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Business Profile

Insurance Claims Processing

Kaiser Permanente

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Insurance Claims Processing.

Complaints

Customer Complaints Summary

  • 3 total complaints in the last 3 years.
  • 1 complaint closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

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Complaint status

Complaint type

  • Initial Complaint

    Date:02/14/2025

    Type:Sales and Advertising Issues
    Status:
    UnresolvedMore info

    Complaint statuses

    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    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.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    01/21/2025 I came in for an annual checkup which is covered 100% through my benefits. The doctor had ask me if I had any issues and I said Im currently not in pain but I did have pain on my foot that comes and goes but lately it has not been hurting. I then received a bill for an office visit because I had a concern. The doctor asked me a question and I answered. I did not authorize for her to charge me for an office visit when my appointment was for an annual check up. I believe it is unethical to trick me into answering the question and slapping me with a bill for it.

    Business Response

    Date: 02/25/2025

    Hello,

    We will be directly responding to the member on this matter upon completion of the investigation.

    Customer Answer

    Date: 02/25/2025

     
    Complaint: 22944765

    I am rejecting this response because: they have not contacted me. 

    Sincerely,

    ***** ****

    Business Response

    Date: 03/04/2025

    Good afternoon,

    The member was sent a resolution letter on February 25, 2025, in response to her complaint. Is this a rebuttal to the resolution letter?

    Customer Answer

    Date: 03/05/2025

     
    Complaint: 22944765

    I am rejecting this response because: I am waiting for ******* to respond with a solution. I was told my charges will be sent to collections if I do not pay for it from another representative. So I had to pay the charges despite not agreeing to the charges because I did not want my credit score to be affected.  Now I am waiting for them to refund my payment.  This is the only solution I will accept. 

    Sincerely,

    ***** ****

    Business Response

    Date: 03/05/2025

    We are investigating ******* concern after communicating with her with and will respond to her directly.

    Customer Answer

    Date: 03/09/2025

     
    Complaint: 22944765

    I am rejecting this response because: I am still waiting for a response from the business. 

    Sincerely,

    ***** ****

    Business Response

    Date: 03/17/2025

    Good morning,

    This case has already been addressed, and response has been made to the ***** ****.

    Customer Answer

    Date: 03/17/2025

     
    Complaint: 22944765

    I am rejecting this response because: From my conservation with ******** on March 4, she said that she would speak to her manager and will then reach back out.  I have not heard back except I did receive a letter stating they have received my complaint and will be working on it. 

    Sincerely,

    ***** ****
  • Initial Complaint

    Date:02/21/2023

    Type:Service or Repair Issues
    Status:
    UnpursuableMore info

    Complaint statuses

    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    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.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    The patient ******************************* (05/29/65) was prepped and prepared for caract surgery on 2/21/22 but was turned away and told she would have to be rescheduled for 3-4 months from now due to her "eyes moving" so she would be required to be sedated. She has been out of work and has been waiting on this surgery for months just to be told it can not happen. While being prep for the surgery she advised the doctor to give her a minute then to at least try it again but was told "no". During the preop appointment she should have been given the option to have sedation if needed but was not given that option. ******************* cannot continue to be out of work and will require Kaiser to proceed with given her a referral as requested months ago to have this surgery done elsewhere so that she doesn't have to wait an additional 3-4 months as she has been out of work since 12/5/22. This is one complaint amongst others that will be filed against Kaiser for ******************* but at this time this one is urgent and needs to be addressed. Thank you for helping reach a more responsive agent at Kaiser who can effectively resolve these urgent patient care issues.
  • Initial Complaint

    Date:11/15/2022

    Type:Service or Repair Issues
    Status:
    UnpursuableMore info

    Complaint statuses

    Resolved:
    The complainant verified the issue was resolved to their satisfaction.
    Unresolved:
    The business responded to the dispute but failed to make a good faith effort to resolve it.
    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.
    Unanswered:
    The business failed to respond to the dispute.
    Unpursuable:
    BBB is unable to locate the business.
    On March 23, 2022, I was rushed to the hospital via ambulance. I was in critical condition and had to have life-saving procedures done to save my life, then admitted to ICU. On March 24, 2022, I was transferred to a different hospital (via ambulance) because the hospital I originally went to, which was in-network with Kaiser when I had surgery last year, is no longer in network with Kaiser...how was I supposed to know that. Blessed by God, I survived. In May, I started receiving bills from the two ambulance companies. They were not in network with my insurance. I reached out to Kaiser to do an appeal because I can not afford either bill.5 times I faxed over the requested documentation (I have all the documentation), but Kaiser claimed they did not receive them. Finally, they received the sixth fax. I constantly called to resolve this matter. I have every name and what they said documented. Finally got supervisor ******, and he told me both appeals were approved. I asked for a letter to send to the collection agency to get them off my back. He said he would. Still waiting to get it. Every time I call, I am told it takes 4 to 6 weeks to process. There's only one lady who does appeals and is behind. I ask for a letter again but have yet to receive them. Every person told me, including ******, because the reps always put me on hold to talk to him, say the appeal was approved, and it takes time. Today, I was told that it was approved but transferred to someone else, and they need to decide on it again. Still trying to figure out when the transition took place. This has been going on since May. I am tired of being lied to. I am tired of reps telling me ****** will call me back, and he doesn't. No letter to send to the collection agency. No communication. NOTHING but lies. This could affect my credit. I trusted Kaiser to do their job, and they are not. This is pure incompetence. It is not my fault they are short staffed. They were originally approved. What is the issue?!!

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