Kaiser Permanente

Review: I stop my health plan with Kaiser Permanente starting Aug, 1st. I had send them a letter with confirmation and they even did acknowledge receiving it.

However, they charged me for the month of August.

So I decided to call them to clear the situation. They acknowledged their mistake and told me I was going to be reimbursed in 6-8 weeks.

I waited 8 weeks, nothing arrived. I called them again, they told me to wait more

My first call to them was on Aug 16th, it's now Nov, 10th I still nothing.... I tried to contacted them but was then unable to reach anyone.Desired Settlement: I just would like to receive my money as soon as possible.

Thanks

Consumer

Response:

---------- Forwarded message ----------

From: [redacted] <[redacted]>

Date: Sat, Nov 23, 2013 at 7:30 PM

Subject: complaint #[redacted]

To: [email protected]

Hello,

My problem has been finally resolved.

Review: I received unsolicited offers from this company and responded twice.

I told them I did not want their insurance, I didn't need their insurance

and to permanently remove my name from their mailing list. I also

informed them that if I received more unsolicited offers, I would file a

complaint with the Revdex.com. However, this apparently didn't bother them

and I am still getting unsolicited offers from them. I would like the RevDex.com to inform these people that I do NOT want their insurance,

I do Not need their insurance, to permanently remove my name from their

mailing list and to stop these unsolicited offers IMMEDIATELY!!! I also don't

want to hear that they will remove my name from their mailing list but it will

take 90 days. That is TOTALLY UNACCEPTABLE!!!Desired Settlement: I would like the Revdex.com to inform these people that I do NOT want their insurance,

I do Not need their insurance, to permanently remove my name from their

mailing list and to stop these unsolicited offers IMMEDIATELY!!! I also don't

want to hear that they will remove my name from their mailing list but it will

take 90 days. That is TOTALLY UNACCEPTABLE!!!

Business

Response:

June 19, 2014Dear [redacted]:This letter is in response to your inquiry dated June 6, 2014 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of **. [redacted], The inquiry was received on June 10, 2014.**. [redacted] is requesting that the Health Plan remove his name from our mailing list.A request was forwarded to the Publications Department to stop all mail to**. [redacted] at [redacted], MD [redacted].If you and/or **. [redacted] have any additional questions, please contact [redacted] at ###-###-####.Sincerely,

Consumer

Response:

[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.]I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me as long as do not receive anymore unsolicited offers from them. Regards, [redacted]

Review: I have sleep apnea and have to use a CPAP Machine by [redacted], for regulations with my job. The standard is you are suppose to get your free reading from the place that provided you with the machine. Kaiser provided me with the machine but refuses to give me a free reading so that I may return to duty. No one else will give me a reading because you have to get it from the place that originally gave you the machine. I contacted the 1st class medical and they started the reading is free and that Kaiser should provide the free reading print out so that I may return back to work. My insurance with Kaiser has lapsed and I cannot get my insurance reinstated until I return back to work. I just need Kaiser to provide me with a reading. I have bee nout of work for a week now trying to get someone to provide me with a reading and have a family to provide for this was my last resort.Desired Settlement: Please provide me with a CPAP reading of my [redacted] machine so that I may return back to work.

Business

Response:

April 24, 2014Dear [redacted]:This letter is in response to your inquiry dated April 10, 2014 to Kaiser Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of **. [redacted]. The inquiry was received on April 15, 2014. **. [redacted] is requesting that the Health Plan provide him with a free reading of his CPAP machine. Please note that **. [redacted]s health insurance coverage terminated effective July 31, 2013.On March 18, 2014 the Health Plan provided [redacted] with a copy of his CPAP machine reading. I have included a copy of the reading for your convenience. If you and/or [redacted] have additional questions regarding this concern, pleas: contact [redacted] at [redacted].Sincerely,

Consumer

Response:

[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.]

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,

Review: I contacted Kaiser Member services by email on July 28, 2013 seeking answers to 3 basic questions involving the number of dermatologists they employ in the DC region (full email is below). I was told on July 29 that I would receive a reply via a letter in 30 days. A day later I received an email saying "your original email require more information than Member Services is capable of providing; we have entered your concerns into the system to be sent to our Regional office, where an assigned case manager can better assist you." I assumed this meant I would still receive a letter in 30 days since this email didn't say otherwise. I was wrong.

I emailed Member Services again on August 22, noting that I had not received a letter and their 30 days was almost up. I was told I had to call the case manager to which my case was assigned. The telephone number they gave me was disconnected. I emailed Member Services again on August 27 to tell them the number they gave me didn't work, and on August 28 they gave me the correct number. I left a message with the worker and have not received a reply.

My full email to them on July 28 is below:

Hello,

I'm writing to express my concern about the inadequate number of dermatologists available to members in the Mid-Atlantic region, and in Washington, DC in particular. My questions below stem from a recent attempt to see the dermatologist in DC. I was told there was a 6 week wait and even then I'd have to travel to [redacted], VA over 25 miles from my home. According to your website, Kaiser, remarkably, employs only one dermatologist in the entire city of Washington, DC. Also, according to your website, as of the end of 2012 you had 481,755 members in the Mid-Atlantic region with a total of 11 dermatologists available to these members. Given these facts available from your website I request answers to the following questions below:

1. Do you believe that having one dermatologist available for members in Washington, DC is the ideal number to employ? If not, do you plan on hiring any in the immediate future?

2. Do you have staffing goals for specialty doctors, i.e., do you use ratios to determine how many specialty doctors you hire? I find it deeply troubling that you employ one dermatologist for every 4,400 members.

3. Is it current policy to ask members to travel throughout the region to obtain basic services, such as dermatology? Knowing that you expect members to travel up to 25 miles to see a doctor will be helpful in determining if I remain a Kaiser member.

Please specifically address my questions. I am not interested in vague answers or mission statements about goals.

END EMAILDesired Settlement: All I am seeking is answers to my questions. As a consumer I have many choices regarding health care. I need to know if the company I choose is doing all they say they are in addressing my needs. Thanks!

Business

Response:

October 9, 2013

[redacted] Revdex.com

Metro [redacted] DC and Eastern Pennsylvania 1411 K St. NW, 10th Floor Washington, DC 20005-3404

RE: Complainant: [redacted] ID #: [redacted]

Member Number: [redacted] Dear **. [redacted]:

This letter is in response to your inquiry dated September 30, 2013 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan) on behalf of **. [redacted].

**. [redacted] is dissatisfied with wait time for an appointment at the Capitol Hill Medical Center's Dermatology Department. In addition, **. [redacted] states that he did not receive a response to his questions from Member Services.

Complaints are thoroughly documented, investigated and resolved by the entire Member Services team through coordination with appropriate departments. This coordination may involve communication with Senior Leadership to ensure complete closure of a member's concerns. We also have processes in place to escalate a member's concern to Physicians-in-Chiefs, Clinical Operation Managers, Department Leaders, Health Plan Managers and the Executive Leadership. 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.

In addition to the processes and actions described above, **. [redacted]'s letter was escalated to [redacted], Physician in Chief of the District of Columbia and Suburban Maryland Service Area; **. [redacted], Administrative Chief of Dermatology; **. [redacted], Operations Manager of the Member Services Call Center; and **. [redacted], Supervisor of the Member Assistant Resource Specialist (MARS) for review and appropriate action.

**. [redacted] would like responses to the following questions:

How many dermatologists are available in the Washington, DC area? Do you believe that one dermatologist in the DC area is ideal? Do you plan on hiring more dermatologists in the immediate future? Do you have staffing goals for specialty doctors, i.e., do you use ratios to determine how many specialty doctors you will hire?

Due to unexpected physician staffing shortages within the past six months, we had three dermatologists servicing the DC metropolitan area which includes Montgomery and Prince George's Counties. However, we have since had the good fortune of hiring four additional dermatologists. One dermatologist has already started at our Capitol Hill Medical Center in the District of Columbia and one has already started at our Largo Medical Office Building. Two additional dermatologists have joined the group this week beginning October 7th, 2013. Physicians will travel to the individual office sites depending on demand for services, however we do anticipate maintaining a steady presence of dermatology at each of our medical hubs, Capitol Hill, Gaithersburg and Largo. The staffing goals for servicing our member population have been met with these additional hires, and we anticipate timely dermatological care for all of our members.

I find it deeply troubling that you hire one dermatologist for every 4,400 members. Is it current policy to ask members to travel throughout the region up to 25 miles to see a doctor?

The Health Plan has the capability to service our members throughout the District of Columbia, Maryland and Virginia Service Areas. Our members occasionally travel throughout the service area to see available physicians at multiple locations.

**. [redacted] also mentioned that he has to wait 6 weeks for an appointment with the Dermatology Department at the Capitol Hill Medical Center. According to our records, **. [redacted] was scheduled for an appointment on September 17, 2013. While there, **.

[redacted] had to reschedule his appointment due to time constraints. The first available appointment with **. [redacted] after September 17th was November 4, 2013.

On October 9, 2013,1 called the Dermatology Department at the Capitol Hill Medical Center to inquire about an earlier appointment time for **. [redacted]. I was advised that there were available appointments on October 25, 2013 with **. [redacted] between 9:30 am to 2:15 pm. **. [redacted] has an appointment available on October 28, 2013 at 11:00 am.

I called **. [redacted] to offer him the earlier appointments but he declined. **. [redacted] informed me that he can wait until November 4, 2013 for his appointment with **. Lorek.

The Health Plan is committed to providing quality care and services to all members. I regret the circumstances that prompted **. [redacted]'s letter. At the same time we thank him for the opportunity to address his concerns.

If you and/or **. [redacted]

have additional questions regarding this inquiry, please contact [redacted] at ###-###-####.

Sincerely,

Consumer

Response:

---------- Forwarded message ----------

From: ** <[redacted]>

Date: Tue, Oct 22, 2013 at 6:41 PM

Subject: Complaint ID [redacted]

To: "[email protected]" <[email protected]>

Dear [redacted]: Thank you for sending me a response from Kaiser on 10/11/2013. Due to a variety of circumstances I was unable to respond to the letter in the 10 days the Revdex.com allots for responding. I just tried to respond but it said the case was closed. I was quite patient in trying to receive information from Kaiser, so I hope you will at least read my response below; as I wholeheartedly disagree that Kaiser addressed my complaint. My original complaint was about general Kaiser business practices, not simply getting an appointment. It was never my intention nor did my letter ever request an appointment. If it is read closely, I was simply questioning their ability to provide members who live in [redacted] DC appropriate access to their health maintenance system. They responded partially but not nearly as specifically as a consumer requires when we have to make very important decisions regarding health insurance providers. · They mention, bizarrely, that they “had the good fortune of hiring four additional dermatologists" for the region. Again, this is for the region, not necessarily DC proper, where I live and where I should be going for health care. The “good fortune?” That is preposterous. They needed those doctors so all they did was fill a gaping staff shortage. But at least I now know that my health care is left to chance or, “fortune,” rather than strong institutional planning. · They responded that "the health plan has the capability to service members throughout DC, Maryland, and Virginia Service Areas." I demonstrated that this simply was not the case in regard to one department, dermatology. Who is to say that they don't lack needed doctors in other areas as well? Without answering how many specialty doctors they feel they need--based on the number of members, as I requested--this statement is woefully incomplete. Say I need to see a neurologist. How can I be confident that I will receive an appointment in an appropriate amount of time without having an understanding of their staffing levels? Am I supposed to take their word that "they have the capability" when I proved otherwise? The timing of hiring new dermatologists seems to coincide with my complaint which I find troubling, although I'm glad other members might not have to wait so long or travel so far. · And finally, when the time for my appointment came on September 17, they say, "**. [redacted] had to reschedule due to time constraints." What they failed to mention was that the dermatologist was at least 60 minutes late arriving to the office that day so his entire schedule was pushed back. I simply didn't have another hour, in addition to the 30 minutes I had already waited, to see the doctor. I had to get to work. I just wanted you to have all the facts and encourage you to revisit their response. Thanks so much for your time and effort in protecting consumers.

Best regards,