Kaiser Permanente

Hello,Here is a play by play of what occurred with regards to my complaint against Kaiser.Please contact me if you need further information.Best,[redacted]

I am rejecting...

this response because: I received a phone call this afternoon in response to my complaint.  I am grateful of the quick action taken by this business.  After sharing my concerns with the woman who called me, there were no answers, or solutions given to the problem.She assured me that she will look into it and it could take up to 30 days to get a response.This is unsatisfactory because I will need a refill in 30 days, and I do not want to go through this process again.Thank you.

(The consumer indicated he/she DID NOT accept the response from the business.)
Postscript:
After I sent my official response to the Revdex.com on...

9/23/14, within three hours, I received an actual communication from the KPH Member Services Director. (Thank you again, Revdex.com.)
He addressed my letter of two months earlier - the second of my three appeals. Although he denied any mistakes on the part of KPH and altogether ignored the basis of my appeals (i.e. that KPH had cashed my premiums, that KPH confirmed my membership at the time of my stroke, and that KPH instructed the hospital to send me to a Kaiser facility), he agreed that KPH would nevertheless finally pay all my related medical bills. Ah! Success. But he also asked that I send him the original bills and claim forms. OK, I thought, just a little more work for me.
Unfortunately (but true to form) the left hand of Kaiser had no idea what the right was doing. The very next day, I received by mail a 5-page letter, a 1-page letter, and a 4-page bill, all stating that I was responsible for the full cost of medical care at the Kaiser facility where I had been transferred - at their instruction - on the day of my stroke.
What an incredibly huge and dysfunctional machine is this "Kaiser Permanente." Administratively, there is little they could do to add more insult to injury; for even after your survival from their system, they charge you fifty cents per page to get a copy of your own medical records - that is, if they ever get around to doing it.

The Health Plan has received this complaint and it was logged on 2/10/15.  The Health Plan has up to 30 days to respond in writing directly to the member/patient.  The case is under review and the correspondance related to outcome will be sent directly to the member/patient.

Hello:
 
Please correct my name.  My name is Keyla W[redacted] not [redacted].  Thank you.
 
The refund process takes 4-6 weeks.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.  Please see attachment or check attachment tab.
Regards,
[redacted]

Kaiser Permanente will be paying claims mentioned in this complaint.
Thank you.

We will be notifying the member that we will be paying for these claims.

Kaiser has repeatedly overcharged and mishandled our company information. We spent over 3 hours on the phone with them trying to find out why they kept overcharging us by several thousand dollars every month and we got nowhere. They continued to ignore our complaints until we finally had to cancel our employee benefits plan with them. The service all around was terrible and we will never do business with them again.

I am rejecting this response because:No one has spoken to me about this. I guess I will just have to go to the insurance commissioner about Kaiser's practices.

Dear Ms. [redacted],
I apologize for the delayed reply as I was only made aware of your concern on February 24. This message is in response to the complaint filed with the Hawaii Revdex.com on January 30, 2015.
A review of your complaint has been conducted.
Our records show that...

you called our Patient Financial Services Department on December 26, 2014 in response to the [redacted] letter you received and spoke with our representative who provided you with the address of our Customer Service Department so that you could file a written complaint. I do not have any record of receipt of your written complaint and apologize if we failed to process it.
Please give me a call so that I can assist you in resolving this concern.
Sincerely,
[redacted]
Manager, Customer Service
[redacted]

I think I'll give up on trying to reason with Kaiser.  They keep telling me that they owe me nothing; but made some adjustments to my account in 2015 ($4000 adjustment to $6000 billing error) and 2017.(mysterious $2000 adjustment; even though I wasn't a member)No one can answer why my son was a Kaiser member for the last year, having a premium paid in full each month....even though he was  a [redacted] member.They aren't owning up to their mistakes and I don't see wasting your or my time on this organization.Thank you so much for all of your help.Sadly...I guess its just best to raise the white flag.[redacted]

I am rejecting this response because: On Aug 30 Kaiser contacted me regarding the complaint. I explained everything in detail and...

was told copies of all invoices would be mailed out immediately for my review. It is now Sept 11 and I still have not received a single invoice I requested (although I have received multiple other mailings from them) and they are refusing to take my invoices out of collections in the meantime. I continually get generic responses like "we are working on it" but no one has offered any information or a solution to my problem. Acceptable solution:  1) take me out of collections, and 2) send me copies of the invoices I supposedly owe.

November 17, 2014Dear [redacted]:
This letter is in response to your inquiry dated November 7, 2014 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted] stated in his complaint that that he applied...

for health insurance coverage through DC Health Link. He also stated that he started employment on February 1, 2014 and he called the Health Plan to terminate his coverage.Complaints are thoroughly documented, investigated and resolved by the Member Services team through coordination with appropriate departments. This coordination may involve communication with senior leaders to ensure complete closure of a member's concerns. We also have processes in place to escalate a member's concern to the relevant physicians-in-chiefs, clinical operation managers, department leaders, Health Plan managers and the executive leaders. In addition, reports of member concerns are shared on a regular basis with our senior executives. These reports contain specific comments shared by our members regarding their experiences.
On behalf of the Health Plan, I apologize for the inconvenience this matter has caused [redacted].[redacted] must request termination of his health insurance coverage through DC Health Link. He may file an appeal with the DC Health Link ([redacted]) to request termination of his coverage effective February 1, 2014. If DC Health Link honors his request, they will notify the Health Plan of the termination date.
If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,
Daisy S
Senior Manager, Member Services

Kaiser sucks. I was a huge pro- kaiser advocate until recently. Service has gone down hill and it's awful. I've asked my husband who carried the Heath ins to switch to bcbs.

For [redacted] - email sent to the patient (member) to validate if complaint is still open.   We have no record of case filed as a formal grievance.  Note received back on 12/23 to open complaint.  Complaint...

was opened and acknowledgment sent.  Direct outcome will be sent to patient (member) directly at no more than 30 day**

The Health Plan responded to the patient in writing on May 28, 2015.  The resolution letter includes any applicable appeal information.

April 6, 2015Dear [redacted]:This letter is in response to your inquiry dated March 27, 2015 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of [redacted] stated in her complaint that she applied for health...

insurance coverage through the Federally Funded Marketplace (Exchange), [redacted] requested an effective date of March 1, 2014. Her policy renewed on January 1, 2015. [redacted] stated that her coverage terminated effective January 31, 2015. She is requesting a refund in the amount of $575.24 for her February 2015 premium.According to our records, [redacted]'s coverage is still active with the Health Plan. Her coverage terminated erroneously on February 25, 2015 and was reinstated on March 3, 2015 with no break in coverage.[redacted] and her family received medical care in January 2015, February 2015, and March 2015. [redacted] also received medical advice from the Health Plan's nurse advice line.
If [redacted] or members of her family have incurred any medical expenses during the time that the policy was not active, she may submit the bills to the Health Plan for payment consideration.
Regrettably, the Health Plan is unable to honor [redacted]'s request to refund her the premium for February 2015.On behalf of the Health Plan, I apologize for the inconvenience this situation has caused [redacted].If you and/or [redacted] have any additional questions, please contact Keyla W[redacted] at ###-###-####.Sincerely,Daisy S
Senior Manager, Member Services

Revdex.com:
I have reviewed the response made by the business in reference to...

my concern, and find that this resolution is satisfactory to me.
I want this done in a timely manner with resolve.  Kaiser has made this same promise to me for 2 years and result is always the same...they reject my claim of being owed money.This cannot continue.  I have been told by countless customer service reps that the refund is sitting there; waiting for release.Please have them release the funds to me and my son [redacted].Thank you.[redacted]