ComplaintsforKaiser Foundation Health Plan Inc

Hospital

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Initial Complaint
05/10/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On October 24, I was contacted by Kaiser membership services by text that their was problem with my "entitlement". I called and was told that I did not pay my September ******** Part A payment. However, I was listed as "active" and was given care. I then called the ****************************** and was told that I had no lapses in payment. I relayed this to Kaiser the next day and was told that everything was fine.On November 24th, I again received a text message that my ******** had not been paid for September. I called Kaiser and was told that their website stated that I did not pay and *** needed to state that they would correct the problem. I was told that the only proof that they would accept was this "website."I went to *** in ************ and received a letter stating that I was current with my ******** Part A and B payments, but they could not correct the problem because I was current with my payments. I sent this to Kaiser Administration. in ************ late December, I received a letter from Kaiser stating the letter was "invalid." I again went to *** and received a more detailed letter again stating that the payments from March 2023 through October 2023 when I was able to use my wife's 40 credits when she turned 62. I did not receive a response.On January 30, I received a letter from Kaiser that I had not responded to their January letter (this was because I had just sent them the *** letter the day before I received theirs). So on February 1st, I went in person to ********** services with a copy of my proof to find that they were closed and only taking phone calls. We then faxed the statements and letters from *** to Kaiser Administration in ********* on February 5th. At this point, my Social Worker called and said that Kaiser had found the letter. I have now begun to receive bills from Kaiser and my Dialysis center (******************* in ******* Dunes) who was contracted by Kaiser to provide my dialysis back to March when I enrolled.
Business response
05/16/2024
Thank you for your email. I've forwarded this information to our Member Relations department. A team member will review and address this concern through the Health Plan grievance process and folllow up with the member directly. Thank you for reaching out.
Initial Complaint
05/06/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Kaiser is deliberately withholding a life changing surgery from me. I am trying to get bariatric surgery because of severe pain stemming from an accident in 2020. I have seen several Kaiser drs that state that this surgery would significantly decrease my pain and quality of life. I have 2 fractured hips that are not being treated by Kaiser, even after telling the doctor about the pain. I have a bar in my left leg and a completely reconstructed ankle. Obviously will all of that, I should be moved up in line. Yet my nutritionist is not even going to schedule my final visit with her until JULY! That is completely egregious. Im just supposed to keep living in pain and taking medication for months? I started this process in January. Its May and Im barely halfway through. Most days I can barely walk and this needs to be taken more seriously. I pay almost $300 a month for this insurance. There is no reason I should be held back from getting this surgery that I desperately need.
Business response
05/06/2024
This case was received by Kaiser Permanente on May 6, 2024. The case will be assigned to a representative for investigation and follow-up with the member. A written response will be provided directly to the member within 30 days from the date of receipt.
Customer response
05/06/2024

Complaint: 21671285

I am rejecting this response because:

Sincerely,

*******************************
Customer response
05/07/2024
No one ahas reached out or fixed the issue.
Business response
05/07/2024
Good afternoon -
Thank you for sharing the members' concerns. We will reach out and follow up with the member directly to address the concerns.
Initial Complaint
05/05/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
This is complaint is to Kaiser SF ***************I need use hearing aid on my 2 ears--both left one $1500 paid $300 after purchase was not working recently went to audiologist was not working she fixed it but she broke the top- then she temp fix it-did not work took again they said we send it out --waited waited no respond and were very rude like always thinking not hearing well i am stupid always threat me like animal the workers there like say go seat ask how long no answer--this is not the point after 2 months they said we keep your hearing aid -I NEED IT CAN NOT HEAR OR WORK TEMPORAY THAT I NEED TO DO--I HAVE MY RIGHT ONE PAID $1500 PLUS OVER $1200 FIXING IT EACH TME OVER YEARS LEFT ONE NEW AND THEY DO NOT ANSWER MY 12+ VOICE MESSAGES BOTTOMLINE I NEED MY HEARING AID--CALLED COMPANY THAT THEY SAID WE SENT IT NO RECORED THEY SAID KAISER KEEP ALL RECORD THEY NEVER GAVE ME DETAIL OF ALL SEND OUT AND EXPLANATION--ONLY ASKME SIGN SIGN SIGN--I ALWAY SIGN NOT KNOWING WHAT I SIGN I ONLY WANTED THEM FIX WHAT AUDIOLOSITBROKE PLEASE HELPthey say was reported and paid $300.00 now I have none on left ear and they are not giving to me even never asked them to replace it just wanted them to fix it---even some one loose and paid $300 they should be able to keep it never seen anything mention that never explained what I sign they are so rude always say go sit there like I am a kid or a dog or petI am neither of them but human need my hearing aid I paid for left one $1800 and right one I$1500 coast plus. $1200.00 REPAIR 4* $300 EACH TIME.My resolution is get back what they got from me to fix THE AUDILOGIST BROKE IT BOT KNOWING HOW TO CLEAN IT THE PERSON MESS IT UP LEFT MEWITH NO HEARING AID FOR 2 MONTHS RUDE AT ALL TIMES DO ALL MIXING UP RIGHT EAR AND LEFT EAR AND NEVER EVER EXPLAIN A THINGCAUSED ALLTHIS TROUBLE FOR ME CAN NOT EVEN WORK TEMP
Business response
05/16/2024
Thank you for your email. I've forwarded this information to the Member Relations department. A representative will review this issue through the Health Plan grievance process and folllow up with the member directly. Thank you for reaching out.
Initial Complaint
05/02/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
My mother is 80 years old and has been diagnosed with DEMENTIA , I called Kaisers GERIATRICS department and asked if my moms doctor could write a letter with a signature because I needed this so I could help with my moms banking. I was eventually told that my moms Geriatric doctor had to see her before she would write that letter. I have tried **3** times to schedule this appointment by leaving a voicemail with the ********************* As of today it has been 4 days and STILL no RETURN call from the ******************** in ******************. I have also left a voicemail with our so-called SOCIAL WORKER, ******* who says she will call by the next business day , she also failed to call me back . Kaiser needs to know this department keeps failing my mother
Business response
05/03/2024
Kaiser Permanente is in receipt of this concern and appreciates you contacting us on behalf of our member. A senior case manager spoke with the advocate by phone on May 1, 2024, to acknowledge receipt of the concern and obtain additional information. The senior consultant also sent a letter to the advocate on May 3, 2024, to acknowledge receipt and explain next steps. The senior consultant will communicate the outcome to the advocate upon completion of the review.
Initial Complaint
04/29/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I am an external provider contracted with Kaiser. I have multiple patients trying to schedule appointments with me but are unable to do so due to the fact that Kaiser is not responding to inquiry attempts. I have emailed and called Kaiser more times than I can count to try and get clients approved for appointments and have gotten zero response. No one responds to email inquires at all, and when I have attempted to call I am told a supervisor would call me back (no call back). This has greatly impacted patient care and has been going on for over a month.
Business response
05/02/2024
On May 1, 2024, a senior consultant in our Member ******************** called and spoke with ************** to acknowledge receipt and obtain clarification of the issues. The matter is currently under review and a written response will be sent directly to ************** upon completion.
Customer response
05/02/2024

Complaint: 21640660

I am rejecting this response because: Although I did hear from someone at Kaiser, all the person did was take down my information and let me know that she will look into the matter. She stated that she would call me back when she had more information. I have not gotten a call back.

Sincerely,

***************************
Business response
05/06/2024
On May 1, 2024, a senior consultant in our Member ******************** called and spoke with ************** to acknowledge receipt and obtain clarification of the issues. A letter was also mailed to ************** on May 1,2024, to confirm receipt and explain that the processing time for investigation can take up to 30 days from the date of receipt. The matter is currently under review and a written response will be mailed no later than May 30, 2024.
Customer response
05/08/2024

Complaint: 21640660

I am rejecting this response because: As you can see from their response, they are stating that they will investigate the issue and a response will be given by end of May. Therefore the issue still isn't actually resolved.

Sincerely,

***************************
Initial Complaint
04/18/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Kaiser Permanente is charging me for 4 months of premium, whereas it should only be 2 months of premium. I've been asking them to adjust the billing but didn't get proper response.1. Feb 2024 premium - $693.74 2. Mar 2024 premium - $693.74 3. April 1, 2024 Effective date - The plan was officially terminated thru call Mar 29, ******. Now they're asking me to pay for $2,774.96 equivalent to 4 months from Feb - May 2024.They need to adjust the attached statement.
Business response
04/26/2024
This case was received on April 18, 2024, and is currently under review. A letter was mailed to the member on April 22, 2024, to acknowledge receipt of the concern and explain next steps. A written response will be sent to the member within 30 days from the date of receipt.
Customer response
04/26/2024

Complaint: 21595390

I am rejecting this response because:
I still have not received resolution on the issue raised. The letter they've sent on April 22, 2024, was only an acknowledgement they received the complaint on April 18, 2024, and will respond soon.

Sincerely,

***********************
Business response
04/29/2024
This case was received on April 18, 2024, and is currently under review. A letter was mailed to the member on April 22, 2024, to acknowledge receipt of the concern and explain next steps, including that the investigation may take up to 30 days to complete. The investigation is in process and a written response with resolution will be sent to the member no later than May 18, 2024.
Customer response
04/29/2024

Complaint: 21595390

I am rejecting this response because:
I'll wait for their official response thru my physical mailing address as per their reply.

Sincerely,

***********************
Initial Complaint
04/12/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
KAISER PERMANENTE HAS CONTINUOUSLY HELD A BACK LOG OF APPOINTMENTS. I RECEIVED AN ENDOCRINOLOGY REFERRAL LAST MONTH 3/2024. THE FIRST AVAILABLE APPT IS IN JUNE 2024. KAISER IS 1ST IN PROVIDING 2ND CLASS SERVICE IF THAT! THIS IS CONSISTENTLY AN ISSUE REQUESTING SPECIALTY APPTS. THEREFORE, IM REQUESTING AN IMMEDIATE REFERRAL OUTSIDE OF KAISER'S NETWORK AT THEIR EXPENSE!S
Business response
04/17/2024
Good afternoon -
Thank you for sharing the members' concerns. We have followed up the member directly and addressed the concerns.
Initial Complaint
04/09/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I submitted a complaint back in February and was contacted by a Kaiser representative ****** who I thought was helping but I havent heard from her since she interpreted the doctors note wrong. She called and tried to put the whole blame on my employer but Kaiser psychiatry department is at fault and I want my two week back pay! There is supposed to be a 30 day timeframe in dealing with matters and they are way past that point! Letoya first contacted me on 2/23/24 and then a few times after but I have yet to hear anything further and will not be letting this matter go!
Business response
04/12/2024
Thank you for your email. I've forwarded this information to the Member Relations department. A team member will review and address this issue through the Health Plan grievance process and follow up with the patient direclty. Thank you for reaching out.
Initial Complaint
04/08/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
In December 2023 I wrote to ************ regarding xrays that show my right hand thumb is still fractured and ************ has never replied. I have gone through ****** Services and the legal department at Kaiser with no resolution. It is time for upper management to listen to my story. Ghosting the patient is not acceptable. Refusal to reply to the message in December shows a lack of patient appreciation and a breach of patient care and a breach of the contract.
Business response
04/09/2024
We have received the member complaint. A case has been set up and assigned to a Case Manager for response. We will respond directly to the member. Thank you!
Initial Complaint
04/08/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I spoke with ***************************** ****, DO on 3/29/24. I was in the middle of an anxiety attack and her actions toward me were quite dismissive. In fact she stated I cant help you and immediately disconnected the call. I had waited 118 minutes for the phone call (which was supposed to be a video call)While reviewing the notes in my Kaiser app I noticed that she stated that the call lasted a total of 9 minutes, however that is a blatant falsehood. The actual call was a total of 3 minutes. I included the screenshots for reference.I believe there may be fraudulent billing involved.
Business response
04/12/2024
Thank you for your email. I've forwarded this information to the Member Relations department. A team member will review and address this concern through the Health Plan grievance process and follow up with the patient directly. Thank you for reaching out.

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