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PRIVACY POLICY 
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                                                                                        Proper procedures a Kaiser patient must follow if dissatisfied with their care;
Prepared by former Kaiser Patient - Hillarie Levy

Request a second opinion with another Kaiser Physician and then a third if still not satisfied.  Only after 2 to 3 second opinions with Kaiser physicians, is Kaiser now obligated to honor, and pay for your request to have a consult with any outside Doctor of your choice.  Always submit these requests in writing (hand deliver) to Member Services, request a stamp date and a copy of your complaint with the stamp date. 
Always keep in mind, anyone from Member Services, Social Services or Ombudsman, who attempts to speak with you and seems real nice and they actually care, IS NOT ON YOUR SIDE!  They work for Kaiser and their goal is to end your complaints.  If they do make any promises, have them put it in writing, right on the spot.

A reminder about Kaiser Hospice;  Although Kaiser makes it sound like a great option for a dying patient, what you aren't told is, Kaiser's only goal is to save money and signing for Hospice means you sign away all rights to medical care.  You are not allowed to have a doctors appointment or ER visit, even if the problem is not related to the illness.

1)  If this is refused or involves another type of medical issue, file a complaint with the Member Services located within your Kaiser facility.

The complaint must be in  writing and if possible, hand deliver it to Member Services and request a stamp date and a copy of your complaint with the stamp date.  Include details in your complaint, of dates seen, with who, and treatment along with witness, if possible.

At this time, (before Kaiser gets suspicious) start requesting medical records.

You can also file a complaint against the Doctor or Nurse with the Medical Board or RN Board.
 
2)  Kaiser must respond within 30 days or a state law is violated.  (send the violation information to DMHC)
Kaiser always responds with a generic form letter usually refusing your request.  File an appeal with Member Services, again requesting a stamp date and copy.  Kaiser has 30 days to respond and it should be a more detailed generic form letter refusing your request. 

3)  Your next move is to file a complaint with Department of Managed Health Care (DMHC), a state agency.  You have an option to do it all over the phone but do everything in writing.  They usually side with Kaiser via a generic form letter.  File an appeal.  Again, expect another generic form letter with more details, denying your request.

This paper trail will help in winning an arbitration, going to the news and/or seeking help from your legislator. 


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