Sunday, August 12, 2012

Kaiser gave patient incorrect instructions, costing patient over $1,000

Kaiser Permanente
Complaint 139447
Date Occurred:03/01/2012
Reported Damages: $1,474.00

I was sent to RAI by Kaiser Permanente 12/12011 to initial renal dialysis. I was approached there by Peter Carrion, a representative from Kaiser, to enroll me in a Kaiser supplemental plan to start when Medicare became effective. I advised Mr Carrion I would be a home hemodialysis patient.

He instructed me to send my enrollment forms for the supplemental Kaiser plan 2 weeks before starting home hemodialysis. I started home hemodialysis classes 1-23-12, and began dialysis at home 2-16-12. I received a Medicare card with an effective date 3-1-12. I called Mr. Carrion and asked him if the effective date was correct as I understood Medicare became effective upon starting home hemodialysis.

He stated Medicare became effective 90 days after the onset of dialysis. I questioned him further but he insisted this was the case. I then accessed a web site for Medicare recepients which states that Medicare is effective the 1st day of the month that home hemodialysis classes are initiated.

I called and fax'd this information to Mr Carrion on numerous occasions without response. I then contacted his supervisor, Norma.

Norma states it was not their responsibility to know when Medicare became effective, that was up to the Social Security office. She was not interested in connecting the timing of the enrollment forms being sent to when the Medicare was made effective. I called the Social Security office who requested documentation from the Kaiser Permanente approved provider who initiated my home hemodialysis classes. This was done, I was advised it would take 6-8 weeks for my card to be corrected. I received my new Medicare card with efffective date 1-1-12 in April. Kaiser has since billed Medicare and received payment for services provided after 1-1-12.

Kaiser will not, however, refund premiums of $747/month for January and February of 2012 as my enrollment forms were not submitted until 2-1-12 as instructed by Mr. Carrion, their representative, and my Medicare was not started due to inaccurate information received from RAI, the Kaiser approved dialysis provider. It wasn't until I intervened that this was corrected. I believe Kaiser should be responsible for the instructions given to applicants and the Social Security office.

Respectfully submitted,

Anonymous SBID #8cab002602
Posted 07/26/2012

No comments: