How to file a complaint against Kaiser Permanente
Medical care is a service provided to consumers, and, as such, you have a right to lodge a complaint if and when things go wrong with any facet of your medical care. And there are any number of reasons for complaints on the part of the medical services consumer.
Kaiser Permanente, one of the country’s largest not-for-profit health plans, is no exception. The types of complaints against Kaiser Permanente may involve:
- Improper care or unsafe conditions
- Hospital conditions
- Licensing questions or unprofessional conduct on the part of a doctor
- Quality of care
- Insurance coverage/billing.
Most states have public agencies that individuals can contact to file a complaint about medical care. In California, the Department of Public Health handles consumer complaints related to complaints against hospitals, home health agencies, hospice providers, and nursing homes. You have the option of downloading complaint forms online and completing them, calling directly, or requesting a form by mail.
If you have issues with your physician or someone on the nursing staff, you can file a complaint with the state’s medical or nursing board. Because Kaiser is an HMO, any complaints concerning Kaiser’s insurance coverage or billing would need to be filed with California’s Department of Managed Care.
All members have a right to file a complaint with Kaiser Permanente for any issue by calling Kaiser’s Customer Service Center, sending written complaints to the Member Services Correspondence Unit, or by downloading and emailing a complaint form.
In order to increase your chances of getting a result, gather as much documentation as possible to substantiate your complaint; in the absence of good documentation, be as detailed and precise in whatever written statements you’re asked to provide.
Serious complaints should be handled with care
When it comes to making a serious complaint against Kaiser, especially in cases involving medical malpractice and/or wrongful death, the process is much more complicated. Unfortunately, if you take the time to read the many complaints from victims who have suffered from medical negligence as members of Kaiser, you’ll find that filing a complaint has little chance of having a positive outcome.
Patients belonging to Kaiser Permanente, and who want to bring an action against a Kaiser healthcare provider or hospital cannot, in most cases, sue for medical malpractice. Instead, they must usually go through Kaiser’s binding arbitration process. This is part of the agreement patients have to sign before being granted membership. Visit http://www.oia-kaiserarb.com with any questions about the rules.
If you feel that you or a loved one has been a victim of medical malpractice or wrongful death due to negligence on the part of a healthcare provider or hospital within the Kaiser system, having an attorney submit a complaint to Kaiser Permanente who has successfully arbitrated, mediated, or settled these types of cases on behalf of Kaiser members is crucial to a favorable outcome to your claim.
Working with your attorney
In cases involving serious complaints against Kaiser, especially if they involve the wrongful death of a family member while in the care of Kaiser doctors, you’ll want to enlist the services of an attorney who is experienced with Kaiser’s arbitration process.
Schedule a free consultation to discuss your situation with Scott S. Harris, San Diego medical malpractice attorney.