Owens Originals, Inc.

The following letter was submitted on 4/24/2017:
April 24,
Revdex.com
***
*** *** ***
*** ***
***
Complaint Case # ***
Consumer: *** ***
Case Opened: April
17,
Dear the Revdex.com,
This is in response to your email received on April 18, 2017,
forwarding concerns on behalf of our prior member, *** ***, regarding
his request to have his January plan cancelled and refunded accordingly. We value the opportunity to review and
respond to their grievance and apologize for any frustration that may have been
caused to Mr*** by this overall matter
Mr***
explained that he had called Kaiser Permanente (KP) immediately upon realizing
that his plan did not cover him to see his outside ***KP will not
cancel/refund the January plan, because it was not received by the
required dateMrs*** states that he did not receive a letter advising of
a due date and requests an immediate termination of the plan initially enrolled
in
I forwarded the details of Mr***’s complaint and
requested resolution details to the Membership Administration Department for
review and feedbackThey confirmed that Mr***’s cancel request was
received on 1/18/2017, and KP termed the plan effective 1/31/Mr***
requested a retro termination back to the effective date, as to not be insured
in the plan with KP at all for January Document review confirms that a
cancel with balance letter was sent to the address that Mr*** placed on
file with KP along with a letter requesting proof of other coverage in order to
process a retro terminationProof of other coverage was never received, and
the Membership Administration Department will, therefore, not honor Mr
***’s retro-termination requestThe plan was subsequently termed for
nonpayment of premium through date 1/26/
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
*** ***
*** *** *** ***
*** *** ***
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an additional
calendar days at the member’s request or if there is a need for additional
information and the delay is in the best interest of the member.
Also, he may contact Member Services:
*** members may call ***, toll free at ***,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
*** *** members please call *** or deaf, hard of hearing or speech-impaired members
who use TTY may call ***. You may also contact our department through
our Web site at kaiserpermanente.org
Please
apologize to Mr*** for his dissatisfaction with this overall matter, as I
do realize that this is not the resolution he was seekingAdditionally, I’d be
glad to answer any further questions from Mr*** or the Revdex.com related to
this matter and may be contacted directly by calling *** ***
Sincerely,
*** ** ***
*** *** *** ***
*** ***

Initial Business Response /* (1000, 6, 2015/09/23) */
September 23,
*** ***
Trade Practices & Helpline Specialist
Denver/Boulder Revdex.com
*** *** XXXXX
Denver, Colorado XXXXX
Complaint Case # XXXXXXXX
Consumer: *** ***
Case Opened: September 14,
Dear Ms***
This is in response to your email received on September 14, 2015, forwarding concerns on behalf of our member, *** ***, and her expressed frustration pertaining to an awaited premium refundWe value the opportunity to review and respond to their grievance and apologize for the member's dissatisfaction
We have formally documented and shared Ms***'s concerns with the appropriate leaders at Service Link/Consolidated Service Center for On-Exchange Issues DepartmentThis notification includes the overseeing department manager
Research of the matter, confirms that Ms*** is due a refund of $for overpayment of premiumI am very sorry that this issue occurred, as well as that it has taken much of Ms***'s own time/effort to resolveOn September 18, 2015, I was advised by the Kaiser Permanente On-Exchange Issues team that the refund request has been submitted and will be processedThe estimated timeframe until the member receives the mailed check for $is within daysThe member may feel free to contact me directly, should any questions persist or additionally related issues arise
The member's feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate *** Our goal is to deliver excellent service to our membersGrievances expressed by our members do not affect their coverage in any wayIf the above noted member is dissatisfied with the resolution, they have the right to request a second reviewPlease have them put the request in writing to:
Kaiser Permanente
Member Services
*** *** *** Street
*** Colorado XXXXX
Written requests will be reviewed by Member Services Administration who will respond to you in writing within calendar days of the receipt of the member's requestWe may extend this timeframe up to an additional calendar days at the member's request or if there is a need for additional information and the delay is in the best interest of the member
If the Revdex.com or the member has any questions, please contact me at (XXX) XXX-XXXX
Also, you may contact Member Services:
Denver/Boulder members may call XXX-XXX-XXXX, toll free at X-XXX-XXX-XXXX, between a.mto p.m., Monday through FridayDeaf, hard of hearing, or speech impaired members who use a TTY may call XXX-XXX-XXXX
Colorado Springs members please call X-XXX-XXX-XXXX or deaf, hard of hearing or speech-impaired members who use TTY may call X-XXX-XXX-XXXXYou may also contact our department through our Web site at kaiserpermanente.org
Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** M***
Complex Case Resolution Specialist
Member Experience

February 8,
*** ***
Trade Practice Specialist
Denver/Boulder Revdex.com
P.OBox
Denver, Colorado
Complaint Case #
Consumer: *** *** **
Case Opened: February
8,
Dear Ms***,
This is in response to your email received on February 8,
2016, forwarding concerns on behalf of *** *** and continued account
issues experienced with her daughter’s health insurance plan. We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction
I am unable to locate a Kaiser Permanente (KP) Colorado
Health Plan under the name of *** *** in our KP system or in the
system of plans purchased through Connect for Health Colorado (C4)My
assumption is that the member is Ms*** daughter as the subscriber,
though this must be confirmed and additional information provided, before I’m capable
of reviewing the matterPlease ask Ms*** to contact me directly for further
discussionThe case details needed are as follows and can left on my
voicemail, if I’m not able to answer:
Name
of subscriberMRN
if availableMember
addressConfirmation
that the requested resolution is to have the account monies reconciled and be
re-enrolled? -Please advise as to the date re-enrollment
is requested for-Also, please keep in mind, that premiums are
not refundable, and I will not be able to waive any part of the premiums for
months of coverage
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
Member Services
South Havana
Street
Aurora,
Colorado
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an
additional calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me
at (303) 338-
Also, you may contact Member Services:
Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call 303-338-3820.
Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ** ***
Complex Case
Resolution Specialist
Member
Experience

Hello, In review of our records we do not see the initial complaint being forwarded to our attention. We will be responding to this request and complaint As Soon As Possible. Thank you!

October 4,
*** ***
Trade Practice Specialist
Denver/Boulder Revdex.com
*** *** ***
*** *** ***
Complaint Case
# ***
Consumer: *** ***
Case Opened: *** *** ***
Dear *** ***,
This is in response to your email received on September 22,
2016, forwarding concerns on behalf of our member, *** ***,
regarding his awaited premium refund. We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction
*** ***
explained that a Kaiser Permanente (KP) error incorrectly caused the July
premium for his health plan purchased through Connect for Health Colorado (C4)
to be automatically deducted from his credit card timesAfter being promised
the refund due, *** *** instead received a bill for the $he
should be receiving as a refund
We have formally documented and shared *** ***’s
concerns with the appropriate Consolidated Service Center/On-Exchange Issues
Department leadership, to include the Department ManagerPlease apologize to
the member for any frustration that may have been caused by this overall
matter
The Member Issues
Resolution Team (MIRT) addresses issues directly related to On-Exchange plansThe
MIRT Business Analyst working this case confirmed that *** ***’s
On-Exchange enrollment does incorrectly reflect coverageAdditionally,
the premium amount is listed incorrectlyThese discrepancies are
currently in the process of being fixed with our billing system, which in
conjunction with the member’s payments made, will result in a $refund
due
Per the reviewed September
20, 2016, at 1:P.Mdocumentation of *** ***’s call to KP inquiring
about a refund, the member was informed that his premium for August was
automatically deductedKP’s Common Membership system reflects a September 4,
On-Exchange plan term date and has not since received an updated file from C
with a July 30, plan term dateThe MIRT Business Analyst verified that the
original file forwarded by Cadvises KP to term *** ***’s On-Exchange
plan as of September 5, Being that the On-Exchange KP plan was purchased
through C4, our members are required to make any plan changes directly through
CShould KP receive an updated term date from C4, *** *** will also
be due an August premium refundIf the member hasn’t already done so, he
will need to contact Cand ask that they forward a plan term date to KP
I am following the
progress of the member’s case, and urge *** *** to contact me for an
update or to further discuss the situationPlease apologize to *** ***
for the admitted account errors, as well as please sincerely thank him for his
patience while resolving
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
Member Services
*** *** *** ***
*** *** ***
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an
additional calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call ***, toll free at ***,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
Colorado Springs members please call *** or deaf, hard of hearing or speech-impaired members
who use TTY may call ***. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ** ***
Complex Case
Resolution Specialist
Member
Experience

September 8,
*** ***
Revdex.com Serving Denver/Boulder
*** ** *** *** ***
*** *** ***
Complaint Case # ***
Consumer: *** * ***
Case Opened: 8/17/
Dear Mr* ***,
This is in response to your email received on September 6, forwarding additional concerns on behalf of our member; *** * *** regarding her request for her refundIn addition, the poor customer service provided by her previous Case Resolution SpecialistWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction
We have formally documented and shared *** *** grievance regarding her experience with the appropriate leadership within the Case Resolution Team
Research indicates the correct refund amount based on premiums due verses premiums paid is ($777.70)The request was processed and the approval was completed on September 7, and currently in processThe member should have her the fund returned to her in hours based on her financial institutions posting policies
If the Revdex.com or the member has any questions, please contact me at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call ***, toll free at ***, between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call ***.
Colorado Springs members please call *** or deaf, hard of hearing or speech-impaired members who use TTY may call ***. You may also contact our department through our Web site at kaiserpermanente.org
Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ***
Complex Case Resolution Specialist
Member Experience

November 28,
*** ***
Revdex.com Serving Denver/Boulder
EFlorida
Ave., Ste
Denver, Colorado
Complaint Case # ***
Consumer: *** ***
Case Opened: ***
Dear *** ***,
This is in response to your email received on November 16,
forwarding concerns on behalf of our member; *** *** regarding his
request for a waiver of charges in the amount of $for service date
October 17, We value the
opportunity to review and respond to their grievance and apologize for the
member’s dissatisfaction
We have formally documented and shared *** *** grievance
with the appropriate leadership
Research confirms that *** *** was provided incorrect information
regarding his vision benefitsPer, *** *** health plan benefits, vision
exams are covered for members under the age of 19. Based on my review, $will be adjusted off of the
member’s account
Please note that Kaiser Permanente is allowed to make
changes to member accounts only as provided and documented by Connect for
Health Colorado. Kaiser Permanente
cannot make any changes to a health plan purchased through Connect for Health
Colorado without authorization from Connect for Health Colorado
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call ***, toll free at ***,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
Colorado Springs members please call *** or deaf, hard of hearing or speech-impaired members
who use TTY may call ***. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ***
Complex Case
Resolution Specialist
Member
Experience

Complaint: ***
I am rejecting this response because:I would love to speak with you further about this caseI am not claiming that I am not responsible for the bill because it was not needed or my care was not satisfactoryAs mentioned in my original complaint, aside from those things, the lab work and procedure was not performed and that is why I shouldn't be responsible for that billI don't want to get into details on a public response but I really think this can be resolved if I was able to talk to someone about itI've tried several times, but I guess I just have to keep tryingI just tried that number and it is a ***, not an ***, but I will try again. Thank you,
Sincerely,
*** ***

September 21,
Adam Chouinard
Revdex.com Serving Denver/Boulder
EFlorida Ave., Ste
Denver, Colorado
Complaint Case # ***
Consumer: *** * ***
Case Opened: 8/17/
Dear *** ***,
This is in response to your email received on September 16, forwarding additional concerns on behalf of our member; *** * *** regarding her request for her waiver of one month freeWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction
Please understand that premium payments are due and payable and are not contingent upon a member’s degree of satisfaction with services. Unfortunately, we will not be able to authorize the members request for a premium waiver.
The member received her refund via overnight mail on sent on September 15, The member has a current balance due for September and October and a special approval was needed to have the refund issued
If the Revdex.com or the member has any questions, please contact me at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call ***, toll free at ###-###-####, between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call ###-###-####.
Colorado Springs members please call ###-###-#### or deaf, hard of hearing or speech-impaired members who use TTY may call ***. You may also contact our department through our Web site at kaiserpermanente.org
Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ***
Complex Case Resolution Specialist
Member Experience

March 7,
*** ***
Trade Practice Specialist
Denver/Boulder Revdex.com
P.OBox
Denver, Colorado
Complaint Case #
Consumer: *** ***
Case Opened: March
2,
Dear Ms***
This is in response to your email received on March 2, 2016,
forwarding the rebuttal to our original response provided on March 1, 2016, on behalf of our member, *** ***The member is
requesting that her account balance discrepancies be completely resolved
First of all, we truly
do value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfactionSecondly, I am sincerely sorry for
misunderstanding the actual member issue
The Member Issues Resolution Team (MIRT) confirmed that both
Kaiser Permanente’s (KP) Common Membership (CM), as well as our billing system
(HPS) reflect *** effective date and birthdate as 9/9/HPS is currently
reviewing the account and will be providing an account auditThough expedited,
the audit is expected to take approximately another week to completeOnce I
receive the summary of payments due/paid, I will contact Ms*** via
telephone to further discuss the detailsThis will allow us to find out where
the problem lies with the incorrect outstanding balance she’s seeing online
I sincerely apologize about the continued problems that the
member is experiencing with her health plan accountI also am appreciative of
her patience, as I realize that resolution has not been timelyAgain, please
offer Ms*** my direct phone number, should she choose to check on the
status of her account auditOtherwise, I will outreach immediately upon
receipt
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
Member Services
South Havana
Street
Aurora,
Colorado
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an
additional calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the
member.
If the Revdex.com or the member has any questions, please contact me
at (303) 338-
Also, you may contact Member Services:
Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call 303-338-3820.
Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ** ***
Complex Case
Resolution Specialist
Member
Experience

March 1,
*** ***
*** *** *** *** ***
*** ** *** ***
***
*** *** ***
Complaint Case # ***
Consumer: *** ***
Case Opened: 02/22/
Dear Mr***,
This is in response to your email received on February 22,
forwarding concerns on behalf of our member; *** *** regarding
charges of $billed to the member on February 22, We value the opportunity to review and respond
to their grievance and apologize for the member’s dissatisfaction
We have formally documented and shared Ms***’s grievance
with the appropriate leadership
Research indicates $was appropriately billed for
service date January 19,
The member was seen and treated on January 19, at the ***
Medical Offices, Primary Care Department.
A
review of our system of confirms the price quote to the member on January 18,
was an estimate of $for current procedural terminology (CPT) code
***, Office or Other Outpatient Visit for Established PatientsAfter the member's visit, the most accurate code was used for billing, ***, New Patient Office
VisitThe estimates quoted to our members
are subject to changed based on the complexity, and any additional procedures
and or tests ordered during the appointment
I
have reviewed the member’s Deductible Health Maintenance Organization (DHMO)
benefits and verified that the member has an individual deductible of $3,500.00. The charges in the amount of $247.47, was
appropriately applied to her individual deductibleThe member will remain responsible for the
charges.
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
*** members may call ***, toll free at ***,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
*** *** members please call *** or deaf, hard of hearing or speech-impaired members
who use TTY may call ***. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ***
*** *** *** ***
Member
Experience

June 28,
*** ***
*** *** *** *** ***
*** ** *** *** ***
*** *** ***
Complaint Case # ***
Consumer: *** ***
Case Opened: 06/12/
Dear *** ***,
This is in response to your email received on June 15, forwarding
concerns on behalf of member; *** *** regarding his request
for Kaiser Permanente to apply his premium payments to his account correctlyWe value the opportunity to review and respond
to their grievance and apologize for the member’s dissatisfaction
We have formally documented and shared *** *** grievance
with the appropriate leadership
Based on review, a one-time service gesture
will be honored and the member’s health plan has been reinstated. The health plan is effective January 1,
to current and there are no gaps in coverage.
Additionally, Kaiser Permanente will honor a one-time service gesture
and *** ***’s June premium amount of $has been adjusted off his account
We confirmed a payment of $was
received in Kaiser Permanente’s Patient Financial Services Department on May
23, 2017, and another payment of $was received on June 6, 2017. *** ***’s medical services account had a
balance of $due and the June 6, 2017, payment covered the
cost-share. The $payment will be
transferred to *** ***’s premium account for July’s premium and the account
will be paid through July 30,
Enclosed please find the past-due notice
mailed to *** ***’s current address on May 6,
Please note, premium payments may be mailed
to:
*** *** *** ***
** *** ***
*** ** ***
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
*** members may call ***, toll free at ***,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
*** *** members please call *** or deaf, hard of hearing or speech-impaired members
who use TTY may call ***. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ***
*** *** *** ***
*** ***

Complaint:
I am rejecting this response because: I did receive the prescription receipt from Kaiser Permanente, however the claim filed with the Hartford was denied because they require a diagnosis code as well as the name of the provider I have mailed Kaiser a copy of the denial from The Hartford along with a request for further assistance
Sincerely,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***

March 12, 2018 *** ***Revdex.com Serving Denver/Boulder EFlorida Ave., SteDenver, Colorado
80210 Complaint Case # *** Consumer: *** ***Case Opened: 02/26/2018 Dear Mr***, This is in response to your email received on February 26, forwarding concerns on behalf of our member; *** *** regarding the billing of treatment received at Kaiser Permanente, billed by both Kaiser Permanente and HRMWe value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction. We have formally documented and shared Ms***’s grievance with the appropriate leadership Research indicates that Ms***’s account was moved to Kaiser Permanente’s internal collections, Healthcare Resource Management (HRM)They are the first stage of collections for CO services billing accounts. Bills are sent to HRM after daysEssentially Kaiser bills days and allows members days to make payment, if payment isn't received, the debt is transferred to HRM and HRM bills for daysIf no payment is received the member is sent to BC Services collectionsThe count down for the days begins the date KP initially bills the member, not the Date of Service (DOS)On November 22, there was a payment of $that was made and Ms*** was told the account was at a zero balance. The account should have been removed from HRM at that timeThe account remained with HRM and Ms*** was continuously billed for treatment received moving forward. The current charges of $are for service dates January 8, 2018, February 2, & 27, 2018. The charges have been reviewed and confirmed to be valid. I have requested a transaction history for Ms***’s HRM and Kaiser Permanente accountI will also provide a summary of how and where her payments were appliedOnce I have received these summaries I will mail copies directly to Ms*** In addition, I also have asked that Ms***’s account be removed from HRM. If the Revdex.com or the member has any questions, please contact me at (303) 338-3827. Also, you may contact Member Services: Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700, between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call 303-338-3820. Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members who use TTY may call 1-800-521-4874. You may also contact our department through our Web site at kaiserpermanente.org. Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, Suda P***Complex Case Resolution SpecialistMember Experience

September 23, 2016 *** ***Revdex.com Serving Denver/Boulder *** ** *** *** ***
*** ***
***
Complaint Case # *** Consumer: *** ** ***Case Opened: *** Dear *** ***, This is in response to your email received on September 22, forwarding concerns on behalf of our member; *** ** *** regarding charges billed to the member for date of service March 10, We value the opportunity to review and respond to their grievance and apologize for the member’s dissatisfaction. We have formally documented and shared *** *** grievance with the appropriate leadership Research indicates an adjustment for $was completed on the member’s account on September 20, 2016. The member was schedule for a physical on March 10, at the Longmont Medical Office, Primary Care Department. The visit went out of scope for preventive care and the member was appropriately billed per his employer group Deductible Health Maintenance Organization (DHMO) benefit planWe provided the member education on how is benefit works for preventive services. As a one-time gesture we have agreed to waive the charges If the Revdex.com or the member has any questions, please contact me at *** ***. Also, you may contact Member Services: Denver/Boulder members may call ***, toll free at ***, between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired members who use a TTY may call ***. Colorado Springs members please call *** or deaf, hard of hearing or speech-impaired members who use TTY may call ***. You may also contact our department through our Web site at kaiserpermanente.org. Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente Sincerely, *** ***Complex Case Resolution SpecialistMember Experience

April 2,
*** ***
Dispute Resolution/Helpline Specialist
Denver/Boulder Revdex.com
P.OBox
Denver, Colorado
Complaint Case #
Consumer: *** ***
Case Opened: March
28,
Dear Ms***,
This is in response to your email received on March 29, 2016,
forwarding concerns on behalf of our member, *** ***, regarding his procedure
scheduling access concern. We value the opportunity to review and
respond to their grievance and apologize for the member’s dissatisfaction
We have formally documented and shared Mr*** grievance details
with the appropriate Kaiser Permanente Colorado Urology Department leadership,
to include the Nursing ManagerI am sincerely sorry for any frustration that
this overall matter may have caused to you
The vasectomy procedure scheduling process was explained to
be booked months in advanceThe next bookable schedule comes out in the
middle of April for appointments in JuneThere are not any sooner
appointments, unless someone is to cancelBeing that cancellations are not
typical, there is not a waitlist availableInstead, members are welcome to
call as often as daily to inquire if there has been any cancellationThis is a
surgical procedure done only on Thursdays and Fridays, and the department will
not be able to accommodate scheduling requests outside of the standard process
Please thank the Mr*** for his much appreciated feedback, as he is a valued
KP memberShould he have any additionally related questions, I am available at
the phone number listed below
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
Member Services
South Havana
Street
Aurora,
Colorado
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an
additional calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call 303-338-3800, toll free at 1-800-632-9700,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call 303-338-3820.
Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ** ***
Complex Case
Resolution Specialist
Member
Experience

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***

March 19,
*** ***
Trade Practice Specialist
Denver/Boulder Revdex.com
P.OBox
Denver, Colorado
Complaint Case #
Consumer: *** ***
Case Opened: March
9,
Dear Ms***,
This is in response to your email received on March 10, 2016,
forwarding concerns on behalf of our member, *** ***, pertaining to
her November 12, inaccurately processed claim. We
value the opportunity to review and respond to their grievance and apologize
for the member’s dissatisfaction
Ms*** case was already being worked within the Case
Resolution TeamTherefore, I’ve opened a Second Review of the initial complaint
and have followed through to ensure that the matter was resolvedMs***
concerns were appropriately documented and shared with the Claims Department
leadership and the disputed claim submitted for reprocessing due to the
accumulation discrepancy expressed
The member has probably already been advised by the Case
Resolution Specialist (CSR) working her initial grievance, that the disputed
claim was in fact reprocessedBanner Health was consequentially paid for
the November 3, date of service accordingly
Please express my sincere apologies to Ms*** for any
frustration and inconvenience that may have been caused by this overall matter
Should she have any remaining questions related to the claim situation, please
encourage her to contact the CSR, per the contact information listed on the
response letter provided
The member’s
feedback is essential to our commitment of continuous improvement in delivering
the highest quality, most appropriate and compassionate care. Our goal is to deliver excellent service to
our members. Grievances
expressed by our members do not affect their coverage in any way. If the above noted member is dissatisfied
with the resolution, they have the right to request a second review. Please have them put the request in writing
to:
Kaiser Permanente
Member Services
South Havana
Street
Aurora,
Colorado
Written requests will be reviewed by Member Services
Administration who will respond to you in writing within calendar days of
the receipt of the member’s requestWe may extend this timeframe up to an
additional calendar days at the member’s request or if there is a need for
additional information and the delay is in the best interest of the member.
If the Revdex.com or the member has any questions, please contact me
at *** ***
Also, you may contact Member Services:
Denver/Boulder members may call ***, toll free at 1-800-632-9700,
between a.mto p.m., Monday through Friday. Deaf, hard of hearing, or speech impaired
members who use a TTY may call ***.
Colorado Springs members please call 1-888-681-or deaf, hard of hearing or speech-impaired members
who use TTY may call 1-800-521-4874. You may also contact our department through
our Web site at kaiserpermanente.org
Please thank
our member for their understanding in this matterWe know that they have a
choice for their healthcare, and we thank them for choosing Kaiser Permanente
Sincerely,
*** ** ***
Complex Case
Resolution Specialist
Member
Experience

Dear *** ***,This is in response to your email received on July 8, 2016, forwarding concerns on behalf of our member, *** ***, and her attempt to select a Primary Care Physician (PCP) We value the opportunity to review and respond to their grievance and apologize for the member’s
dissatisfaction.Ms*** stated she is continually informed by Kaiser Permanente that *** *** *** is not accepting new patients and is limited to seeing patients ages and older In searching kp.org for physicians, Ms*** has found that *** ***’s biography indicates he is available to see new patients and sees patients of all ages We have formally documented and shared Ms***’s concerns of incorrect information on kp.org with the Senior Product Manager of the Internet Services Group.In addition, I discussed Ms***’s desire to select *** *** as her PCP with the Operations Supervisor of the Personal Physician Selection Services (PPSS) Unfortunately, we are unable to honor the request to link Ms*** to *** *** at this time When searching physicians on the kp.org web-site, it is important to note that all physicians are listed The top of the page has an option to view physicians who are accepting new members Once this option is selected, the filter must be applied to view the specified list Ms*** may contact PPSS at ###-###-#### to obtain the most up-to-date information on physicians who are accepting new members The member’s feedback is essential to our commitment of continuous improvement in delivering the highest quality, most appropriate and compassionate care Our goal is to deliver excellent service to our members Grievances expressed by our members do not affect their coverage in any way If the above noted member is dissatisfied with the resolution, they have the right to request a second review Please have them put the request in writing to:Kaiser PermanenteMember Services *** *** *** ***
*** *** ***Written requests will be reviewed by Member Services Administration who will respond to you in writing within calendar days of the receipt of the member’s requestWe may extend this timeframe up to an additional calendar days at the member’s request or if there is a need for additional information and the delay is in the best interest of the member If the Revdex.com or the member has any questions, please contact me at ###-###-####.Also, you may contact Member Services: Denver/Boulder members may call ###-###-####, toll free at ###-###-####, between a.mto p.m., Monday through Friday Deaf, hard of hearing, or speech impaired members who use a TTY may call ###-###-#### Colorado Springs members please call ###-###-#### or deaf, hard of hearing or speech-impaired members who use TTY may call ###-###-#### You may also contact our department through our Web site at kaiserpermanente.org.Please thank our member for their understanding in this matterWe know that they have a choice for their healthcare, and we thank them for choosing Kaiser Permanente. Sincerely,*** ***Complex Case Resolution SpecialistCustomer Experience