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Good Luck Seeing A Dr.
Posted by Elainerov on 12/01/2011
WOODLAND HILLS, CALIFORNIA -- I broke my ankle, went to urgent care. ($40 copay). They referred me to orthopedics. ($40 copay). They told me I needed to go to the "casting dept", but they only put casts on from 8 am to 10 am and it's on a first come first serve basis so get there by 7 am. the next day. That's 2 days with a broken ankle, with no brace and no cast. 7 am the next day I arrive and sit with many other people with broken bones waiting for their casts. I saw an "attendant" ($40 copay) who was very rude. For my follow up visits if I wanted to see an orthopedist it would take 2 months to get an appointment, so I could only see an assistant also for a $40 copay. Now that I am assigned to an assistant, I can not see an orthopedist, only the assistant. After 6 weeks, the "assistant" told me I should be healed and to "just walk on it". That was 7 months ago and many complications and lack of answers. I have run the gambit of seeing Podiatrists, Physical Therapists (which you cannot get a standing appointment for each week). Today I called to ask the Orthopedists assistant can renew my temporary handicapped placard, because Physical Therapist can't do it, and orthopedics said they won't renew it because I should "be healed by now". My records indicate that I am in Physical therapy, and still walking with a cane. The person on the phone said maybe he would renew it if I came to see him again ($40 copay). It could be so easy, but Kaiser doesn't make anything easy. Most times when I've gone to Kaiser for anything it's been an assistant, not a doctor or there is about a 2 month wait. Why is the copay the same to see an assistant as it is a doctor? If I could get off Kaiser I would in a heartbeat.

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Posted by Kris10 on 2011-12-02:
you may want to talk to a lawyer to see if you have a malpractice suit. This is crazy. They're squeezing you for money and you're in pain.
Posted by Skye on 2011-12-02:
Kaiser is one of the best health insurance companies to deal with.

You didn't need to go through all of that. You should have called your primary doctor immediately to let them know the run around that began for you. You could have seen another ortho doctor, and you can change ortho's anytime your not happy. Nobody should have to go through what you did, but this isn't Kaiser's fault, it's the fault of the orthopedic doctor's office you first dealt with. Anytime you are not happy with how you are being treated, and must immediately let your primary know and call Kaiser and speak to them about what's going on.

Sometimes you have to take the horse by the reigns and get things moving. It's ridiculous what you've been put through.
Posted by Mrs. V on 2011-12-02:
The Kiser in my area has one huge building that does everything (primary,gyn,ortho,GI,PT, ect) and it's just like the OP stated :( You can never get in quickly. You are charged your co-pay if you see your primary, walk across the hall to see a specialest and it's another co-pay.
Posted by holidaylacasa86 on 2012-01-15:
Becareful what you sign up for!! Kaiser is awful they write a lot of scripts and send you on your way . If you live in Temecula and just need your reg Dr. its ok but if you need a referal hurry up and wait it can take up too a month , and if you need a othro, derm. a cardio dr. etc. get ready to do a hour trip to riverside two hr wait at the drs and a hour trip home = 4 hours.They are a marketing bussiness I had 13 messages on my phone from a call center in one week to remind me of a flu shot really. a call center to drive me nuts ... Dont know if they get paid by commission but its insain .They can send you anyplace they want thats why they are so big!! They only have one machine for the whole company and the one you may need could be in Hollywood! so thats where your appt will be or cancer could send you to irvine !! And they have no local Hospital the best thing for a Patient is to have family around them! How many of your family members are willing or able to drive up to 1=2 hours to see you after a long day at work?Kaiser does not care about your health they care about money yours!! Ihave been goinf to Phys Therarpy referd by kasier in temecula for 2 months now Im trying to get a tens unit(somthing for my arm ) and they call me to say I have a appt in riverside next week at 100pm! I didnt make an appt!!! I call and they said I have to go to river side PT so I can take a 2 hour class to learn how to put the stickers on my arm!! I ask if the PT in Temecula could just show me? and they said NO So they want me to leave my Job for 4 hours to take this stupid class really. So I filed a complaint and surpize they said I would have an answer in 30 days!! In the mean time I paid cash out of pocket to go to my old Dr. and got a tens unit . Thank Kasier for nothing I know u dont care that my arm has been hurting for 3 months now.If this wasnt paid for by my company I would not still be here . You Get what you pay for .and I will continue to write about this company even when Im not with them PEOPLE IF YOU HAVE A CHOICE DONT PICK THIS COMPAY
Posted by celtic on 2012-09-29:
I have severe arthritis in my left hip they are making me "jump through hoops" just to get a sugery schedule date after waiting for 6 months. Kaiser only cares about money. I don't even know who my primary care physician is every time I go to the drs to complain about how I can barely walk (even with a cane) and am in severe pain (plus have spinal stenosis and two ruptered discs in lower back) they just tell me to go to the pain management clinic which isn't available till April 2013 (they called and asked me if I wanted to schedule an appt. for then, yea thanks........Oh and about my back I complained about back pain for over a year and the dr was like oh ladedah then they finally did an MRI and found out I wasn't just making it up so yea Kaiser sucks bigtime...................
Posted by Ms. Ann on 2013-02-26:
I've had great luck with the Kaiser emergency room in Oakland. Unfortunately you are so right about the copay situation with Kaiser.
I have painful cyst in my knuckle that I've been trying to get removed for months. I went to my primary care doctor because I had to since it is Kaiser (co-pay) who referred me to the Oakland orthopedic department (co-pay). After an 8 week wait for an appointment I was seen by a doctor didn't specialize in hands so she literally did not even look at my hand at the appointment. She referred me to another doctor in the department (co-pay) who tried injecting it with something and told me to come back in a month (co-pay). I returned to that doctor and nothing had happened (if anything it got bigger) since the injection but he told me that surgery was too risky on a knuckle so I should take Tylenol and live with it. At this point it had been months of pain, 4 times I've had to take work off, and so much $ in co-pays and his answer was Tylenol? I lost it and he agreed to refer me to an Orthopedic surgeon in the department who I am waiting to see for a consultation (co-pay) before she will operate (co-pay). I hope that 6 appointments later I can get this cyst removed.
Posted by Jose on 2014-03-15:
I have been through a similar experience and I did started with my PCP. NOBODY cares. I filed a complaint against the doctor and the response was that it was my fault for not providing exact information. If you have coworkers who do not speak English but look Asian Kaiser will hire them. I say this based on experience.
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The Kaiser WAY of doing Business
Posted by Rseascape on 08/12/2007
SANTA CLARA, CALIFORNIA -- My Mother has Kaiser...always has. She pays for her benefits quarterly, and always on time. She under went bi-lateral knee replacement at the old Santa Clara Facility. Her Orthopedic Surgeon was great. While in the hospital (Kaiser Santa Clara) she was subject to the usually poor "in hospital" care that we all have heard about. She was transferred on a holiday to the SNF (Skilled Nursing Facility) without her medications or CPM devices. On her second day at the SNF, a "Patient Care Nurse" (that's DISCHARGE NURSE") told her that her rehab was not progressing. The nurse then later ignored the Durable Power for Health care and violated her privacy (Sections 160 and 164, SS A,E according to the OCR). In a conversation with the son (DPH), the nurse blurted out that the patient didn't even deserve to have Kaiser benefits, because she only had them because of a retirement package! The nurse then made 2 harassing phone calls to family C.P.C. 653M (a crime, misdemeanor) which the family recorded and played back to the Santa Clara County Sheriff. Upon filing a complaint with Kaiser's "Patient Relations" a series of letters discounted the ordeal and claimed it never happened. In some letters, the issue was never even addressed, it was as if they were having a monologue. Kaiser NEVER even asked for any clarification, to listen to the tape...NOTHING!! It was reported to the OCR, Office of Civil Rights, and a year later....nothing has happened.

Recently, My mother went into Kaiser because her foot was red and swollen...they took an MRI, and prescribed 2 courses of antibiotics...without taking a culture. 25 days later still painful and swollen, I insisted on a referral to Podiatry, they took a X-ray....BROKEN FOOT! The moral of the story: Don't bother complaining...Kaiser will brush it under the rug....then discriminate against you....in a very business-like manner giving the appearance that they are doing everything they can. This "Patient Relations" is a nothing but a drop bucket for complaints....that go no-where. KAISER FOUNDATION is a business. While other hospitals are going under and struggling with budgets...they built a $700 MILLION PLUS new hospital in Santa Clara Ca. You figure it out. I can't get my mother to leave Kaiser, though she knows it's not all she thought it was. She knows Kaiser isn't the best, she CAN afford better....I guess she's used to Kaiser's abuse and sometimes does not seek treatment, because she says;"Kaiser is trying to kill off old people". NOW THAT"S NUTS....In my opinion Kaiser isn't trying to kill off old people....Kaiser is running a hospital as a business....as cheaply as possible....and if people die...so what!.

The day they opened the new hospital, they had all the Kaiser big wigs there for a walk through....these are some of the most repugnant individuals I have ever seen....all patting themselves on the back about what a great hospital they have....I wonder how many people they have MIS-Treated to build that thing! It was the 2nd largest construction project in California!!! The stories people tell about Kaiser...I'd have to say they are ALL true. Kaiser is in it for the money....nothing else! Even Kaiser employees say it's LOUSY care!!!Too Much!
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Posted by Anonymous on 2007-08-12:
I wanted to complain about a Nurse Practitioner NP cutting my colon area with an exacto knife via insufficient anesthesia. The area was not numb and she just knifed right into me. Nobody should feel the pain I suffered!!!! I complained to the kaiser Ombudsman. The NP was approached and she denied ever remember treating me. I tried to go the distance to repremand Kaiser's incompetant employee but they started bringing in thier heavy artillery about them having more power design to invalidate me. I would not have enough money to finish before they would have enough to sweep me under the carpet.

So I believe Kaiser can callously invalidate whom ever and when ever they want. Kaiser can not be faught unless theres a class action suit.
Posted by DebtorBasher on 2007-08-12:
My Mother went to Kaiser (different location) after she hurt her back across her shoulder-blades. She had difficulty just sitting. After the doctor took her into to the examining room and told her get undressed and sit up on the examining table, he left the room. And left her sitting on that table waiting, and waiting and waiting as her pain got worse because she had nothing to lean back onto, it was just the exam table and she couldn't lay down. The doctor finally came in for a minute only to leave again and she asked,"How much longer do I have to wait because I can't sit in this position like this"...and his answer, "Well, this isn't a McDonald's drive through where you just pull up and order what you want and drive off"...the doctor later apologized for his remark after the x-rays showed she had two crushed vitibre....she never went back.
Posted by jktshff1 on 2007-08-12:
Is Kaiser a nursing home or a hospital.
Posted by Anonymous on 2007-08-12:
Sure looks that way does'nt it?
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Posted by Momilei on 09/29/2010
WAIPIO, HAWAII -- Tons of situations are flying through my head that I desperately need to say so. Ok soo I am pregnant with my 2nd child. This time around I am on Kaiser for my medical plan. The first thing they tell you to do is choose your doctor to provide you your prenatal care. Ok done. I'm 7 months pregnant and have only seen him twice. The rest of my visits was with a nurse practitioner or another doctor that, who I believe, was just working that day and had some time to spear. I'm still not sure how things work.

I drive 30 minutes from home to for the following to occur:
1. wait in a waiting room full of people with who knows what(10mins)
2. pee in a cup (1min)
3. wait in an exam room for a nurse practioner to measure my stomach(5 sec)
4. listen to heartbeat of my baby (5 seconds)--(the only exciting part)
5. get none of my questions answered (2 seconds)
6. told I might have gestational diabetes and yet when tests are done I'm no way near it(4 minutes)
7. waddle out
thats right about 15 minutes of awkwardness

I can go on and on. Its too late for me to change plans now from work so I have no choice but to stick it out. But believe me I'm switching as soon as I have the opportunity too!!
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Posted by Venice09 on 2010-09-29:
Are these visits any different than the ones during your first pregnancy? I really don't remember much happening at my doctor's visits. If all is going well, there's really not too much for them to do. Does someone take your blood pressure?
Posted by clutzycook on 2010-09-29:
That's pretty typical for most OB visits. With the exception of my first OB visit, I spent more time in the waiting room than I did in the exam room. It's also not uncommon to see other doctors/nurse practitioners when you go for these visits. When you go into labor, you never know for sure if your doctor is going to be the one on call that week and it's nice if you kinda sorta know the other doctors in the practice.
Posted by MRM on 2010-09-29:
Congratulations on your soon-to-be born newborn! HOORAH!
Posted by MRM on 2010-09-29:
I look forward towards your 3rd child, and your 4th child, and so forth! You must keep your clan alive!
Posted by Venice09 on 2010-09-29:
That's a good point, clutzy. My first baby was born on Christmas Eve, and my doctor was away. I ended up with someone I had never seen before. My second baby was born on Rosh Hashanah. Again, my doctor was not exactly available but did show up in the nick of time. That's the drawback to having a sole practitioner. It's better to be familiar with more than one doctor. I thought about going for a third on Easter, but I think my doctor would have abandoned me!
Posted by momsey on 2010-09-29:
I don't think that's anything exclusive to Kaiser. I did see the same doctor every time I went for checkups, but that's how it was in my doctor's practice. Have you thought about changing doctors? It has to be possible to change doctors, no?

I see your frustration, but I don't know how this is Kaiser's fault, unless I'm missing something.
Posted by Anonymous on 2010-09-29:
Its probably too late to change doctors, the OP is already 7 months pregnant. With pregnancy, doctors are usually reluctant to take on patients who have already been seeing another doctor and the further along you are, the hard it is to find a doctor willing to see you,
To the OP, honestly, I think the majority of your complaint is invalid and I think your just being hormonal. I can see being upset over not getting questions answered but the rest of it? Your really complaining about a 10 minute wait? Really? I had to wait a minimum of an HOUR in the waiting room and I was usually the only patient there, sometimes there was one or two other patients but the wait was always atleast an hour before I was taken to an exam room. And as far as what happens during your appointment-urine sample, weight check, heartbeat, etc, be thankful that that is all that happens during your appointment because that obviously means you and your baby are healthy. If they were doing more tests and ultrasounds, it would be because of a problem with your baby. Be thankful that your baby is healthy! What else do you think should be done at your appointments? You complain about re-taking the glucose test, which I know is not fun, but really now?
Posted by momilei on 2010-10-04:
yes this pregnancy has been different from my first. my first plan was HMSA. my obgyn was there from day one till delivery day. answered all my questions. even the dumb out of nervousness ones. this last visit with my KAISER plan i have seen doctor #3. she had no idea what i was goin through, who i was and when she asked who my primary doctor was she said it had shown another doctor on my chart.

the waiting period is not the problem at KAISER..i honestly feel like a waste of time going to prenatal care just to measure my belly.

my first ultrasound was at 9 weeks. I was told that i have a cyst. I havent heard anything since. I asked about it and was told by the numerous nurse practioners that i would receive a call later and unless i was in any kind of pain i shouldnt worry. never got the call. and had to google what a cyst was.

i called one day because of severe headaches and was told over the phone that i was dehydrated and should drink tons of water. later after a blood test a month later im anemic and had a very low blood count.

i gots lots more...
Posted by Venice09 on 2010-10-04:
I agree that your questions and concerns should be addressed, and that the doctors should be familiar with your chart. You shouldn't have to wait an unreasonable amount of time for a call back either. That is very stressful when you're worrying about something. If someone is having issues with the pregnancy, then the visits are usually more involved. It does sound like you need more attention than you are getting.
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StarStarEmpty StarEmpty StarEmpty Star
Charges Like Kaiser, but Serves Like Medicaid
Posted by Patriciapurl on 12/28/2012
REDLANDS, CALIFORNIA -- I had a bad seizure on Dec 7, and was taken to Redlands Community Hospital ER. They brought me out of it, stabilized and discharged me the same night. I called in to my primary care doctor at the Kaiser Redlands clinic; and he saw me in a very timely manner. But then he ordered a follow up visit to a neurologist, and the earliest appointment I could get was not until Jan-16. The reason I need to see him is that the seizure zapped my short term memory; that and during waking hours my experiences become dreams instead of memories. The ER doctor thought that I had suffered hypoxia during the seizure. I can't believe that Kaiser, knowing what I went through and the after effects, thinks it is fine for me not to see a neurologist for six weeks after a seizure that nearly killed me. I have to call in every day hoping there will be a cancellation, but it's no use. I suspect that Kaiser Fontana is understaffed. My husband and I pay almost $1,800/month for our two premiums. That is why I say that Kaiser charges like Kaiser, but at least in this case it feels like I'm on Medicaid! Perhaps that is naive. Perhaps it takes six months to see a neurologist on Medicaid. I just think that considering the brain damage from a seizure that almost killed me, I'd be a higher priority to Kaiser.

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Posted by Anonymous on 2012-12-28:
I sympathize with your situation but the 6 week wait has nothing to do with Kaiser. It doesn't matter who your insurance is, there are often long wait to see specialists. Heck, I was told I couldn't get my kids in to see their pediatrician for 8 weeks! ( So I switched pediatricians). But when your dealing with specialists, there is almost always going to be a wait and evidently your doctor doesn't think this is an immediate emergency. I suggest you call the specialist and ask them to take down your info & call you if they have a cancellation before your appointment. Good luck & I wish you a speedy recovery.
Posted by Skye on 2012-12-28:
Excellent advice samanthasmom!
Posted by Anonymous on 2012-12-29:
Last year, I couldn't walk due to severe pain in my feet. I had to wait 6 weeks to see a specialist. It doesn't have anything to do with insurance. They don't control how many patients a doctor has.
Posted by leet60 on 2012-12-29:
I just wanted to offer the OP some information on seizures and memory affect following. This is very informative:

Posted by Vinnie11 on 2012-12-29:
I also see a neurologist and suffer the typical 6-week wait. I waited 8 weeks for an appt. on 11/27 and the morning of the appt. they called me and cancelled. They decided they wanted me to have some addition tests PRIOR to coming which I had promptly but guess when I get to see him again? Six weeks. Has little to do with your insurance and btw...Medicaid patients have the same illnesses as we do.
Posted by trmn8r on 2012-12-29:
I don't believe this has anything to do with your insurance, nor should it.

It the doctor who prescribed this followup visit was concerned that you needed to see a specialist immediately, I would think that you would in the hospital and that visit would happen.

However, you are "stabilized", and this sounds like a precautionary followup. Hope your recovery proceeds smoothly...
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Being Screwed
Posted by Lovit on 11/16/2011
Folks, Obama care is not the answer. We have to go back to Public-Option, just like Britain and Canada. Don't listen to the Crap we are being fed by the Health industry. They will never give consumers a break. They have tasted our blood for years and they like it. Lets make the Public-option number 1 priority in coming elections.
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Posted by Anonymous on 2011-11-16:
What does this complaint have to do with Kaiser Permanente?
Posted by trmn8r on 2011-11-16:
Nothing, but connecting it to an insurer in some manner makes sense.

A lot more sense than other things I heard today...
Posted by Kris10 on 2011-11-17:
Go back to the public option like Canada and Britian? We've never had the same kind of healthcare that they have. Please explain further.
Posted by Old Timer on 2011-11-17:
Canada? Six months to get in to see a doctor because all their doctors are in Florida now making a ton of money. A family friend is a doctor that used to live in Canada. He moved to Scottsdale Az to be closer to the aging American Baby Boomers. He has no plans to ever go back to Canada to practice.
Posted by clutzycook on 2011-11-17:
Go back to public option? I never knew we had been there to begin with. Frankly, I don't think it'll happen in any of our lifetimes. It would raise taxes higher than they already are and this country is already broke. If you think the OWS people are PO'd now, imagine how cheesed they'd be if their taxes went up even more!
Posted by madconsumer on 2011-11-17:
very good idea 'lovit'. there was a time when the public opinion elected the president and congress. then perhaps the insurance companies will be put in their place.

very helpful review.
Posted by trmn8r on 2011-11-17:
Clutzy, I believe the OP means go back to a public option *plan*, which I believe the Democrats were supporting until Obama shifted to what he ended up with.

I think you are on the right track, clutzy. A public option would raise our taxes, which would be a horrible idea right now. Great advice!
Posted by Skye on 2011-11-18:
This country has never had socialized medicine and NO WAY am I for it.

As for Kaiser, what did they do to cause you to write this? They are actually one of the best out there, and they are giving away free flu shots to Kaiser members.
Posted by Churro on 2011-11-18:
Let's not kid ourselves we do have socialized medicine in this country today with a good chunk administered by a handful of "for profit" corporate health insurance providers and those ranks will grow with the successes of their lobbyists. Those not covered by private plans are on the government healthcare dole. Private health insurance is no less 'socialized' than a government program.

All forms of health insurance whether it is private or government only serves to raise the cost of health care and thwart free market price control pressures. Believe it or not private health insurance providers make more money as the cost of health care rises. The only free market pressure is to keep the premiums just a hair below the affordable line of their targeted market. They will squeeze the insured for ever last possible premium penny. We ARE always at that point. It's no coincidence health care costs rose at the same pace as the growth of the private health insurance industry.

I say scrap all health insurance policies both private and government and go back to the days when communities through trusts and public donations were responsible for health care without corporate or federal government interference. It worked. Don't believe me? Ask somebody in their sixties who paid the hospital bill for the birth of their children?
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Kaiser denied MRI because"it is expensive" (doctor's words)
Posted by Sfvicinity on 11/24/2010
SOUTH SAN FRANCISCO -- A Kaiser Dr. finally prescribed an MRI for my lower back when I began showing nerve damage, never mind I've been suffering from back pain since the age of 26. It takes nerve damage people so if you need an MRI then say you have nerve damage, as evidenced by the numbness in my legs.

Anyhow, I also had upper back/lower neck pain and requested that area have an MRI as well in the same visit rather than my having to take more time off work to have it done on another day, and hopefully before nerve damage happened.

I was denied by the Dr. and the MRI was not granted until I asked for the denial in writing. So ask for denials of care in writing! I asked the reason for her denial and she said " because it's expensive". Even if that's the reason and I know and she knows it, I couldn't believe she said those words, but she did. As a side note, the MRI techs said it is not that much more expensive to combine the tests.

Now I am truly afraid to trust Kaiser for any back surgery, so I live in pain every day. I have been denied other insurance due to my existing back condition. When COBRA runs out, I'm screwed.

My advice to anyone/everyone dealing with Kaiser. You MUST do your own research, and DEMAND care. It is stressful and I left Kaiser crying but you have to do it. I understand You cannot sue Kaiser in most cases because your policy calls for arbitration. If I had any other choice I would get other insurance.
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Posted by saj80 on 2010-11-24:
Many insurance providers are either denying MRI coverage or requiring preapproval. This is for two reasons: it is very expensive, and many studies have proven that in many cases, MRI's are no better than xrays. As with many other health matters, use of MRI's has been abused by doctors and patients.
Posted by Anonymous on 2010-11-24:
MRI's required authorization for most insurances. Just because they did the lower back does not mean that they can do the upper back. The back consists of three areas, cervical, thoracic, and lumbar spine. Each area is a different cpt code for the MRI. If they had approval for the lower spine (lubmar) and went ahead and did the middle and upper spine (thoracic and cervical) without authorization, then the claim would be denied and the dr would eat the costs or they might even bill you the cost. So yes it would have been more expensive. Ask them to do the upper spine later on when you get an authorization for it. And BTW, an MRI is not going to help with the pain.
Posted by Anonymous on 2010-11-24:
I should also mention that anything the dr does he has to bill the insurance company for. If the MRI was not approved for another part of the back, the claim will be denied, you will get billed, the dr won't get paid. It has nothing to do with not wanting to help you
Posted by madconsumer on 2010-11-24:
numbness in legs can also be a pinched nerve, not always nerve damage.
Posted by sam35 on 2011-02-17:
I can understand your felling .You pay for Kaiser and you need some help ! If your in a lot of pain
you are having a tuff time working . So you don't
have a lot of money to go elstwear. It took a long
time, maybe 6 month or more but I got two M.R.Is. I
still have the pictures today. That cost Kaiser
thousands ! And did nothing to help me . Maybe
Kaiser is learning from seeing the same thing over
and over ? What treatment is worth it and what really wrong with you ! Doctors have a good idea
what wrong with you in 30 seconds .Or at least they think they do . Kaiser can't win with this one, They put me threw hell, but I did the same to them ! 20 years latter I still go out of my way
to give them grief . If you have the money go to
a pain management Doctor and get a eppuardal and
get into P.T . Yes that not easy and it going to hurt, but it sure beats back surgery ! And you will have to go threw same grief after surgery .
And from what I heard one surgery just leads to another . This is good advice for Kaiser too.This
would be much more cost effected and have a higher success rate ! You really don't need to spend a bundle just to get another pissed off ex
member !

Posted by Kaiser = Scientology like cult on 2013-06-27:
some of these responses seem to be coming from Kaiser employees or Kaiser lovers. If a Kaiser doctor orders an MRI it gets done...period. They don't need authorization. And "most insurances" don't need authorization for MRI. Maybe HMO's, but NEVER a PPO. Or indemnity insurance. And cost should have nothing to do with anything at Kaiser. But it does. Because Kaiser is not in the business of health--they are in the business of making money. The doctors answer to a corporation. The less medical treatment they give, the more money Kaiser makes. Its a profit machine. That can NEVER equal good medicine. It's a crime.
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Denial of Health Insurance to extremely healthy RN Kaiser employee
Posted by Kaiser is Sicko! on 06/16/2009
I couldn't believe it- I'm a 52 year old RN who has worked for Kaiser Medical Center as a per diem RN for 11 years. I am in perfect health. I windsurf, surf, roller blade, hike, bike... I never get sick. I have always worked as a per diem RN ( for 30 yrs.) so that I can control my own schedule and travel etc. I have always had high deductible Blue Cross. I have never used it. I was always a little embarrassed when my pts. in the hospital would ask me something about my personal experiences with Kaiser health care and I would have to say I don't have Kaiser- I have Blue Cross major medical. I would try to avoid telling them that I have almost never had a Dr. appt. in my life. My only preventive health care is occasional paps at Planned Parenthood (all negative).

So I decided to finally fork up some more dough and pay for a Kaiser plan that would include regular check ups so I would finally start getting regular check ups.

I filled out the application online with no doubt in my mind I would be accepted. I wanted to be sure they couldn't ever use the excuse that I didn't reveal something on the application so I put everything I have ever been seen for down- a sprained knee, pre-cancer from too much sun on my face removed by the derm (show my an adult that doesn't have that and I'll show you a person that never gets sun- it is completely benign), and to the question "Do you have regular periods?" I answered "no" because I have been in menopause for a yr. ( a perfectly normal situation for a 52 yr. old- DUH!)... but they offered no chance in the application to elaborate that I'm in menopause.

I couldn't believe it when I was denied health insurance because :

1- Unspecified muskuloskelatal condition
2-Unspecified gynecological condition- irregular periods
3- Unspecified skin condition

Keep in mind I provided the name, addresses and phone numbers of the dermatologist and the orthopod that treated my face and diagnosed my knee (no treatment needed- just resting it).

Meanwhile I'm back on the medical surgical unit at Kaiser Hospital lifting and turning pts., running around the unit --- but they won't give me health insurance!!!! (I very seldom call in sick and when I do it is really a mental health day.)

I'm so furious! At least I will never again be embarrassed when pts. ask my about my Kaiser health care and I have to say I don't have Kaiser.

I will also never be embarrassed if I ever have to go to an ER or Dr. with my essentially worthless Blue Cross insurance. I did my part to attempt to pay for better insurance. I will have no qualms if the need arises to get the health care I need and then just declare bankruptcy and refuse to pay it. The system is so screwed up it begs for that.

Thanks for giving us a voice!

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Posted by PTCuda on 2009-08-25:
welcome to the wonderful world of indivudual health insurance.. Sucks don't it..
Posted by sam35 on 2011-02-19:
I love R.Ns ! Iam sorry to hear your story . But Iam not surprised . Who is at fault ? Kaiser is not cheap
if you get to be are age ! I have had Kaiser and Blue cross . Kaiser has good Doctors ,but their running like track stars trying to keep all the interns from killing someone . The way I see it,Blue
Cross is better for finding a good doctor that will
help you in a timely manor ! If private practice
Doctors try to pull the stuff that Kaiser get away
with they will be getting sue ! Right or wrong their
insurance will have to pay out because they sure
don't want to go to court ! The way most people
fell about insurance Co. With Kaiser and Blue cross the system is the problem ! Have you ever
seen how much resource's go into administration ?
With Kaiser the problem is the care you get !With
Blue cross it is the bill you get ! I hope you get the care you need ! If you are a Veteran you might try the V.A ! As far as Iam concerned it is
the best health care I have ever gotten for cheap !
Posted by Susie-Q on 2012-02-01:
Kaiser's Trickle-It-Down-and Maybe-It-Will-Cause-Something-Important-to-Happen Management approach has a lot to be desired. Kaiser will continue to punish employees, as well as work to have the nasty employees hound the good ones, so long as it suits their business model. And who will always suffer in the end? The patients.

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StarEmpty StarEmpty StarEmpty StarEmpty Star
Nightmare Organization
Posted by Denisehall on 01/02/2014
LARGO -- Double nightmare with Kaiser. I am livid to the point of tears. These people are more interested in the number of patients and days of stay than providing care and information. I am still dealing with a mess of a system that only cares about the Kaiser bottom line. I can not speak to one person that can answer my questions or provide advice. Everyone tells me I need to talk to someone else, yet I find that decisions are being made without my knowledge, consult or advisement. I can not plan for these decisions without being advised of then in advance. They have major implications for my time, purse and other resources that I have to have in place. They discharged my mother, who has Alzheimers, from a Kaiser facility and I was not advised that this would occur, never told them that where she would go upon discharge, was never advised of the discharge care needed, of the equipment that the facility to have to rent (which I will have to pay for), was never given an opportunity to plan for an alternative facility for the discharge, the list goes on and on. I was advised that she would be discharged in 2 days. I was called after 4 o'clock on New Year's eve. Which gives me only 1 working day to prepare for the discharge, financially and otherwise. I would have appreciated some prior discussion before they decision regarding her care were made and put in motion. I am not invisible, deaf or dumb, and I am her surrogate of record.

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StarEmpty StarEmpty StarEmpty StarEmpty Star
Kiaser Members "Beware"!!!!!!!
Posted by CICIJONES6451 on 04/24/2013
SANTA ROSA , CA ., CALIFORNIA -- Please! If you have KIASER, HMO, for a few dollars more you can have an 'PPO' . If, you have serious issues, you need to venture on to a 'PPO'! Its literally a few dollars more. We "WERE" members threw his work, and they were taking $40.00 month out of his check.

PPO.....$5.00 more.... a month ! Prescriptions 1/2 the cost!!!!!!!!! He went in and, was diagnosed to have hepatitis B, then they fraud gently said he has hepatitis A-C-D-E, and was charging his insurance $100,s of thousands of dollars! They had us in there every 3-5 days, we were dropping $20's and $40's like playing the slot machines! repeating the same test. I kid you not............you know us women........... IF, I DONT GET AN STRAIGHT ANSER, LIKE THE STRAIGHT QUESTION I ASKED, THEN YOU KNOW, THERE HIM HOLLEN YOU AROUND!!!!!!!!

And, guess what O.M.G! Proof, it was just that! This the Santa Rosa, Ca . Located at #401 Bicentennial . the main one. Dr. Susan, his liver doctor, the gastroenterologist dept. O. M.G! Please beware. I had his primary doctor call me he was like " Hay this is doctor James, I was like hay!, he's not here..... he's at work! He was like," well you are the one ,...I want to speak with............... you're always together! You know ,.... he's very, very, sick !!!!!!!!!! He has less than 10 percent liver function, and he can die today or next year."( And, a little more said of the same.) He's very sick from the hepatitis A-B-C-D-E . And , I was already being doubtful.( now keep in mind we know of the b, and he will out live all of us, not a issue ). Okay I get to the point. I knew something was terribly wrong when .... a botched hernia operation... went in with 1, and came out with 6. It was obvious for a the need of a second opinion, they refused .... so we dropped them.... and got a PPO and,.... was cheaper, (we see who we want, when we want for the same money ! You see .....if its a closed network, that allows them to lie, make up, and create bogas non- existing reports , ) We had 4 test done Sutter, Memorial, Santa Rosa Community Clinic, and, UCSF, and O.M.G! it came back 'NEGATIVE!!!!!! NEGATIVE !!!!!!!!!!!! NEGATIVE!!!!!!!!!!!

Never, even came in contact (We all come in contact, 1/2 creates antibody to rid of those diseases, and the other 1/2, has issues. ) And the B.... he's so low, it's undetectable. That is ;1 of 5, serious on going medicals procedures, being "on going" makes it to be one of the most expensive treatment's to treat, because its" on going ," beside aide's !!!!!!!!! And ,they charge the insurance up the " WAH- ZOO " !!!!!!!!!! They refused us second opinion, by law you can get a second opinion . They are one net work... all one network. He ,now have" ANTHEM- BLU- CROSS" not the one, just anyone off the street can get ..... we know that can be pricey !! BUT threw your work, of course its going to be cheaper,. you can get it .... but you to drop KIASER . They will have the option, for you to have ANTHEM-BLU-CROSS, among other's, we liked ANTHEM. We so far LOVE ANTHEM. Kiaser is a poor mans insurance. *Now, you'll see I left out some letters, of the doctors names .. but , I guarantee, you will find the names if ,you pull them up. So , I guess I would not get in trouble!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! OOOOOOOOOOOOOOO!

But! Dr. Richard, the hernia dept. ( He would refuse to see us even if, we made an appointment, he would cancel ,or do a no show.!!!!! concerning the 6 hernias, that sticks out 10 inches I swear! There was a Dr.M , he popped up from absolutely no where and purposely jammed a 3 inch needle into the hernia and ,..smiled like.. when you say....did it hurt !!!! The nurse said ;" we need to file a complaint on him for his conduct !!!!! " When , we tried doing just that , we were told", that he did not work there any longer! Dr. James, primary doctor (he said, I'm sorry I can't get involved in this hernia drama, but urged us to keep asking the right questions !!!!!!!!!! All these hernia issues ....politics .....we said " yeah we know its a job... I know we couldn't help but ,... feel for him! Dr. Susan- the gastroenterologist dept. Now! you make your decisions, and while your doing that ....don't count on the research on these doctors, because ,...they will come up as magnificent brain surgeons, and they cook for the needy...and pay for it all !!!!! Its ALL a bunch of crap!

As long as they Kiaser keeps there dues to the city/state paid , they can write what ever, REMEMBER ITS A FREE SPEACH, and its a network, within a network, so ........ your not going to find out squat . Here's the real messed up thing ,...from the liver doctor Susan she was like yeah! his , "doe doe" is a little high and his" gaga " is a little low ( and if that's all true then the only thing is in question to have done is a biopsy!

But ,no issue, then no biopsy. Yeah!!!!!!!!!!!! We know now .Please good luck. I pray for you. ex Kaiser member.
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Universal Health / Beware Of Kaiser Pharmacy
Posted by Gj703elon37 on 12/30/2011
ROCKVILLE, MARYLAND -- Kaiser started billing me after I had a foot surgery even though I had paid for everything up front, and went against their own member services, and surgeon on the 90 day universal health laws in the state of VA/ They also refused to fill my primary DR's prescriptions at their own pharmacy! Stay away ! Each Primary has hundreds to thousands of patients and has no time for you ( 5 min or less per visit, I was told the 1 st day by my Dr) If you have serious issues, you will get 3 world care at best! These Dr's are there due to failing at their own practices, or being sued for malpractice! Think about what your doing ?
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