Company Review: Kaiser Permanente

When I review companies I give my honest opinions and this will be a very long and brutal review. Let me set the overall tone. Kaiser Permanente is one of the worst companies that I have ever had the misfortune to deal with. They are bureaucratic beyond belief, their internal systems are a complete failure, their staff is poorly trained, and the management seems to be either clueless or incompetent. While this assessment may seem harsh this review will demonstrate that it is completely accurate.

With Obamacare I am forced to purchase individual health care insurance. I live in Washington State and the policies of our state insurance commissioner caused many health insurance companies to leave. As a result, individuals who need health insurance have very few options and all of them seem to be bad. I chose Kaiser because it seemed to be best of the bad options and my personal doctor and local hospitals were in their network.

Trouble from Day One

I signed up for Kaiser and received a welcome letter instructing me to go a website, create a profile, and enter my billing information. When I tried to create an account it asked for my 6-digit (if my memory is correct) ID number but the letter had an 8-digit member ID and a 5-digit payer ID. No numbers in the letter met the criteria. I tried different numbers, searched for other details, added a prefix to the 5-digt number, etc. and could not create an account. Finally, I called the support line and was informed that the welcome letter contained the wrong website URL. I asked how I would have known to go to the other website and she stated that the only way to know is to call. So, I wasted probably 20 minutes trying a non-working website, had to call Kaiser, wait on hold, and talk to a representative for 15 minutes just to find the billing website.

This was my first experience with Kaiser and I had to waste about an hour to do something that should have taken 10 minutes. The web address on the letter was wrong, the nomenclature on the letter did not match the terms used in the website, and Kaiser had to expend resources to answer a question that should have been answered by the welcome letter.

These letters are generated from template files and the system inserts customer details and prints them. Fixing the template file is a trivial task (I have done this before). I would assume that every new customer who received this letter had to waste their time, waste Kaiser’s time, and go through tremendous frustration. Later in my course of dealing with Kaiser problems a different representative told me that he overheard his cubicle mate explaining to customers that the website was wrong and then he had to help them create their accounts.

If Kaiser got 200 new customers and if they were required to spend 15 minutes with each that means this single error required Kaiser to expend 50 hours of unnecessary phone support time. If each customer spend an hour this means that Kaiser stole 200 hours of time from customers. It would take 1-2 hours to fix the form letter file. Spending 2 hours to save your customers hundreds of hours of time, frustration, and saving 50 hours of company time is an obvious decision. Kaiser management would rather burn the time of their employees and customers than spend almost no time to actually fix the problem. This happened some time ago and hopefully Kaiser fixed the problem.

This issue clearly demonstrates that Kaiser does not have an adequate trouble ticket and escalation process. This demonstrates that management at all levels either ignores these problems and does not care about time wasted by employees and customers. These problems cause frustration for customers, increase overhead costs, increase customer service hold times, and result in higher premiums. As I stated initially this is an example of failed systems and incompetent management at all levels.

Doctor Dropped

A key factor for selecting Kaiser was that my doctor was in their network. If my doctor was not in their network I would NOT have selected Kaiser. Long after joining Kaiser I received a letter saying that my doctor would no longer be part of the network and I would have to choose a Kaiser doctor. I called Kaiser and was told that my doctor removed himself from the network but his clinic was still in-network. I then called my doctor’s office and was told that Kaiser dropped the entire clinic from their network.

The Kaiser representative gave me two wrong answers: (1) my doctor removed himself from the network (WRONG), and (2) the clinic was still part of the network (WRONG). Kaiser forced me to find a new doctor after being with my current doctor over 25 years and the Kaiser representatives gave me multiple wrong answers. Given this incident, and others to be detailed later, Kaiser representatives freely give wrong information to customers if they do not know the correct answer. When I shopped for a Kaiser doctor I found that my choices were very limited. I was also told that if I went outside of the Kaiser network I would have NO coverage.

Surprise Charges

I have a problem with my hand and went on the chat line to see if I should schedule a doctor visit. I was advised to get an x-ray first and this was scheduled. I got the x-ray and then received a statement for the chat session. It was only $35 and the entire amount was written off but I did not recall being warned that the chat was billable. I was also billed for the x-ray and the doctor visit. I am now afraid to use the phone consultation or chats because I do not know what is billable and what is not. These system should make it clear when charges will be involved. Will other systems give me surprise bills? How much would these charges be? I have a high-deductible plan so these are concerns for me. Because of this I no longer use the phone consultation or chats.

Optometry Fiasco

When I got an x-ray I noticed that the clinic had an optometry office. I need new glasses and wanted to know if Kaiser would give me a good deal. I asked at the clinic and they had no pricing information. I called and they could not give me any price details. I looked online and saw images of several pairs of glasses but there were no prices for the glasses, exams, or lenses. I tried calling a couple more times over the course of a few weeks and was again told that they had no pricing information for exams, frames, or lenses. On the last call I was finally told that a normal exam costs about $284 which was $199 more than my normal optometrist. Needless to say, I will not be using Kaiser for glasses. Why is it that other optical companies post prices but Kaiser employees do not even know basic costs?

Nearly Impossible Task

Near the end of 2019 I had to have Kaiser do an incredibly difficult task that took over 2.5 months to resolve and cost me somewhere between 8-12 hours of time on the phone. This task was so complicated that it took about a dozen phone calls, over half a dozen Kaiser representatives, and it caused me to receive several letter threatening to cancel my coverage. This nearly impossible task was changing the credit card number for my automatic payment. I may have some of the details out of order but you will get a good idea of how bad this ordeal was.

Sometime about November, 2019 I changed the credit card number for my auto-pay. I then received a bill for almost double my monthly premium. I also received threatening letters stating my account lapsed and my coverage would be terminated. I immediately called Kaiser with letter in hand and they tried to find my account from the ID number. I gave them the ID on the letter and they could not find me. After probably 10 minutes they found me using birth date, social security number, etc. It turns out the ID on the letter was the subscriber ID and not the member ID. This could have been avoided if the form letter used the correct nomenclature for the number. I asked if the extra charge was a penalty or late fee. I talked with several representatives and one of them told me to pay only the normal premium and said that if I paid the amount billed then my auto-pay would charge me the wrong amount going forward. Then I would have to call back to have the amount reduced and get refunds. I went online and manually paid the normal monthly premium as instructed.

The next bill had the same problem and showed the new amount with the previous amount as an overdue amount. I received another letter threatening to cancel my policy. I called several times again and got a variety of answers. One person said that my payments were behind one month for the entire year and I had to pay the extra premium to get caught up (this was WRONG). Another, particularly rude woman, simply told me to get to the billing department and pay the entire amount listed (contradicting a previous phone conversation). This was after I spent over 40 minutes on the phone, my original call was dropped, I had to call again, wait on hold, and then listen to a rude and unhelpful representative who refused to explain the charges. I simply hung-up on her and tried again days later.

After repeatedly being threatened with policy cancellation (through nasty and vague letters), making lots of calls, wasting probably 10 hours on the phone, the issue finally got resolved. The problem was that the Kaiser billing computer erroneously created the problem and the representatives were unhelpful, gave me wrong answers, and could not resolve the issue. Kaiser should have an escalation process to address issues like this that are caused by your failed systems and inept management. When my credit card number was changed I was billed for December and January. The premium went down in January and the billing system was a month out of sync. That minor problem took 2.5 months, probably 10 hours of my time, and probably a dozen phone calls to fix. A properly working billing system would have avoided this entire problem.

Non-Functional Grievance Department

During the credit card fiasco I was told that complaints were sent to the Grievance Department. I do not recall getting any correspondence from this department. It does not appear that they helped in any way with the problem. Months after this mess I called and asked for the names and addresses of senior Kaiser management so that I could send them my complaints directly. The representative advised me to contact the Grievance Department and I stated that it appears that this department has no power or ability to do anything. I insisted on getting names and addresses. After waiting for about 40 minutes I was told that he could not find an address for the Kaiser corporate office and could not get the names of senior management. After the call I did some quick research and found this information by looking through online Kaiser financial details. The Kaiser Grievance Department appears to be useless group that does nothing to resolve issues.

Feeble Excuses

I have heard many excuses for Kaiser’s abysmal customer service. The most worn excuse is that they are understaffed. The problems that I detailed were caused directly by errors and bad practices generated by Kaiser. The welcome letter contained wrong information. If the letter was correct it would have required no phone intervention. The credit card problem cost me probably 10 hours of time and probably a similar amount of time for Kaiser. This entire situation could have been prevented if the billing system worked properly. The repeated phone calls for costs could have been avoided if representatives gave me correct answers rather than giving different answers to the same question on different calls.

Kaiser could have saved HOURS of their time if the welcome letter was correct and if the billing system allowed me to change my credit card number. Fixing these issues would probably save customer like me thousands of collective hours of time and would save Kaiser potentially hundreds of hours of phone support calls. It is clear that Kaiser places NO value on the customer’s time. However, fixing these systems would free representatives from handing unnecessary calls, reduce customer frustration, lower IT costs because calls would not have to stored and archived, and give greater confidence to customers. Kaiser management chooses not to fix the problems and would rather leave the problems and frustrate their customers.

Another sore spot is the length of time that I have wait on hold when calling. Please do not include on hold messages such as, “Your call is very important to us.” If my call was important then you would hire enough people to answer the damn phones. Messages like this are an insult. You should have a message such as, “We care more about our bottom line than we do about your time so please continue to hold.” At least this statement would be honest.

Final Shock

The final shock with Kaiser was when I finally saw your doctors for the first time (over a year after I signed up). I was nervous because of all of the problems that I had with Kaiser thus far. I stated to a few providers that I didn’t know if I could trust Kaiser with my health care because the problems that I had with the billing department. I was shocked that no one in Kaiser was shocked. They would say things like, “Yes, billing is a known issue,” and “I am not surprised.” They must have heard so many complaints about the billing department that they were not surprised at all.

If the internal departments at Kaiser are this bad then that demonstrates a complete lack of management and no system of problem escalation. If the billing department is this bad then why does senior management not step in and fix it? If the people who run the billing department are this inept then they should be replaced by people who can do the job. These problems cost vast amounts of time for customers, waste Kaiser’s time (and money), and cause customers to doubt the overall ability of Kaiser to provide decent health care. Kaiser representatives repeatedly gave me wrong answers and they seem to fabricate answers if they do not know the correct answer: (1) credit card update (MANY wrong answers as documented above), (2) charges for colonoscopy (told it was fully covered and someone else told me that charges might apply to my deductible — only one of these can be correct), (3) my billing was one month off for the entire year (WRONG), (4) my doctor removed himself from the network (WRONG), (5) my clinic was still in the network (WRONG), (6) my auto-pay account was working properly again (WRONG), etc.

Summary

From my personal experience Kaiser seems to be poorly managed bureaucratic mess of a company that cares nothing about providing good service to their customers. Personnel are poorly training, routinely give wrong information to customers, and care nothing about the time that they cause customers to waste. The billing department is a marvel of inefficiency and incompetence and every Kaiser employee that I spoke with knows that it is a problem and yet management allows the problem to remain. In spite of this, Kaiser senior management allows this travesty of a department to continue operating in this way. The Grievance Department does nothing, communicates nothing, and gets nothing resolved.

The worst (and most scary) thing is that if I have a life-threatening health care emergency I have to rely on this company for my care. If they cannot update my credit card number for auto-payment then how can I trust them if my life in danger? Companies like Kaiser should do better. Kaiser management should be ashamed and embarrassed by this company. If I have had this many problems with Kaiser then there are probably hundreds of people like me who have had problems. Needless to say, if I can find ANY other decent health care options I will drop Kaiser without given them a second thought.