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 meThe aforementioned credit has been appliedThank you for your assistance Sincerely, [redacted]
January 29, [redacted] Revdex.com Serving Denver/Boulder EFlorida Ave., SteDenver, Colorado 80210Complaint Case # [redacted] Consumer: [redacted] ***Case Opened: 1/19/2018Dear Mr [redacted] ,This is in response to your email received on January 24, 2018, forwarding continued concerns on behalf of our member; [redacted] regarding his request to see a Liver Specialists at [redacted] , or [redacted] in Aurora, ColoradoWe 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 leadershipOur Provider Relations Department has confirmed that there are two contracted physicians in the Southern Colorado region that are both Hepatology Specialist and treat PSC In addition, Children's Hospital will not start treatment for patients Mr [redacted] age and would refer to adult hepatology.Mr [redacted] rebuttal received on January 24, was submitted and accepted with Kaiser Permanente’s Member Appeals DepartmentOn January 25, 2018, the Member Appeals Department sent Mr [redacted] a written request for copies of his medicals recordsAn Authorization to Release Medical Records form was attached and must be completed and signed in order for us to obtain those recordsThe authorization form must be signed and dated by Mr [redacted] or his authorized representative With this request Mr***’s was also provided with his Member Appeals Analyst contact information for questions as it relates to his appeal Mr***’s will receive separate correspondence with the decision of his appeal which will include the next steps if the decision is not in his favorIf the Revdex.com or the member has any questions, please contact me at (303) 338-3827.Also, you may contact Member Services: Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700, between a.mto p.m., Monday through Friday Deaf, hard of hearing, or speech impaired members who use a TTY may call 303-338- Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521- You 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 PermanenteSincerely,Suda P [redacted] Complex Case Resolution SpecialistMember Experience
Revdex.com:The address change was submitted months prior on occasions At the time of notice from Collections, the employer was no longer allowed access to the site to change the address.A breakdown of the billing would have solved all before sending to collections The balance will be paid to Kaiser I have reviewed the response made by the business in reference to complaint ID 11401135, and find that this resolution is satisfactory to me Sincerely, [redacted] *
September 29, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: [redacted] Dear [redacted] , This is in response to your email received on September 15, forwarding concerns on behalf of our member; [redacted] regarding his request for Kaiser Permanente to pay the balance owed on his biopsy completed on February 24, at [redacted] *** 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 The member states that if he had the procedure completed within the Kaiser Permanente network, his out of pocket costs would have been approximately $2,The member at the time of services was on a DHMO plan with a $500/Individual deducible and a 20% Coinsurance for Outpatient surgery at designated outpatient facilities (Subject to medical Deductible; Applies to Out-of-Pocket Maximum) The review of the charges are as follows for [redacted] Facility charges: $3, $474.15- Deducible $2,712.05- Co-insurance Professional charges: $ $Deducible $646.18- Co-insurance I have contacted [redacted] Patient Account Services and has confirmed the member currently has an outstanding balance of $2,The member has made a $payment The leadership as agreed to pay the difference between his charges for the outside provider and his quoted $2,I will issue a payment directly to [redacted] in the amount of $1,This is a onetime only good will gesture The member was advised on the referral letter that was mailed on February 22, the following information: You are responsible for payment of the applicable copayment(s) or coinsurancePlease refer to your Evidence of Coverage, Plan Document or Federal Employees Health Benefits Program Brochure as it applies to you for how much you pay for services or contact Member Services If the Revdex.com or the member has any questions, please contact me at [redacted] Also, you may contact Member Services: [redacted] members may call [redacted] , toll free at [redacted] , between a.mto 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 matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because it says Kaiser will be issuing a refund within 1-business days without any further detailThis does not include when we will be receiving the refund or how we will be receiving the refund (bank transfer? overnight delivery? first class mail?)Is there any type of tracking information to ensure receipt? Since we have already been waiting several months, this does not solve the issue of confirming that a refund has been issued and no sense of urgency in getting the refund back to usAdditionally, when we spoke to someone over the phone earlier this month, they advised that the refund was already issued and will take 4-weeks to receive in the mail When the business then states that a refund will be issued within 1-business days, this is another example of giving me different information each time we try to resolve this matterWas the previously given statement by the business misinformation? Is this a different check that will be issued more urgently? I'm more confused and still don't have the refund due to us Sincerely, [redacted]
July 10, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: 07/06/ Dear [redacted] , This is in response to your email received on July 6, forwarding concerns on behalf of member; [redacted] regarding his request for Kaiser Permanente to reinstate his health planWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction We have formally documented and shared MrPeelgrane grievance with the appropriate leadership Based on review Membership Management has approved reinstatementMember's health plan was reinstated with no gaps in coverageA reinstatement bill and EFT form were sent to the address on file Member must pay $before August 10, If the Revdex.com or the member has any questions, please contact me at [redacted] Also, you may contact Member Services: [redacted] members may call [redacted] , toll free at [redacted] , between a.mto 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 matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, [redacted]
March 7, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: 02/20/ Dear Mr [redacted] , This is in response to your email received on February 20,forwarding concerns on behalf of member; [redacted] regarding his concern regarding Kaiser Permanente (KP) not providing the correct premium billing statements for his health planWe 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 Based on the review, Mr [redacted] s account was on a Failed bill report the root cause for the member not being billed timelyThe system has been addressed and to prevent further issues a new policy was created for the member to speed up the process to resolve the member's issueI do see that the bill went through smoothly on the new policy for the month of MarchI have confirmed that there are no past due lettersAnd the account has a net due of $and New policy [redacted] 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 a.mto 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 [redacted] 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, [redacted] Complex Case Resolution Specialist Member Experience
Complaint: [redacted] I am rejecting this response because: I appreciate the timely response from Kaiser Permanente and am not surprised with the lack of resolution I would like to make clear that we have been with Kaiser Permanente for several years and am only a new member because your organization mandated it We had our coverage dropped when Obama Care became active and were told we had to get coverage through Connect for Colorado Kaiser Permanente would not honor our current coverage and would not let us go through them to get a plan Going through Connect for Colorado started our account which made us a new member We changed our plan last year through Connect for Colorado which again started a new plan The first year of billing with Obama Care was a complete mess but we were patient However with the beginning of the new year, Kaiser Permanente changed their billing practices in which you had to pay a month ahead as opposed to having the payment by the last of the month Again I am aware I was a little late on the payment but a letter days prior with no subsequent reminder, the payment got overlooked I was trying to make the account current with a payment but was told my family could not be reinstated, all this for a one late payment My family is now unable to get health care coverage until open enrollment for Obama Care in November I am extremely disappointed by how this situation is being handled and wanted to make clear that we are not new members, we have been members for many years Sincerely, [redacted] ***
October 18, [redacted] Dispute Resolution SpecialistDenver/Boulder Revdex.com [redacted] ***Complaint Case # [redacted] Consumer: [redacted] ***Case Opened: October 5, 2016Dear [redacted] ,This is in response to your email received on October 5, 2016, forwarding concerns on behalf of our member, [redacted] , regarding a request for refund of health plan premiums paid after the Kaiser Permanente health plan coverage terminatedWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction[redacted] explained that his last day of Kaiser Permanente health plan coverage was July 31, Although he was informed that the August premium would not be deducted through auto-payment, $was deducted [redacted] states he has called multiple times requesting the refundEach time an inquiry was made, different explanations were provided as to the time frame of when the refund could be expected.We have formally documented and shared [redacted] ’s concerns with the appropriate leadership of our Member Issue Resolution Team (MIRT), to include the Vice PresidentPlease apologize to the member, on behalf of Kaiser Permanente (KP), for any frustration and hardship that may have been caused by this overall matter.I additionally forwarded [redacted] ’s refund request to MIRT, as they specifically address issues related to health plans purchased through Connect for Health ColoradoOn October 17, 2016, the MIRT Business Analyst was able to confirm the total refund due of $The refund is in process and is estimated to be issued in the next one to three business daysI will continue to monitor [redacted] ’s account to ensure the refund is issued.Please ask [redacted] to review the response and contact me directly if he has any related questionsAgain, please express my sincere apologies for the conflicting information when contacting Kaiser Permanente and hardship [redacted] endured.The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate careOur 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 PermanenteMember Services [redacted] ***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 [redacted] .Also, you may contact Member Services:Denver/Boulder members may call [redacted] , toll free at [redacted] , between a.mto p.m., Monday through FridayDeaf, 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 matterWe 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 / [redacted] (1000, 6, 2015/11/19) */ November 19, [redacted] Trade Practices & Helpline Specialist Denver/Boulder Revdex.com P.OBox XXXXX Denver, Colorado XXXXX Complaint Case # XXXXXXXX Consumer: [redacted] , [redacted] Case Opened: November 4, Dear Ms [redacted] This is in response to your email received on November 4, 2015, forwarding concerns on behalf of our member, [redacted] , regarding an awaited healthcare premium refundWe value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction The member case scenario has been forwarded to our Consolidated Service Center/KPIF Department that assists with issues pertaining to plans purchased through Connect for Health ColoradoThe details were thoroughly researched, as to confirm the refund amount due back to Mr [redacted] The payment premium calculation confirms that the member is due a refund of $768.39, once the correct termination date is reflected of April 30, Kaiser Permanente (KP) has submitted to the Connect for Health Colorado vendor that the December 31, end date be appropriately changedOnce the termination date is corrected, the requested refund will processUnfortunately, KP is not able to provide a date as to when this will be complete, though I welcome the member to contact me directly for progress updates Please apologize to the member for any consequential inconvenience and frustration experiencedShould any related issues or concerns arise pertaining to Mr [redacted] 's plan, I'd be happy to personally assist, as to avoid continued inconsistent information being provided 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 [redacted] Street Aurora, [redacted] 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, [redacted] M [redacted] Complex Case Resolution Specialist Member Experience Initial Consumer Rebuttal / [redacted] (3000, 8, 2015/11/20) */ (The consumer indicated he/she DID NOT accept the response from the business.) There is still no resolution in sightI have been given this answer for months...they admit they owe a refund but give every excuse out there as to why they can't send me a refundThey have been holding onto almost dollars, of my money, for monthsIts not theirs and they need to issue the refund check immediately or my next step is to hire an attorneyI've contacted connect for health Colorado on multiple occasions and they have confirmed that they have sent the correct termination date to kaiser months ago Final Business Response / [redacted] (4000, 10, 2015/12/04) */ December 4, [redacted] Dispute Resolution & Helpline Specialist Denver/Boulder Revdex.com [redacted] Box XXXXX [redacted] Colorado XXXXX Complaint Case # XXXXXXXX Consumer: [redacted] , [redacted] Case Opened: November 18, Dear Ms [redacted] This is in response to your email received on November 18, 2015, forwarding the rebuttal to our original, on behalf of our member [redacted] The member is requesting a more immediate refund of premiums be received On December 4, 2015, the Member Issues Resolution Team (MIRT) advised that the Mr [redacted] 's expected refund will go out early next weekThere was a delay with the Kaiser Permanente Finance Department, due to a new procedure being implemented to handle the influx of recent refund requestsPlease apologize to the member for the inconvenience experienced, and he is welcome to contact me with any further questions or concerns relating to this matter 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 [redacted] South [redacted] Street [redacted] 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, [redacted] Complex Case Resolution Specialist Member Experience
Complaint: I am rejecting this response because:Once my premium billing discrepancy is resolved, I will consider the matter closedPlease reference letter dated March 7, Also, [redacted] birthdate is JUNE 9, It is not spelled ***, and he wasnt born on June (last letter) or September 9, (this letter)Thanks, Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because:Yesterday, I was pleased to finally receive my refund check in the mailThank you for helping me with thatHowever, the same day I also received a bill from KaiserIt seems that after writing my check, they immediately added that amount to my balance rather than subtracting itI want Kaiser to zero out my balance and send me confirmation immediately that I owe them exactly $I would do this through your system except I can't figure out how to reopen my complaintAttached is a copy of the bill I receivedThank you, [redacted] Sincerely, [redacted]
Complaint: I am rejecting this response because: My wife and I have been patient from literally 12/16/15; following every step and advice given to us regarding my family and their coverage I did not want to accept the response by Kaiser and have this case closed as it is not resolved The response is what we have been receiving on all occasions 1/9/16, 1/27/16, 1/29/16, 2/1/16, 2/3/again on 2/15/and on this date we were given days for resolution In notes by [redacted] on 2/15/was quoted "we need to get this turned around as this was no fault of your's Mrs [redacted] " [redacted] from California Rep for Kaiser took enrollment on 1/27/English was very broken heavy Spanish accent, clearly marked the wrong box when the same information had been given to her We were directed to enroll directly through Kaiser since the Exchange gave us no tax credit We followed advice and are in a worse situation My children are without Medical Coverage as I am too We don't feel that we need to wait even longer to get coverage Kaiser has taken so long that even our Certificates of Coverage are now VOID giving us a break in coverage WAY OVER days from 12/31/ This has truly left our family in a detrimental position, causing a hardship emotionally and Financially especially if Kaiser rejects reinstatement My wife and I are losing sleep over this, we have never been without coverage in over years.Kaiser on many occasions even reference conversation #Sreassured by filing Grievance we would taken care within days (3/24/16) if not sooner, now we have an even longer extension going into April My wife is prepared to pay full premiums dated back to 1/1/to bring us current to meet premium requirements My kids need medications and visits, and the Believe Policy makes my family feel like we are in the wrong by the way of treatment rec'd in clinic I have a hernia I can't take care of and we have had kaiser for over years Please help my family get coverage this is all we are asking, we applied within deadlines and gave payment via Credit Card, and the error was not ours We are not asking for extra money or anything just the coverage we applied for and by the advice of Kaiser Reps we got off the Exchange Now in worse position.The resolution is simple please reinstate prefer back to 1/1/if not as recommended by [redacted] in California 2/1/ We feel for some reason we are being discriminated against and our Health Coverage is being held hostage This wait is long enough and not good for our health at all costs Sincerely, [redacted]
February 18, [redacted] Dispute Resolution/Helpline Specialist Denver/Boulder Revdex.com P.OBox Denver, Colorado Complaint Case # Consumer: [redacted] Case Opened: February 2, 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 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 refundPlease 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 Cand our third party billing vendor, SLP, in an attempt to solve member experienced problemsIn this scenario, MIRT submitted the refund to SLP on the same date that the case was openedUp until today, there was not an update provided as to where the refund stands in the entire refund processJust today, MIRT was able to confirm the following information: -MIRT had initially requested a $refund from C4, which was denied on 11/14/(Cneeded more information) -Per my outreach, MIRT again verified the refund amount due and submitted the request to C -The refund was approved, and a $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 herUnfortunately, more issues with On-Exchange purchased plans have presented than ever expected or planned forThis is absolutely not the problem of Ms [redacted] , nor should it affect her as it hasKP, 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 approvedI am also able to personally assist with reaching out for updates, should she like to contact me directlyPlease 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 South Havana Street Aurora, Colorado 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 [redacted] Also, you may contact Member Services: Denver/Boulder members may call [redacted] , toll free at 1-800-632-9700, between a.mto 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-or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521- You 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, [redacted] Complex Case Resolution Specialist Member Experience
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 meThe aforementioned credit has been appliedThank you for your assistance Sincerely, [redacted]
January 29, [redacted] Revdex.com Serving Denver/Boulder EFlorida Ave., SteDenver, Colorado 80210Complaint Case # [redacted] Consumer: [redacted] ***Case Opened: 1/19/2018Dear Mr [redacted] ,This is in response to your email received on January 24, 2018, forwarding continued concerns on behalf of our member; [redacted] regarding his request to see a Liver Specialists at [redacted] , or [redacted] in Aurora, ColoradoWe 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 leadershipOur Provider Relations Department has confirmed that there are two contracted physicians in the Southern Colorado region that are both Hepatology Specialist and treat PSC In addition, Children's Hospital will not start treatment for patients Mr [redacted] age and would refer to adult hepatology.Mr [redacted] rebuttal received on January 24, was submitted and accepted with Kaiser Permanente’s Member Appeals DepartmentOn January 25, 2018, the Member Appeals Department sent Mr [redacted] a written request for copies of his medicals recordsAn Authorization to Release Medical Records form was attached and must be completed and signed in order for us to obtain those recordsThe authorization form must be signed and dated by Mr [redacted] or his authorized representative With this request Mr***’s was also provided with his Member Appeals Analyst contact information for questions as it relates to his appeal Mr***’s will receive separate correspondence with the decision of his appeal which will include the next steps if the decision is not in his favorIf the Revdex.com or the member has any questions, please contact me at (303) 338-3827.Also, you may contact Member Services: Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700, between a.mto p.m., Monday through Friday Deaf, hard of hearing, or speech impaired members who use a TTY may call 303-338- Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521- You 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 PermanenteSincerely,Suda P [redacted] Complex Case Resolution SpecialistMember Experience
Revdex.com:The address change was submitted months prior on occasions At the time of notice from Collections, the employer was no longer allowed access to the site to change the address.A breakdown of the billing would have solved all before sending to collections The balance will be paid to Kaiser I have reviewed the response made by the business in reference to complaint ID 11401135, and find that this resolution is satisfactory to me Sincerely, [redacted] *
September 29, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: [redacted] Dear [redacted] , This is in response to your email received on September 15, forwarding concerns on behalf of our member; [redacted] regarding his request for Kaiser Permanente to pay the balance owed on his biopsy completed on February 24, at [redacted] *** 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 The member states that if he had the procedure completed within the Kaiser Permanente network, his out of pocket costs would have been approximately $2,The member at the time of services was on a DHMO plan with a $500/Individual deducible and a 20% Coinsurance for Outpatient surgery at designated outpatient facilities (Subject to medical Deductible; Applies to Out-of-Pocket Maximum) The review of the charges are as follows for [redacted] Facility charges: $3, $474.15- Deducible $2,712.05- Co-insurance Professional charges: $ $Deducible $646.18- Co-insurance I have contacted [redacted] Patient Account Services and has confirmed the member currently has an outstanding balance of $2,The member has made a $payment The leadership as agreed to pay the difference between his charges for the outside provider and his quoted $2,I will issue a payment directly to [redacted] in the amount of $1,This is a onetime only good will gesture The member was advised on the referral letter that was mailed on February 22, the following information: You are responsible for payment of the applicable copayment(s) or coinsurancePlease refer to your Evidence of Coverage, Plan Document or Federal Employees Health Benefits Program Brochure as it applies to you for how much you pay for services or contact Member Services If the Revdex.com or the member has any questions, please contact me at [redacted] Also, you may contact Member Services: [redacted] members may call [redacted] , toll free at [redacted] , between a.mto 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 matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because it says Kaiser will be issuing a refund within 1-business days without any further detailThis does not include when we will be receiving the refund or how we will be receiving the refund (bank transfer? overnight delivery? first class mail?)Is there any type of tracking information to ensure receipt? Since we have already been waiting several months, this does not solve the issue of confirming that a refund has been issued and no sense of urgency in getting the refund back to usAdditionally, when we spoke to someone over the phone earlier this month, they advised that the refund was already issued and will take 4-weeks to receive in the mail When the business then states that a refund will be issued within 1-business days, this is another example of giving me different information each time we try to resolve this matterWas the previously given statement by the business misinformation? Is this a different check that will be issued more urgently? I'm more confused and still don't have the refund due to us Sincerely, [redacted]
July 10, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: 07/06/ Dear [redacted] , This is in response to your email received on July 6, forwarding concerns on behalf of member; [redacted] regarding his request for Kaiser Permanente to reinstate his health planWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction We have formally documented and shared MrPeelgrane grievance with the appropriate leadership Based on review Membership Management has approved reinstatementMember's health plan was reinstated with no gaps in coverageA reinstatement bill and EFT form were sent to the address on file Member must pay $before August 10, If the Revdex.com or the member has any questions, please contact me at [redacted] Also, you may contact Member Services: [redacted] members may call [redacted] , toll free at [redacted] , between a.mto 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 matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, [redacted]
March 7, [redacted] [redacted] Complaint Case # [redacted] Consumer: [redacted] Case Opened: 02/20/ Dear Mr [redacted] , This is in response to your email received on February 20,forwarding concerns on behalf of member; [redacted] regarding his concern regarding Kaiser Permanente (KP) not providing the correct premium billing statements for his health planWe 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 Based on the review, Mr [redacted] s account was on a Failed bill report the root cause for the member not being billed timelyThe system has been addressed and to prevent further issues a new policy was created for the member to speed up the process to resolve the member's issueI do see that the bill went through smoothly on the new policy for the month of MarchI have confirmed that there are no past due lettersAnd the account has a net due of $and New policy [redacted] 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 a.mto 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 [redacted] 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, [redacted] Complex Case Resolution Specialist Member Experience
Complaint: 11155486 I am rejecting this response because:I have not received the refund yet. Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because: I appreciate the timely response from Kaiser Permanente and am not surprised with the lack of resolution I would like to make clear that we have been with Kaiser Permanente for several years and am only a new member because your organization mandated it We had our coverage dropped when Obama Care became active and were told we had to get coverage through Connect for Colorado Kaiser Permanente would not honor our current coverage and would not let us go through them to get a plan Going through Connect for Colorado started our account which made us a new member We changed our plan last year through Connect for Colorado which again started a new plan The first year of billing with Obama Care was a complete mess but we were patient However with the beginning of the new year, Kaiser Permanente changed their billing practices in which you had to pay a month ahead as opposed to having the payment by the last of the month Again I am aware I was a little late on the payment but a letter days prior with no subsequent reminder, the payment got overlooked I was trying to make the account current with a payment but was told my family could not be reinstated, all this for a one late payment My family is now unable to get health care coverage until open enrollment for Obama Care in November I am extremely disappointed by how this situation is being handled and wanted to make clear that we are not new members, we have been members for many years Sincerely, [redacted] ***
October 18, [redacted] Dispute Resolution SpecialistDenver/Boulder Revdex.com [redacted] ***Complaint Case # [redacted] Consumer: [redacted] ***Case Opened: October 5, 2016Dear [redacted] ,This is in response to your email received on October 5, 2016, forwarding concerns on behalf of our member, [redacted] , regarding a request for refund of health plan premiums paid after the Kaiser Permanente health plan coverage terminatedWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction[redacted] explained that his last day of Kaiser Permanente health plan coverage was July 31, Although he was informed that the August premium would not be deducted through auto-payment, $was deducted [redacted] states he has called multiple times requesting the refundEach time an inquiry was made, different explanations were provided as to the time frame of when the refund could be expected.We have formally documented and shared [redacted] ’s concerns with the appropriate leadership of our Member Issue Resolution Team (MIRT), to include the Vice PresidentPlease apologize to the member, on behalf of Kaiser Permanente (KP), for any frustration and hardship that may have been caused by this overall matter.I additionally forwarded [redacted] ’s refund request to MIRT, as they specifically address issues related to health plans purchased through Connect for Health ColoradoOn October 17, 2016, the MIRT Business Analyst was able to confirm the total refund due of $The refund is in process and is estimated to be issued in the next one to three business daysI will continue to monitor [redacted] ’s account to ensure the refund is issued.Please ask [redacted] to review the response and contact me directly if he has any related questionsAgain, please express my sincere apologies for the conflicting information when contacting Kaiser Permanente and hardship [redacted] endured.The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate careOur 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 PermanenteMember Services [redacted] ***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 [redacted] .Also, you may contact Member Services:Denver/Boulder members may call [redacted] , toll free at [redacted] , between a.mto p.m., Monday through FridayDeaf, 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 matterWe 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 / [redacted] (1000, 6, 2015/11/19) */ November 19, [redacted] Trade Practices & Helpline Specialist Denver/Boulder Revdex.com P.OBox XXXXX Denver, Colorado XXXXX Complaint Case # XXXXXXXX Consumer: [redacted] , [redacted] Case Opened: November 4, Dear Ms [redacted] This is in response to your email received on November 4, 2015, forwarding concerns on behalf of our member, [redacted] , regarding an awaited healthcare premium refundWe value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction The member case scenario has been forwarded to our Consolidated Service Center/KPIF Department that assists with issues pertaining to plans purchased through Connect for Health ColoradoThe details were thoroughly researched, as to confirm the refund amount due back to Mr [redacted] The payment premium calculation confirms that the member is due a refund of $768.39, once the correct termination date is reflected of April 30, Kaiser Permanente (KP) has submitted to the Connect for Health Colorado vendor that the December 31, end date be appropriately changedOnce the termination date is corrected, the requested refund will processUnfortunately, KP is not able to provide a date as to when this will be complete, though I welcome the member to contact me directly for progress updates Please apologize to the member for any consequential inconvenience and frustration experiencedShould any related issues or concerns arise pertaining to Mr [redacted] 's plan, I'd be happy to personally assist, as to avoid continued inconsistent information being provided 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 [redacted] Street Aurora, [redacted] 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, [redacted] M [redacted] Complex Case Resolution Specialist Member Experience Initial Consumer Rebuttal / [redacted] (3000, 8, 2015/11/20) */ (The consumer indicated he/she DID NOT accept the response from the business.) There is still no resolution in sightI have been given this answer for months...they admit they owe a refund but give every excuse out there as to why they can't send me a refundThey have been holding onto almost dollars, of my money, for monthsIts not theirs and they need to issue the refund check immediately or my next step is to hire an attorneyI've contacted connect for health Colorado on multiple occasions and they have confirmed that they have sent the correct termination date to kaiser months ago Final Business Response / [redacted] (4000, 10, 2015/12/04) */ December 4, [redacted] Dispute Resolution & Helpline Specialist Denver/Boulder Revdex.com [redacted] Box XXXXX [redacted] Colorado XXXXX Complaint Case # XXXXXXXX Consumer: [redacted] , [redacted] Case Opened: November 18, Dear Ms [redacted] This is in response to your email received on November 18, 2015, forwarding the rebuttal to our original, on behalf of our member [redacted] The member is requesting a more immediate refund of premiums be received On December 4, 2015, the Member Issues Resolution Team (MIRT) advised that the Mr [redacted] 's expected refund will go out early next weekThere was a delay with the Kaiser Permanente Finance Department, due to a new procedure being implemented to handle the influx of recent refund requestsPlease apologize to the member for the inconvenience experienced, and he is welcome to contact me with any further questions or concerns relating to this matter 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 [redacted] South [redacted] Street [redacted] 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, [redacted] Complex Case Resolution Specialist Member Experience
Complaint: I am rejecting this response because:Once my premium billing discrepancy is resolved, I will consider the matter closedPlease reference letter dated March 7, Also, [redacted] birthdate is JUNE 9, It is not spelled ***, and he wasnt born on June (last letter) or September 9, (this letter)Thanks, Sincerely, [redacted]
Complaint: [redacted] I am rejecting this response because:Yesterday, I was pleased to finally receive my refund check in the mailThank you for helping me with thatHowever, the same day I also received a bill from KaiserIt seems that after writing my check, they immediately added that amount to my balance rather than subtracting itI want Kaiser to zero out my balance and send me confirmation immediately that I owe them exactly $I would do this through your system except I can't figure out how to reopen my complaintAttached is a copy of the bill I receivedThank you, [redacted] Sincerely, [redacted]
Complaint: I am rejecting this response because: My wife and I have been patient from literally 12/16/15; following every step and advice given to us regarding my family and their coverage I did not want to accept the response by Kaiser and have this case closed as it is not resolved The response is what we have been receiving on all occasions 1/9/16, 1/27/16, 1/29/16, 2/1/16, 2/3/again on 2/15/and on this date we were given days for resolution In notes by [redacted] on 2/15/was quoted "we need to get this turned around as this was no fault of your's Mrs [redacted] " [redacted] from California Rep for Kaiser took enrollment on 1/27/English was very broken heavy Spanish accent, clearly marked the wrong box when the same information had been given to her We were directed to enroll directly through Kaiser since the Exchange gave us no tax credit We followed advice and are in a worse situation My children are without Medical Coverage as I am too We don't feel that we need to wait even longer to get coverage Kaiser has taken so long that even our Certificates of Coverage are now VOID giving us a break in coverage WAY OVER days from 12/31/ This has truly left our family in a detrimental position, causing a hardship emotionally and Financially especially if Kaiser rejects reinstatement My wife and I are losing sleep over this, we have never been without coverage in over years.Kaiser on many occasions even reference conversation #Sreassured by filing Grievance we would taken care within days (3/24/16) if not sooner, now we have an even longer extension going into April My wife is prepared to pay full premiums dated back to 1/1/to bring us current to meet premium requirements My kids need medications and visits, and the Believe Policy makes my family feel like we are in the wrong by the way of treatment rec'd in clinic I have a hernia I can't take care of and we have had kaiser for over years Please help my family get coverage this is all we are asking, we applied within deadlines and gave payment via Credit Card, and the error was not ours We are not asking for extra money or anything just the coverage we applied for and by the advice of Kaiser Reps we got off the Exchange Now in worse position.The resolution is simple please reinstate prefer back to 1/1/if not as recommended by [redacted] in California 2/1/ We feel for some reason we are being discriminated against and our Health Coverage is being held hostage This wait is long enough and not good for our health at all costs Sincerely, [redacted]
February 18, [redacted] Dispute Resolution/Helpline Specialist Denver/Boulder Revdex.com P.OBox Denver, Colorado Complaint Case # Consumer: [redacted] Case Opened: February 2, 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 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 refundPlease 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 Cand our third party billing vendor, SLP, in an attempt to solve member experienced problemsIn this scenario, MIRT submitted the refund to SLP on the same date that the case was openedUp until today, there was not an update provided as to where the refund stands in the entire refund processJust today, MIRT was able to confirm the following information: -MIRT had initially requested a $refund from C4, which was denied on 11/14/(Cneeded more information) -Per my outreach, MIRT again verified the refund amount due and submitted the request to C -The refund was approved, and a $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 herUnfortunately, more issues with On-Exchange purchased plans have presented than ever expected or planned forThis is absolutely not the problem of Ms [redacted] , nor should it affect her as it hasKP, 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 approvedI am also able to personally assist with reaching out for updates, should she like to contact me directlyPlease 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 South Havana Street Aurora, Colorado 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 [redacted] Also, you may contact Member Services: Denver/Boulder members may call [redacted] , toll free at 1-800-632-9700, between a.mto 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-or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521- You 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, [redacted] Complex Case Resolution Specialist Member Experience