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Kaiser Permanente of Colorado Reviews (80)

Initial Business Response / [redacted] */ June 18, Ms [redacted] Adams Trade Practices & Helpline Specialist Denver/Boulder Revdex.com P.OBox XXXXX Denver, Colorado XXXXX Complaint Case # XXXXXXXX Consumer: [redacted] , [redacted] Case Opened: 06/05/ Dear Ms Adams, This is in response to your email received on June 05, 2015, forwarding concerns on behalf of our member; [redacted] , regarding his wife's medical needsWe value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction I contacted Mr [redacted] 's wife directly, as we are unable to file complaints or work complaints through a spouse, without written consent of the memberI spoke to Emily [redacted] regarding her experience and the complaint filed by her husband Mrs [redacted] confirmed that she was able to obtain an earlier appointment and that she has received the injection for her back painShe states she is feeling better and that she is unsure of what steps to take next We spoke a while about being her own best advocate for her care and that if she is ever uncomfortable with a suggestion made by a physician, she always has the right to a second opinionI encouraged Mrs [redacted] to touch base with her Primary Care Physician about some of her concerns and see if they have any suggestionsI also told her that the kp.org website is useful to email her doctors with any questions or concernsI told her that I was troubled that she felt she had to become a different person, become rude, to obtain assistanceWe talked about what it means to advocate for her best interests and how important it was to communicate with her doctorsI also informed her that if she ever has a poor experience with a department at Kaiser Permanente or a physician, that she can file a complaint directly with the Member Services Department by phone (XXX-XXX-XXXX) or through the kp.org website I asked if Mrs [redacted] would like to proceed with a formal complaint against the Neurosurgery Department regarding the difficulty obtaining appointments, and she said she did not want to file a complaintI apologized for the frustrations and I informed her that when she files a complaint directly with Member Services, that the Case Resolution Department has a staff of physicians and nurses who assist with trying to get earlier appointments and address medical concerns The member's feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate [redacted] Our goal is to deliver excellent service to our membersGrievances expressed by our members do not affect their coverage in any wayIf the above noted member is dissatisfied with the resolution, they have the right to request a second reviewPlease have them put the request in writing to: Kaiser Permanente Member Services South Havana Street Aurora, Colorado XXXXX Written requests will be reviewed by Member Services Administration who will respond to you in writing within calendar days of the receipt of the member's requestWe may extend this timeframe up to an additional calendar days at the member's request or if there is a need for additional information and the delay is in the best interest of the member If the Revdex.com or the member has any questions, please contact me at (XXX) XXX-XXXX Also, you may contact Member Services: Denver/Boulder members may call XXX-XXX-XXXX, toll free at X-XXX-XXX-XXXX, between a.mto p.m., Monday through FridayDeaf, hard of hearing, or speech impaired members who use a TTY may call XXX-XXX-XXXX Colorado Springs members please call X-XXX-XXX-XXXX or deaf, hard of hearing or speech-impaired members who use TTY may call X-XXX-XXX-XXXXYou may also contact our department through our Web site at kaiserpermanente.org Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, Tina K.CKimpo Complex Case Resolution Specialist Member Experience

February 13, 2016
[redacted]
Dispute Resolution/Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #             ...

11110992
Consumer:                            [redacted]
Case Opened:                      January
28, 2016
Dear Ms. [redacted],
This is in response to your email received on January 29,
2016, forwarding concerns on behalf of our member, [redacted], regarding
continuing issues experienced with his Kaiser Permanente (KP) healthcare plan
purchased from Connect for Health Colorado (C4).  We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction.
We have formally documented and shared Mr. [redacted] complaint
details with the appropriate Consolidated Service Center/KPIF, On-Exchange
Issues Department leadership, to include the overseeing Manager. I am very
sorry for frustration caused to Mr. [redacted] and his wife, as a result of
dealing with the same issues for such a lengthy period of time.
C4, KP, and HPS (our third party billing vendor), all 3 communicate
member problems with their accounts by way of a posted case and review of the
added notes by a representative of each party. For KP, the Member Issues Resolution
Team (MIRT), is the case owner, and the Case Resolution Team (CRT) acts as the
liaison between our members and MIRT to provide members with relevant
information and case updates. I realize that the timeliness of resolving issues
that pertain to healthcare plans purchased through C4, have NOT been ideal. For
this, I am sincerely apologetic, as I understand the urgency of needing to settle
issues affecting an individual’s healthcare insurance.
MIRT has unfortunately been greatly affected in its ability to
resolve these cases quickly for 2 reasons. They are dealing around the clock
with more cases than ever planned for or expected; new MIRT representatives
continue to join the team in an attempt to resolve cases. Secondly, they must
(via the posted case) outreach C4 to confirm any eligibility/benefit discrepancies,
as KP is not able to change any information for plans purchased through C4
until advised to do so by them. Any monies issues are then communicated through
HPS, as they are responsible for correctly updating the billing system. Though
MIRT is able to ensure that KP’s system reflects eligibility, once confirming
the information with C4, they are unable to personally change monetary figures.
None of this is an excuse for Mr. [redacted] inconvenienced by our processes, but
rather an explanation as to provide a clearer picture of the situation. Upper
management is very aware of the excessive amount of problems that KP is
currently attempting to assist members with, and will hopefully come up with an
effective resolution, so that are members do not have to worry about persistent
account discrepancies.
At this time, Mr. [redacted] reflects eligibility from
1/1/2015 through current, and his wife Anna Mudale from 10/1/2015 through
current:
GROUP SGR RL ST
EFF       END RS RGN PL TP EN C CARR
80001 015 AA AC
010116       999999                                NCXS
                  AA AC 010115       123115                               NCXS
427-4030-23
[redacted],[redacted]D   12201977 AA  010115
424-4030-29
[redacted]           03151977
BB  100115
MIRT noted in the posted
case on 2/4/2016 a detailed summary of the founded issues, which appear to have
all stemmed from the incorrect addition of the member’s wife. Mr. [redacted]
account was at one time changed to the 10/1/2015 effective date, and Mrs.
[redacted] at one time changed to a 1/1/2015 effective date. MIRT is noted to having
requested for HPS to adjust the erroneous premium charges from 1/1/2015 to
9/1/2015. This is confirmed to have been updated accordingly on 2/9/2016,
though 2/11/2016 notes that a bill/invoice adjustment is still required; MIRT
emailed HPS to update immediately.
I ask that Mr.
[redacted] contact me directly for any related questions or concerns. Sometimes
members that have experienced previous plan issues have additional ones arise,
and I am able to view/communicate case updates/progress. In regards to any
claims that processed for the member or his wife, please ask Mr. [redacted] to
contact me if these have not been reprocessed.
Again, my apologies
for the frustration and inconvenience caused to our member and his wife. I am
available to personally further assist.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at [redacted].
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience
Tell us why here...

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 11193296, and while I'm ultimately satisfied with the resolution, I am still very unhappy with the customer service I received throughout this entire process. Kaiser Permanente's response indicates that my case was in the process of being resolved when I filed this complaint with the Revdex.com, that my "case was already being worked within the Case Resolution Team"; I would like to point out that before I filed a formal complaint I tried to work with the Member Services Representatives, who 1) kept telling me that a resolution would be reached within 30-45 days (this was 3 months or approximately 90 days after I initially requested the claim be reprocessed) 2) had absolutely no idea how their insurance coverage worked (telling me that I had not reached my out of pocket maximum) 3) told me that a supervisor would call me back, when in fact, I never was able to speak with a supervisor even after requesting two times. The fact of the matter is that I requested on at least five different occasions that this claim be reprocessed, and it was not until I asked to file a complaint about each and every Member Services Representative that I spoke with from 11/3/2015-3/8/2016 that my claim was even forwarded to the Case Resolution Team, this information is from one of the members of that team, who reported she only received my information after I made a complaint on 3/8/2016. I genuinely feel like Kaiser was stalling in order to avoid paying the claim; whether that is truthfully what they were doing is impossible to know, but as a consumer that is certainly how it appeared. I will say that once I filed multiple complaints, my situation was resolved rather quickly, and that I appreciate. 
Sincerely,
[redacted]

Complaint: [redacted]
I am rejecting this response because:I called C4 and they are unable to change my term date. This should not matter though as my new employer plan is also through Kaiser, so they received and August premium from my employer. Either way, my refund should have been processed well before this issue of the term dates. The only reason these two separate issues are being conflated in because Kaiser dragged its heels so long on what should have been a simple refund for their error. It is ridiculous that they would take 6-8 weeks to issue the refund after acknowledging that it was entirely their mistake for overcharging me. I don't get 6-8 weeks to pay my premiums or medical bills.
Sincerely,
[redacted]

August 31, 2016
 
                         
[redacted]
Revdex.com Serving Denver/Boulder
3801 E. Florida Ave., Ste.350
Denver, Colorado...

80210
 
 
Complaint Case #               [redacted]
Consumer:                            [redacted] [redacted]
Case Opened:                      [redacted]
 
Dear [redacted],
 
This is in response to your email received on August 24, 2016 forwarding concerns on behalf of our member; [redacted] [redacted] regarding his request to have a refund for the premium payment that was made for his 2016 policy through Connect for Health Colorado. We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction.
 
We have formally documented and shared [redacted] grievance with the appropriate leadership.
 
Research indicates a refund has been approved and sent to member for $205.87 on credit card ending XXXX-[redacted] on August 30,2016.
 
Please note that Kaiser Permanente is allowed to make changes to member accounts only as provided and documented by Connect for Health Colorado.  Kaiser Permanente cannot make any changes to a health plan purchased through Connect for Health Colorado without authorization from Connect for Health Colorado.
 
 
If the Revdex.com or the member has any questions, please contact me at [redacted].
 
Also, you may contact Member Services:
 
Denver/Boulder members may call [redacted], toll free at [redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted]. 
 
Colorado Springs members please call [redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.
 
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
 
 
 
Sincerely,
 
[redacted]
Complex Case Resolution Specialist
Member Experience

October 31, 2016[redacted]Dispute Resolution SpecialistDenver/Boulder Revdex.com[redacted]
[redacted]
Complaint Case #           [redacted]Consumer: [redacted]   Case Opened: October 15, 2016 Dear [redacted],This is in response to...

your email received on October 18, 2016, forwarding concerns on behalf of our member, [redacted] regarding the billing for services she received August 10, 2016, and August 29, 2016.  We value the opportunity to review and respond to her grievance and apologize for her dissatisfaction.[redacted] expressed her dissatisfaction with the care she received, stating the service provided was not needed, and therefore caused unnecessary pain and time off work.  Additionally, when contacting Kaiser Permanente, [redacted] did not receive the response she expected in filing a complaint.  [redacted] requested that the bill totaling $432.66 be adjusted off her accountWe have formally documented and shared [redacted]’s concerns with the appropriate physician leadership, to include the chief of OB-GYN. Please apologize to the member, on behalf of Kaiser Permanente (KP), for any frustration that may have been caused by this overall matter. After review, I am unable to honor the request for waiver of charges associated with the visit on August 10, 2016, totaling $417.06.  This amount applied to the benefit appropriately based on the Evidence of Coverage in effect at the time service was received, and will remain your financial responsibility.However, I am able to adjust the amount of $15.60 for the visit August 29, 2016 off the account.  This may take more than one billing cycle to reflect on [redacted]’ account.  I have confirmed no additional charges were billed for this date of service.  Please ask [redacted] to review the response and contact me directly, if she has any related questions. Again, please express my sincere apologies for her consequential frustration, as I realize that this is not the resolution she was seeking.The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to our members.  Grievances expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied with the resolution, they have the right to request a second review.  Please have them put the request in writing to:Kaiser PermanenteMember Services [redacted]
[redacted]  [redacted]Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member’s request. We may extend this timeframe up to an additional 14 calendar days at the member’s request or if there is a need for additional information and the delay is in the best interest of the member.  If the Revdex.com or the member has any questions, please contact me at [redacted].Also, you may contact Member Services: Denver/Boulder members may call [redacted], toll free at [redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted]  Colorado Springs members please call [redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente. Sincerely,[redacted]Complex Case Resolution SpecialistCustomer Experience

Initial Business Response /* (1000, 6, 2015/06/26) */
June 26, 2015
[redacted]
Trade Practices & Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box XXXXX
Denver, Colorado XXXXX
Complaint Case # XXXXXXXX
Consumer: [redacted], [redacted]
Case Opened: June 25, 2015
Dear Ms. [redacted]
This is in...

response to your email received on June 22, 2015, forwarding concerns on behalf of our member, [redacted], regarding a refund request for services his wife received at [redacted] and [redacted] Department. We value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction.
Unfortunately, an Appointment of Representative (AOR) form is required to be completed and placed on file, in order for Mr. [redacted] to speak on behalf of his wife. I have mailed the necessary document to Mr. and Mrs. [redacted] and included a brief explanation letter including my contact information. This will allow Mrs. [redacted] to call me directly. If she would like to place the complaint in her name, I will be happy to follow through on the formal complaint process and monetary request. Otherwise, I will be able to reach out to Mr. [redacted] for further complaint and requested resolution clarification, upon receipt of the completed AOR. I am sincerely sorry that the member and his wife are experiencing the issues described, and I look forward to the opportunity to appropriately address the matter.
The member's feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to our members. Grievances expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied with the resolution, they have the right to request a second review. Please have them put the request in writing to:
Kaiser Permanente
Member Services
[redacted]
Aurora, Colorado XXXXX
Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member's request. We may extend this timeframe up to an additional 14 calendar days at the member's request or if there is a need for additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me at (XXX) XXX-XXXX.
Also, you may contact Member Services:
Denver/Boulder members may call XXX-XXX-XXXX, toll free at X-XXX-XXX-XXXX, between 8 a.m. to 5 p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call XXX-XXX-XXXX.
Colorado Springs members please call X-XXX-XXX-XXXX or deaf, hard of hearing or speech-impaired members who use TTY may call X-XXX-XXX-XXXX. You may also contact our department through our Web site at kaiserpermanente.org.
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case Resolution Specialist
Member Experience
Initial Consumer Rebuttal /* (3000, 8, 2015/07/08) */
(The consumer indicated he/she DID NOT accept the response from the business.)
After receiving an email from Revdex.com asking me to respond, I called Kaiser (who still hadn't contacted either my wife or me) and spoke with [redacted] While pleasant, [redacted] said she still couldn't move forward with handling anything since she had yet to receive the AOR form.
We completed this form and mailed it back to the address listed on the instructions the day after we received it in the mail. I can almost guarantee that it is sitting in a pile somewhere in Kaiser's mailroom.
[redacted] spoke with my wife for a few moments on the phone, but did not offer any solution to our problem whatsoever. She promised she will be back in touch with us, but obviously we cannot accept Kaiser's response so far, since they effectively have provided us none.
It is difficult to say whether Kaiser simply has a policy of stalling in hopes that customers will simply get fed up and give up, or if their internal systems are so disorganized and slow that they honestly don't really know what is going on.
As I was typing this, [redacted] called again. She said that another woman was "working on" my wife's claim and we will hear back no later than 30 days from the date of our initial complaint. She also said that the reason my first complaint was never addressed was that it was transferred over to my wife's health record, and that I should have been notified that that had taken place.
So, to reiterate, we still have received no refund of any kind from Kaiser (nor any formal apology or offer to help us moving forward with treatments) and so I do not accept their response.
Final Business Response /* (1000, 22, 2015/09/21) */
The Case Resolution Specialist assisting the member advised that she picked up the check here at Waterpark I in Aurora, yesterday August 19, 2015.
Again, I apologize for the overall inconvenience that has been caused. Please let me know if I may be of any further assistance relating to this matter.
[redacted]
XXX XXX-XXXX
KP Case Resolution Team
Final Consumer Response /* (2000, 24, 2015/09/22) */
(The consumer indicated he/she ACCEPTED the response from the business.)
The customer service has generally been slow and inconsistent. However, we finally did receive a full refund.

February 28, 2016
*
[redacted]
Trade Practice Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #               ...

11137943
Consumer:                             [redacted]
Case Opened:                       February
15, 2016
Dear Ms. [redacted]
This is in response to your email received on February 17,
2016, forwarding concerns on behalf of our member, [redacted], regarding
lingering claim discrepancies.  We value the opportunity to review and
respond to their grievance and apologize for the member’s dissatisfaction.
We have formally documented and shared Ms. [redacted] concerns
with the appropriate Claims Department leadership, to include the Supervisor.
Please apologize to the member, on behalf of Kaiser Permanente (KP), for any
frustration caused by previously requesting assistance, yet never having the
issues satisfactorily resolved.
I also submitted for an account audit from 2012 through
current, which I have attached to the Revdex.com case for Ms. [redacted]. Each year benefits
are summarized, and 10 claims were reprocessed, as to go toward the Individual Deductible/OPM,
rather than the Family Deductible/OPM.
Should Ms. [redacted] have any remaining account
questions, please ask her to contact the Claims Department, as they will be
able to assist with audit clarifications, specific claim inquiries, and
requests to have any claim Explanation of Benefits (EOB) mailed. Please thank
Ms. [redacted] for her patience with this overall matter, as I realize that she has
been waiting for requested claim assistance and information for some time now. I
am also available, should the member like to contact me directly.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at [redacted]
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience

Complaint Case #               [redacted]
Consumer:                            [redacted]
Case...

Opened:                      6/28/2016
 
 
Dear Ms. [redacted],
 
This is in response to your email received on June 29,2016, forwarding concerns on behalf of our member; [redacted] regarding his request to have the charge of $305.00 to be waived for an MRI. We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction.
 
We have formally documented and shared Mr. [redacted] grievance with the appropriate leadership.
 
Research indicates that the charge of $305.00 for November 20, 2015 was adjusted off on May 21, 2016. The charge for the original MRI on October 31, 2015 reflects as paid. The payment that Mr. [redacted] made was applied to the first MRI. Mr. [redacted] has no outstanding balance as of the date of this letter for the MRI’s in question.
 
If the Revdex.com or the member has any questions, please contact me at ###-###-####.
 
Also, you may contact Member Services:
 
Denver/Boulder members may call ###-###-####, toll free at ###-###-####, between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call ###-###-####. 
 
Colorado Springs members please call ###-###-#### or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.
 
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
 
 
 
Sincerely,
 
[redacted]
Complex Case Resolution SpecialistMember Experience

May 3, 2017
 
[redacted]
 
 
 
Complaint Case...

#                [redacted]
Consumer:                             [redacted]
Case Opened:                       April
4, 2017
 
 
Dear Mr. [redacted],
 
This is in response to your email received May 1, 2017
advising that a reply email had not yet been received regarding our member,
[redacted], and her concerns submitted to the Revdex.com on April 4, 2017. Unfortunately, we haven’t any record
of receiving Ms. [redacted]’s previous Revdex.com, due to changes in our
notification preferences that we were not aware of. We have since confirmed
with you that our preference has been changed back to email notification. We value the opportunity to review and respond
to their grievance and apologize for the member’s dissatisfaction.
 
Ms. [redacted]
stated that she has been disputing two $29.86 charges billed for nurse visits
in primary care on 10/12/2016 and 1/16/2017. She also explained her belief that
a premium payment applied towards Kaiser Permanente (KP) services, which she
did not owe for. The member also advised that she paid for an appointment that
should’ve been a free preventive visit, as well as requested a review of
charges for her husband.
 
Ms.
[redacted]’s concerns have been documented and shared with appropriate Patient
Financial Services (PFS) Department, to include the Supervisor. Additionally, our
Medicare Team confirmed that Ms. [redacted] was Medicaid eligible in
January 2017, however, it was not assigned to a provider. Ms. [redacted]
was Medicaid eligible effective February 1, 2017 through current, and the
benefits are assigned to KP.
 
In regards to the
two nurse visits, PFS forwarded the matter to our Coding Department, and the
two $29.86 charges have been voided from Ms. [redacted]’s account. I can
also see that the member made a payment in the amount of $177.29. I’ve
outreached PFS inquiring what services the payment applied towards. If the date
of service was not processed according to the benefits on file, I will ensure
that they are and call the member to advise if any account credit/refund due. Should
the member like to have a detailed audit of her and/or her husband’s accounts,
please ask her contact the Member Service Contact Center (MSCC) with both of
their medical record numbers and submit the audit request(s) clarifying the
time frame in which she is seeking that the audit be conducted for.
 
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
 
Kaiser Permanente
Member Services
[redacted]
 
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an additional
14 calendar days at the member’s request or if there is a need for additional
information and the delay is in the best interest of the member. 
 
If the Revdex.com or the member has any additionally related questions,
please contact me at [redacted].
Also, the MSCC may be contacted by calling:
 
[redacted] members may call [redacted], toll free at [redacted],
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
 
[redacted] members please call [redacted] or deaf, hard of hearing or speech-impaired members
who use TTY may call [redacted].  You may also contact our department through
our Web site at kaiserpermanente.org.
 
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
 
 
 
Sincerely,
 
[redacted]

May 10, 2016
*
[redacted]
Dispute Resolution/Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #               ...

11417689
Consumer:                             [redacted]
Case Opened:                       April
27, 2016
Dear Ms. [redacted],
This is in response to your email received on April 29,
2016, forwarding concerns on behalf of our member [redacted] and current
premium payment account discrepancies. We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction.
We have formally documented and shared Mr. [redacted]
concerns with the appropriate Consolidated Service Center/On-Exchange Issues
Department leadership. The case has been assigned to the Member Issues
Resolution Team (MIRT), whom I have been communicating with directly.
Mr. [redacted] is confirmed in Kaiser Permanente’s (KP) system
to have health plan coverage from December 1, 2015 through current. MIRT is
working with our third party vendor (HPS) to ensure that all of the information
reflected in the HPS billing system (SLP) is accurate and the same as KP’s
system. I am sincerely sorry for any frustration and inconvenience that may
have been caused to Mr. [redacted] by this overall matter. I ask that he please
allow MIRT and HPS some time to follow through accordingly. Please encourage
Mr. [redacted] to contact me directly for progress updates, as well as to discuss
any additionally related issues that might arise.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at [redacted].
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience

February 12, 2016
[redacted]
Dispute/Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #               ...

11133083
Consumer:                             [redacted]
Case Opened:                       February
11, 2016
Dear Ms. [redacted]
This is in response to your email received on February 12,
2016, forwarding concerns on behalf of our member, [redacted], regarding
documents which he has been trying to retrieve from Kaiser Permanente (KP).  We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction.
We have formally documented and shared [redacted] concerns
with the appropriate Member Services Contact Center (MSCC) Department
leadership. I reviewed the January 20, 2016 call documentation, and was able to
confirm that the MSCC representative intended to mail him his 2016 Evidence of
Coverage (EOC) packet. Please apologize to the member for inconveniently being
mailed the 2015 EOC. Today, February 12, 2016, I did personally print/mail Mr.
[redacted] his requested 2016 EOC. Should he not received the packet within a
week, he is welcome to contact me directly for follow through.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at [redacted]
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted] 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience

June 22, 2016
 
[redacted]
Trade Practice Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
 
 
 
Complaint Case #               ...

[redacted]
Consumer:                             [redacted]  
Case Opened:                       June 14, 2016
 
 
Dear Ms. [redacted],
 
This is in response to your email received on June 16, 2016, forwarding concerns on behalf of our member, [redacted], regarding termination of her healthcare plan purchased through Connect for Health Colorado (C4).  We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction.
 
Mrs. [redacted] explained that their policy was cancelled due to non-payment, due to confusion as to when the monthly premium was due. She is disappointed with C4’s unwillingness to work with them, and is requesting that Kaiser Permanente (KP) consider allowing for coverage to continue once the account is paid to be current.
 
We have formally documented and shared Mrs. [redacted]’s concerns with the appropriate Consolidated Service Center/On-Exchange Issues Department leadership, to include the Department Manager. Please apologize to the member, on behalf of Kaiser Permanente (KP), for any frustration that may have been caused to her and her family by this overall matter.
 
I additionally forwarded Mrs. [redacted]’s reinstatement request to our Member Issues Resolution Team (MIRT), as they specifically address On-Exchange issues. On June 21, 2016, the MIRT Business Analyst submitted for reinstatement consideration. I regret to inform that the Membership Administration responded that they will not honor the Mrs. [redacted]’s request, and they provided the following explanation:
 
The Non-compliant verbiage only applies to members who have dunning notices or past due letters. This is a new enrollment, and there is no indication that the member attempted to make a payment. All KP notices are compliant and the member was termed correctly. The member is paid until Apr 2016, and proper notifications were issued before plan termination on 6/7/2016 (grace period is 30 days). We can reconsider the request, if proof of payment after 4/28/16 can be provided. Thank you.
 
Please ask Mrs. [redacted] to review the Membership Administration response and contact me directly, if she has any related questions. Again, please express my sincere apologies for her consequential frustration, as I realize that this is not the resolution she was seeking.
 
The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to our members.  Grievances expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied with the resolution, they have the right to request a second review.  Please have them put the request in writing to:
 
Kaiser Permanente
Member Services
[redacted]
Aurora, Colorado  80014
 
Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member’s request. We may extend this timeframe up to an additional 14 calendar days at the member’s request or if there is a need for additional information and the delay is in the best interest of the member. 
 
If the Revdex.com or the member has any questions, please contact me at [redacted].
 
Also, you may contact Member Services:
 
Denver/Boulder members may call [redacted], toll free at 1-800-[redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted]. 
 
Colorado Springs members please call 1-888-[redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-[redacted].  You may also contact our department through our Web site at kaiserpermanente.org.
 
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
 
 
 
 
 
 
 
Sincerely,
 
 
[redacted]
Complex Case Resolution Specialist
Member Experience

May 17, 2016
*
[redacted]
Trade Practice Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #               11417689
Consumer:                            [redacted]
Case Opened:                      April
27, 2016
Dear Ms. [redacted]
This is in response to your email received on May 12, 2016,
forwarding the rebuttal to our original response, on behalf of our member, [redacted]. The member is requesting
to have his On-Exchange issues resolved.
We value the
opportunity to review and respond to their grievance and apologize for the
member’s dissatisfaction.
Our Member Issues Resolution Team (MIRT) has advised that
Mr. [redacted] billing history was updated on May 16, 2016. The member is now
billed correctly from 12/1/2015 to current (6/1/2016) and shows a correct net due
amount of $386.61 (June); account is paid through 5/31/2015.
If the premium payments are still not being deducted from
the member’s credit card, please ask him to verify the information entered for
the automatic withdrawal. The payment system is not a feature that we will be
able to adjust/change on his behalf. Should Mr. [redacted] have any further
questions relating to his account, please advise him that I’d be happy to
assist.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied with
the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at ([redacted].
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience

December 30, 2015
[redacted]
Dispute Resolution & Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case # 75272338
Consumer: [redacted]
Case Opened: December 18, 2015
Dear Ms. [redacted]
This is in response...

to your email received on December 21, 2015, forwarding concerns on behalf of our member, [redacted], regarding a disputed service bill received. We value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction.
We have formally documented and shared Mrs. [redacted] concerns with the appropriate leaders at the Patient Financial Services (PFS) Department, to include the PFS Supervisor. On behalf of Kaiser Permanent (KP), I am very sorry for any frustration and inconvenience that may have been caused to the member by this matter. I reached out, via telephone to the member, to further inquire about the disputed bill, as I was not able to locate the amount specified in her complaint. Feedback received from PFS confirms that the $2,327.56 bill was mailed in November and December 2015 to the member for services received from November 12, 2014 through November 15, 2014. The charges, however, were corrected on December 15, 2015, which is why I was not able to locate the amount. Apparently, there were issues with Connect for Health Colorado (C4), causing a discrepancy in the member's health plan coverage details. Therefore, the bills mailed were being processed as a non-member. The corrected plan information is showing to have been updated in our system on December 14, 2015, at which time the claims were filed for the first time to the insurance, and the charges consequentially corrected.
Should the member have any additional questions pertaining to services received within KP, please advise her to contact PFS at [redacted]). The Claims Department ([redacted]) will be able to assist with questions about services received outside of. KP.
The member's feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to our members. Grievances expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied with the resolution, they have the right to request a second review. Please have them put the request in writing to:
Kaiser Permanente
Member Services
2500 South Havana Street
Aurora, Colorado 80014
Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member's request. We may extend this timeframe up to an additional 14 calendar days at the member's request or if there is a need for additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me at [redacted]
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700, between 8 a.m. to 5 p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted].
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521-4874. You may also contact our department through our Web site at kaiserpermanente.org.
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case Resolution Specialist
Member Experience

November 8, 2016[redacted]Dispute Resolution SpecialistDenver/Boulder Revdex.comP.O. Box 48179Denver, Colorado 80204Complaint Case # [redacted]Consumer:  [redacted]  Case Opened: October 18, 2016Dear [redacted]This is in response to your email received on November 7, 2016, forwarding the rebuttal to our original response provided on November 1, 2016, on behalf of our member, [redacted]. The member is advising that the services in question were not completed, and therefore she should not have to pay. We value the opportunity to review and respond to the grievance. We also apologize for the member’s dissatisfaction.I’ve confirmed the procedure was completed and was appropriately billed.  A one-time gesture will be offered to remove the charge of $15.60 off the account, as mentioned in the initial response.  [redacted] and I had the opportunity to speak this afternoon about the procedure and subsequent bills she received.  Should [redacted] have further questions regarding her concerns, she is welcome to call me at 303-338-3757.  The member’s communication is appreciated, as it allows us to try to remedy this entire situation. Please apologize to the member again for his expressed dissatisfaction and continued inconvenience caused.The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to our members.  Grievances expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied with the resolution, they have the right to request a second review.  Please have them put the request in writing to:Kaiser PermanenteMember Services [redacted]
[redacted]  [redacted]Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member’s request. We may extend this timeframe up to an additional 14 calendar days at the member’s request or if there is a need for additional information and the delay is in the best interest of the member.  If the Revdex.com has any questions, please contact me at [redacted].Also, you may contact Member Services: Denver/Boulder members may call [redacted], toll free at [redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted]  Colorado Springs members please call [redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente. Sincerely,[redacted]Complex Case Resolution SpecialistCustomer Experience

February 18, 2016
[redacted]
Dispute Resolution/Helpline Specialist
Denver/Boulder Revdex.com
P.O. Box 48179
Denver, Colorado 80204
Complaint Case #              ...

11118025
Consumer:                            [redacted]
Case Opened:                      February
2, 2016
Dear Ms. [redacted],
This is in response to your email received on February 3,
2016, forwarding concerns on behalf of, [redacted], regarding an awaited
refund of premium overpayment in 2015. We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction.
Appropriate Consolidated Service Center/On-Exchange Issues
Department leadership, to include the Manager, has been notified of Ms.
[redacted] continued issue in not receiving her requested refund. Please
apologize to Ms. [redacted] for the inconvenience caused and lack of resolution timeliness.
On February 3, 2016, I reviewed the account and opened a
case with our Member Issues Resolution Team (MIRT). MIRT specifically handles
issues relating to plans purchased through Connect for Health Colorado (C4). MIRT
communicates accordingly with C4 and our third party billing vendor, SLP, in an
attempt to solve member experienced problems. In this scenario, MIRT submitted
the refund to SLP on the same date that the case was opened. Up until today,
there was not an update provided as to where the refund stands in the entire
refund process. Just today, MIRT was able to confirm the following information:
-MIRT had initially requested a $652.98 refund from C4,
which was denied on 11/14/2015 (C4 needed more information).
-Per my outreach, MIRT again verified the refund amount due
and submitted the request to C4.
-The refund was approved, and a $652.98 check is now in line
to be issued and   mailed to the member
I realize that it is quite frustrating for the member to
have to wait so long for monies to be returned to her. Unfortunately, more
issues with On-Exchange purchased plans have presented than ever expected or planned
for. This is absolutely not the problem of Ms. [redacted], nor should it affect
her as it has. KP, C4, and SLP management continues to work through the
trending issues, as well as with bettering their communication process, which
is currently slowing down the reaching of satisfactory resolution for our
members.
Please assure the member that her refund has been submitted
and approved. I am also able to personally assist with reaching out for
updates, should she like to contact me directly. Please thank Ms. [redacted] for
her appreciated patience, and I will be following through with this case until
her refund is received.
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to
our members.  Grievances
expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied
with the resolution, they have the right to request a second review.  Please have them put the request in writing
to:
Kaiser Permanente
Member Services
2500 South Havana
Street
Aurora,
Colorado  80014
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within 14 calendar days of
the receipt of the member’s request. We may extend this timeframe up to an
additional 14 calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member. 
If the Revdex.com or the member has any questions, please contact me
at [redacted].
Also, you may contact Member Services:
Denver/Boulder members may call [redacted], toll free at 1-800-632-9700,
between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired
members who use a TTY may call [redacted]. 
Colorado Springs members please call 1-888-681-7878 or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874.  You may also contact our department through
our Web site at kaiserpermanente.org.
Please thank
our member for their understanding in this matter. We know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente.
Sincerely,
[redacted]
Complex Case
Resolution Specialist
Member
Experience

October 19, 2017  
[redacted]       Complaint Case #               [redacted]...

Consumer:                            [redacted]   Case Opened:                      October 15, 2017     Dear Mr. [redacted],   This is in response to your email received on October 15, 2017, forwarding concerns on behalf of our member, [redacted], regarding payment of $59.08 made April 10, 2017, for services received March 20,2017.  Mr. [redacted] received information from Kaiser Permanente Customer Experience department August 1, 2017, advising charges for services on March 20, 2017, had been adjusted to show he owed $29.54, rather than $59.08, leaving a credit of $29.54.  Mr.  [redacted] has asked the refund in this amount be issued to him.  We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction.   We have confirmed Mr. [redacted]’s previous concerns submitted to Kaiser Permanente were appropriately documented in our record keeping system and shared with leaders of our organization.   Research has confirmed Mr. [redacted] had an appointment June 5, 2017, which resulted in a charge of $29.54.  Since the credit on the account matched the amount due, the credit of $29.54 was applied to the charges due for services June 5, 2017.  We verified a bill was not mailed to Mr. [redacted] for services June 5, 2017, as the payment had been applied to the account and showed no balance due.  We have verified a refund is not due to Mr. [redacted].   The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care.  Our goal is to deliver excellent service to our members.  Grievances expressed by our members do not affect their coverage in any way.  If the above noted member is dissatisfied with the resolution, they have the right to request a second review.  Please have them put the request in writing to:   [redacted]   Written requests will be reviewed by Member Services Administration who will respond to you in writing within 14 calendar days of the receipt of the member’s request. We may extend this timeframe up to an additional 14 calendar days at the member’s request or if there is a need for additional information and the delay is in the best interest of the member.    If the Revdex.com or the member has any questions, please contact me at [redacted].   Also, you may contact Member Services:   Denver/Boulder members may call [redacted], toll free at [redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted].    Colorado Springs members please call [redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.   Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.               Sincerely,     [redacted]

February 21, 2017
                         ...


                         
[redacted]
 
 
Complaint Case #               [redacted]                                   ...
Consumer:                            [redacted] [redacted]
Case Opened:                      01/16/2017
 
Dear Mr. [redacted],
 
This is in response to your email received on February 17, 2017 forwarding concerns on behalf of our member; [redacted] [redacted] regarding his request for Kaiser Permanente to honor the cancellation date of December 1,2016 for the health plan purchased through [redacted]. In addition, correct and remove any past due balances for the months of December 2016 and January 2017. We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction.
 
We have formally documented and shared Mr. [redacted]’s grievance with the appropriate leadership.
 
The member’s disenrollment has been updated to reflect a term date of November 30, 2016. The members billing for December 2016 and January 2017 premiums have been adjusted off to reflect a zero balance. Kaiser Permanente does not report past due premiums to any credit agencies.
 
 
If the Revdex.com or the member has any questions, please contact me at [redacted].
 
Also, you may contact Member Services:
 
Denver/Boulder members may call [redacted], toll free at [redacted], between 8 a.m. to 5 p.m., Monday through Friday.  Deaf, hard of hearing, or speech impaired members who use a TTY may call [redacted]. 
 
[redacted] members please call [redacted] or deaf, hard of hearing or speech-impaired members who use TTY may call [redacted].  You may also contact our department through our Web site at kaiserpermanente.org.
 
Please thank our member for their understanding in this matter. We know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente.
 
 
 
Sincerely,
 
[redacted]
Member Experience

Complaint: 11110992
I am rejecting this response because:Most of the serious issues for my original complaint still exist. I will not accept an explanation of the circumstances that Kaiser finds itself in as a resolution to the issue. Given Kaiser's record in my case, every issue needs to be resolved before any acceptance occurs. The issues as I see them now:1. I received a notice in the mail on Saturday, Feb 20th, and dated February 12, 2016, that says my coverage will be terminated if a payment of $3,636.87 isn't received by March 14th, 2016. I find myself right back where I was in December of 2015 with this issue. Kaiser has been aware of these erroneous charges for at least two months, has agreed, and said these incorrect charges would be removed promplty. Demanding payment for monies not owed, with the threat of termination, seems to be fraudulent to me at this point. This issue needs to be fixed immediately. This is my second written complaint for this issue.2. My wife, [redacted], still has an active bill on her account for services rendered that do not reflect charges as per our policy. The guarantor Acct # is 1061328, and her health record number is 424403029. The amount total amount billed is $390.59. My estimate for services due should be equal to or less than $165.59. Any and all bills needs to be corrected to reflect our insured status in 2015 and 2016 immediately. 3. Billing amounts and dates on my account do not reflect actual payments made, though the total is correct. Please correct this. 4. My current bill on the kaiser site has a due date of 2017.Thank you for your prompt attention, and resolution of these issues.
Sincerely,
[redacted]

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