ComplaintsforKaiser Permanente

• Initial Complaint

  05/23/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Im currently in the lobby at urgent care in ********* GA. My name was called before I could grab my bag the lady turned around and went back in the doors. There were no chairs where she came out and about 20 other patients where I was sitting. She didnt even bother to look and see if someone was coming. I went to the receptionist she called to the back and said someone would be back out to get me. I stood by the door for ********************************************************** they called someone else you just have to wait until they come back? I waited another 25 mins and was finally called back by a very polite lady that waited for me to get out of my chair before storming off and was very nice while doing my Xray. They need more people like her and to get rid of the dead weight . I sat in pain for another 45 minutes because she didnt want to bother to wait 10 seconds. Shame on it all!

  Business response

  05/24/2024

  Kaiser Permanente will respond directly to the member. Thank you

• Initial Complaint

  12/18/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Kaiser Permanente would not pay for a bill made back in August 9th 2021 I was in the hospital. They keep passing from one place to another place. I had 2 issues company. They paid for all but one. I was using Kaiser cause it was the one I will cover me or so. They said it's 2021 I've been fighting just bill. They covered everything else but this bill. Now I'm gonna be taken to court for it and I am on SSD. I I don't know what to do if there's no insurance commissioner. To fight a file against him, I would do it. It's God is something to do for people who are handicap. In on a social security disabled income like me sincerely ***************************** I pay insurance but being passed around I am 62 yrs old and similar handicapped

  Business response

  12/19/2023

  
  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

  12/11/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Subject: Urgent Matter: Request for Assistance with Insurance Coverage I hope this message finds you well. I am writing to bring to your attention a pressing issue I am currently facing with my insurance coverage through Kaiser Permanente.Recently, and without any prior notice, I discovered that I had been dropped from my insurance plan in the midst of ongoing treatment for major depression and the initiation of a new medication regimen for recently diagnosed ADD. This unexpected disruption has caused me significant distress, both emotionally and financially.In response to this sudden change, I took the initiative to self-pay for an appointment to ensure continuity of care. However, I believe there may be an error or misunderstanding, as I am aware that, per the **** regulations, I should be able to use my work zip code for enrollment in insurance.The consequences of this situation are not only inconvenient but have led to unnecessary expenses, great discomfort, and the discontinuation of my critical treatment. I understand that administrative matters can be complex, but the impact on my mental health is substantial, and I am eager to resolve this issue promptly.I kindly request your assistance in investigating the circumstances surrounding my insurance termination and exploring potential avenues for reinstatement. I will provide any additional information or documentation to facilitate the resolution process if necessary.Please understand the urgency of this matter and the importance of maintaining continuity in my treatment plan. I appreciate your prompt attention to this issue and look forward to your assistance in rectifying this situation.Thank you for your understanding and support.

  Business response

  12/19/2023

  We appreciate you bringing this to our attention. Upon receipt of this concern, we have contacted the member to further discuss her concerns with her directly. Thank you.

• Initial Complaint

  11/15/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I submitted all of my documentation for reimbursement through a policy that I had in 2022. The claim repeatedly got rejected and I had to call in several times to try and figure out why. I talked with representatives that weren't sure but I wasn't allowed to talk to the people processing the claims. I sent in new info each time that I was asked for something new. Even if it wasn't something that the provider was capable of doing, I made it work. The last time, I faxed in the new documents. The first time, it apparently wasn't received. So I called again and sent it in again. The representative stated that he would call me to confirm whether or not it was received. I never got a call. So I called in again and asked to speak to a manager. I was told my case was being escalated and someone would be in touch in 2 days. It's been about 2 months since that call with no contact attempts.The company has all of the required information to process the claim and to provide me with the refund that I am owed. They also have the contact information for the provider if they require any more information.If they require more information, they can contact the providers who are the only ones capable of providing the information.

  Business response

  11/20/2023

  Dear Better Business Bureau (BBB),

  Thank you for your notice about a concern brought to your office by the individual named in your letter dated November 15, 2023.
  
  Due to privacy reasons, we are unable to address any individuals complaint in detail through correspondence with the BBB. Therefore, this response is acknowledgement that we are in receipt of this concern. If this individual received services at a Kaiser Permanente facility, we will forward this complaint to ****** Relations to investigate and provide resolution. Upon the completion of the investigation, we will contact the individual directly by letter with the outcome within 30 days.
  
  Our mission is to offer care and service of the highest quality, and we appreciate your dedication to helping individuals who may have received care at our facilities or through our plans. Thank you for your partnership.
  
  If the individual named in the complaint wants assistance in the meantime, they can alternatively reach ****** Services by phone at **************, Monday through Friday from 8 a.m. to 5 p.m.
  
  Sincerely,
  
  **************
  ****** Relations Coordinator
  
  Coverage provided by Kaiser Foundation Health Plan of Washington or ********************** Foundation Health Plan of Washington ************.

• Initial Complaint

  09/13/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Hello, I am writing to complain that Kaiser Permanente's coverage and contracted pediatric specialty services is not providing us timely access to pulmonology care for our 12-year old son who is experiencing chronic breathing issues. The earliest access we have to see a pediatric pulmonologist is now Nov. 13 (two months from the referral date).On Sept. 5, 2023, I initiated pediatric care services for my child with Kaiser Permanente through their remote tele-health service, which was satisfactory. My 12-yr old son was coughing, wheezing and had shortness of breath concerns.On Sept. 7, 2023, I took my child to see a Pediatrician at Kaiser Permanente's Townpark Pediatrics for coughing and wheezing. He started a round of antibiotics and steroids during that visit. On Sat., Sept. 9, as he was still coughing/wheezing he was seen by a Pediatrician in Kaiser Permanente's ********************* He was administered an X-Ray exam and given a nebulizer. In a followup call with ********************, on Monday, *** was referred to a pediatric pulmonology clinic at Children's Healthcare of *******. The earliest appointment we were offered at CHOA was for Nov 13 (two months from today).Our son has missed 8 days of school due to this condition. He is needing to be seen by a specialist.Our options are to pay out of network and pursue more timely care with a provider that can see him sooner. Or we can present him at a pediatric ** and hope that a pulmonologist will be on staff to see him. The ** fee will cost us $300 if it is within the ** network of providers, which does include Children's Healthcare of Atlanta.Can you assist us in working with Kasier Permanente to get faster access to the recommended care specialist: a pediatric pulmonologist? Thank you.

  Business response

  09/29/2023

  Concerns have been addressed by Healthplan directly

• Initial Complaint

  08/09/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  June 12th I was provided a case number by a phone operator due to not being able to access my KP online account. This issue of no access was pushed for escalation to the IT team for assistance. I was told I would be contacted within two days. Following two days, was not contacted so called a Kaiser on the third day for an update. Was advised through the operator they were unable to assist and because it was the third day, someone will reach out because it takes three days. Was also advised that resolution typically takes 30 days. June 16th- Received an email from Arlloe, an IT support analyst stating that the issue has now been escalated to colleagues who work with the KP.org maintenance team and I will receive an update of resolution when available. June 19th- Explained to the IT tech that I need access to my account to correspond with my doctors and be able to view the documents online. As I have a high risk pregnancy, I need to be able to upload specific data for constant review. My area of care is still not available for log in. From June 20th-July 27th, I have reached out multiple times asking for an update, an event log of the investigation thats been claimed to be completed, and more information on an expected timeline of resolution. *** asked to speak with management, and was not provided any request information. I was advised to call the customer service line to communicate with doctors. As this option is not efficient for communication, considering I waited for two hours to speak with an on call nurse, I would appreciate my access to my account. I have constant updates being sent to my personal email, but still no access to my area of care. I have yet to receive proactive communication from IT and the issue has now gone on for close to three months. When Kaisers website constantly refers you to log into your account to fill out such form or advises to speak with doctors through email, how is this advisable when I have no account access?

• Initial Complaint

  08/03/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I came into Kaiser Infectious Disease to hold my appointment with **************** , she came in very rude I was 10min its late due to traffic - she told me that she would have to zoom through this apportionment because their was another appt coming waiting - She was very rude and unprofessional she didnt look me in the eyes one time , she began to rundown everything Ive been doing wrong & telling me the previous doctors Ive seen have been doing things wrong - she made comments about my sexual orientation and me being irresponsible- I stopped her there and tried to explain why I have not been in so long- she continued to tell me that I wouldnt be getting help today , I would only have blood work done. I pleased with her that I needed medication. HIV is not something you take lightly - Ive had suicidal thoughts and very depressing times , after this visit - I see no point to live. **************** needs to have her licenses revoked she is not helping the world she is discriminating, judging & making things worst. I would not recommend her at all unless your looking to be depressed and take your own life thats how I felt leaving that office.

  Business response

  08/07/2023

  The complaint has been received, and is being addressed. The acknowledgment letter was mailed to the member on 8/4/2023.  The member will have all contact information for the person handling the complaint.  Thank you for letting us assist you.  *****************************************;

• Initial Complaint

  07/31/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  Over the past year and a half, I have had NON-STOP issues with being reimbursed by Kaiser for my son's medical billing. I literally have to call them every month in order to try to have them fix a glitch in their system that NO ONE knows how to fix. His medical info and checks continue to be sent to a ******** address that is not on my file. I was provided a specialist who NEVER contacts me. They have to re-issue checks every time and this has become apparent that they have no clue what they are doing and I continue to get the runaround. I have a list as of now of 4 missing payments to me and each rep tells me there going to re-issue checks some come and some dont then when I call back in they always see the checks being sent to a ******** ** address. Here are the claims and dates that as of now are missing and I have not been paid for.*************************** Medical Record number :******** - DOB **/2/************** - FEBRUARY ********* - APRIL ********* - MAY ********* - JUNE I last called in on 6/30 and was last told it would be corrected again as I have been told over 30 plus times to wait for checks. This has become a joke and I'm also afraid that my son's check and medical info are still being sent to an address that does not belong to me. KAISER refuses to fix this and help me and I do not have time to keep taking off work to call them during business hours. Re-explain this each time and wait.

• Initial Complaint

  06/14/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I reached out to my provider due to an injury and was given a referral for a MRI. I was given an order for a HIGH priority which means I was to be contacted within 5 days by radiology to schedule. I was NOT contacted ever, I was provided the wrong number when I called to inquire how an appt was made, then waited days to speak to someone for an appt. I needed the appt in ************* and was told I could call and schedule it where I wanted. However, I was refused when calling Kaiser today as the referral was closed. The initial referral was made on 5/31/23 and per KP policy the department is required to make 3 attempts to contact the patient before closing the referral. ***** called me ONCE about the referral or any appt and instead closed the referral on 6/2/23 without any attempt to contact the patient. I had a similar experience when trying to schedule a therapy appt and was sent to an outside provider. Kaiser should not be able to charge premiums for services they cannot provide. I should have my insurance premiums refused to me for the months I cannot seek service I paid for. I have made attempts to reach the grievance ***** I have left message for the Case Manager on my case, and NEVER received a call back. The grievance department is a joke, they do not respond to the members. The insurance authority should investigate Kaiser because they cannot provide the services advertised to their customers. .

• Initial Complaint

  04/10/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  For several months now, I have attempted to provide billing details regarding my er visit to customer accounts. I have been directed by the ***** of Veterans Affairs to have customer accounts send an invoice / bill of the care received to the VA's CCN medical billing address in *******. Earlier this year, I tried having this matter resolves only to have your billing employee (****** - DC/VA metro customer accounts specialist). After being belittled by your agent (being spoken down to, interrupted, talked to in a sing-song voice akin to how a parent speaks to a child), I requested another agent or manager reach out to resolve this matter.This has not happened. The simplest resolution is a bill/invoice/charge/ whatever document KP sends to the VA for compensation to be sent. I seriously doubt that I am the first and only veteran that has used a KP emergency room (this assumption based solely on the knowledge of and the attempts by the VA CCN representative to resolve this issue), this matter will remain unresolved.A complaint was filed using via a KP patient advocate. I will upload said complaint in the coming days if desired.The tone of this message is the exact tone used by your agent towards me, bottom line - I am ready to get this taken care of as quickly as possible.

  Business response

  04/18/2023

  Complaint was resolved appropriately.  Complainant notified of the resolution of his concerns via telephone.  Complainant was satisfied with the results of his resolution.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩