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

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Flagrant coverage and billing fraud

Have you noticed that Kaiser Permanente flagrantly disregards its own policies to the detriment of patients? I have. I am a customer (I.e. Health Plan "member") in an HSA (Health Savings Account) plan. I've noticed that their plan policies and sales documentation bear little relationship to the actual bills it sends out, prices it charges and coverage decisions it makes.

Examples

Annual Physicals

I go 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 I arrived for the appointment. The second time, they did not, but sent me a bill for around $200.

STD / VD Testing

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

STD / VD Testing

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

Secret cost information

I tried to find out how much things would cost, ahead of time. I wanted to get I 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 I 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.) I've asked if i can get a copy of my plan contract (the so-called Evidence of Coverage booklet) online, but they tell me 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" )

I've 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

I've disputed many of these fraudulent bills and charges. I've received 0 apologies. I've receive 0 thanks for pointing out the errors. Most of the time, the charges are dropped, but often they aren't - e.g. the STD charges were reduced to around $50.

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