external billing inquiries can be directed to our Member Service Contact Center at [redacted].In addition, our Members may call the Customer Services Department from 8:00 a.m. to 5:00p.m. Monday through Friday (except holidays) and Saturday 8:00 a.m. to noon, toll free at ###-###-#### with general questions or for help with benefits or coverage issues. For TTY users, please call ###-###-#### . For free language interpretation services, please call ###-###-#### .We appreciate your giving us the opportunity to respond to these concerns