Directory:Kaiser Permanente Customer Class

Name: Kaiser Permanente Customer Class

Contact: http://www.mywikibiz.com/index.php?title=Directory_talk:Kaiser_Permanente_Customer_Class&action=edit
Title: A place for potential Kaiser Permanente Customer Class members can discuss rationales and pros and cons of a class action lawsuit (started by IRDT/IReceivedDeathThreats)

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IRDT joined Kaiser largely because he had discovered that they were the only HMO to do significant medical research and emphasize preventative care. (And they were competitive, have cool ads and sponsor progressively).

Flagrant coverage and billing fraud

Have you noticed that Kaiser Permanente flagrantly disregards its own policies to the detriment of patients? IRDT has. IRDT is a customer (I.e. Health Plan "member") in an HSA (Health Savings Account) plan. IRDT noticed that Kaiser plan policies and sales documentation bear little relationship to the actual bills it sends out, prices it charges and coverage decisions it makes. HSAs have been around for a few years now; Kaiser should have ironed out most of these sorts of problems by now! (Or perhaps all Kaiser customers are treated this badly!?!)

Examples

Annual Physicals

IRDT goes annually for an annual physical, which is supposed to be free, per the plan policies The first time, they insisted on a copayment of around $75 when IRDT arrived for the appointment. The second time, they did not, but sent him a bill for around $200.

STD / VD Testing

IRDT goes annually for STD testing, which is supposed to be free, per the plan policies. They billed IRDT around $150 for the tests.

STD / VD Testing

IRDT went for a hearing test, which is supposed to be free, per the plan policies. They set IRDT a bill for a around two hundred dollars.

Secret cost information

IRDT tried to find out how much things would cost, ahead of time. IRDT wanted to get information on how much it would cost to see a doctor for a brief follow-up about a growth, and he called and was told there would be no charge. He arrived for the appointment and they insisted on a copayment of around $75 when IRDT arrived.

IRDT was told that they did not have any kind of price list by two employees. They both said the information was in their computers, and they could not print it out, or otherwise provide access to it (e.g. via email, download, kp.org, etc.) or answer questions about what was in it. Then IRDT found just such information online (a sampling of the common ones, that is, but certainly a huge improvement over having nothing!), here: http://members.kaiserpermanente.org/kpweb/pdf/cal/ncal_fees.pdf (There are similar documents for customers in other areas available online; google "Kaiser Permanente Northern California Sample Fee List", but with your area instead of NorCal.) IRDT has asked if he can get a copy of his plan contract (the so-called Evidence of Coverage booklet) online, but they tell him they don't put it online. (Some quotes:

• "The following preventive care is exempt from the Deductible:
  • The following lab tests:
    • STD tests (2009 version)
    • VD tests (2007 version);

• "No charge": "Routine preventative hearing tests" )

IRDT found copies online in the past. At least there's this: http://www.fortierinsurance.com/pdf/Kaiser%20Plan%20$0.1500%20Description%20of%20Benefits.pdf. (Some quotes:

• "No charge": "Routine preventative physical exams" (i.e. annual physicals);
• "No charge": "Routine preventative hearing tests" )

Poor Dispute Policies

IRDT has disputed many of these fraudulent bills and charges. IRDT received 0 apologies. IRDT received 0 thanks for pointing out the errors. In IRDT's experience, most of the time, the charges are dropped, but often they aren't - e.g. the STD charges were reduced to around $50.