We've been with Kaiser for several years and have been generally satisfied with the service until now.
Our family member was having some health problems that required medical attention, so we called his Kaiser doctor for medical advice/set up an appointment. We were told that because the insurance plan does not start until February 1, they could not help us THOUGH WE'VE BEEN WITH KAISER FOR SEVERAL YEARS AND THE PLAN LAPSED ONLY A COUPLE WEEKS AGO. We asked if we could speak with our primary care provider over the phone. Again, they said we would have to wait until February 1 to speak to the family doctor.
Our family member is an elderly patient with a history of stroke and a heart condition. We told the Kaiser representative (and later, member services) that we would like to speak with the primary care provider earlier than February 1 given the patient's medical history. The representative then connected us to member services to see if member services could expedite the activation (again, as a reminder, we had been Kaiser members for several years. Had it not been for Kaiser cancelling the plan, we would not even be in this situation), who repeated the same canned spiel about the February 1 start date. Did not seem to care one bit about the patient's health situation and circumstance, not to mention our concerns. At this point, we're exasperated --- it's stressful enough worrying about a family member's health, but add the administrative regs on top of it --- so then we ask then what our options are.
Member services says we can go see another doctor outside of Kaiser --- to clarify, this would mean FINDING A NEW DOCTOR OUTSIDE OF THE KAISER NETWORK (calling various providers, asking for availability and whether they would take new patients, etc.) WHEN IN FACT THE KAISER PRIMARY PROVIDER HAS/KNOWS ALL OF THE PATIENTS MEDICAL HISTORY. Efficiency here?
We pointed out the great inconvenience and really, utter lack of common sense in the member services rep's recommendation. We pressed on the urgency of the health issue. All we needed was one call with the primary care provider, but Kaiser, due to some strict and unproductive set of regulations, would not budge.
At this point, there was no utility in continuing the conversation. So point-blank, we asked member services, "So do you expect the patient to just drop dead after waiting until February 1?" After a few seconds, they said they would talk to someone, put us on hold for at least several minutes (perhaps longer), and later, the line was disconnected so we did not even get to hear what they had to say.
Had we been brand new members to Kaiser, it would be another story. But we have been dealing with Kaiser network for several years, and the patient has already established a lengthy medical record within Kaiser. On top of that, the patient has a medical history. So for Kaiser to refuse to accommodate and leave the patient with no choice but to either WAIT OUT THE SICKNESS until February 1, or see another doctor outside the network, to us, seemed counterproductive and not at all sympathetic or cognizant of the role and mission of providing medical care to sick patients.
Apathy, laziness, and the "we don't really care because we're following regs and it's not our fault if the patient is unable to receive the proper medical care in due time" puts the interests of the corporation and bureaucracy first before patient care.
I would also add that Kaiser still employs a doctor who has received dismal reviews from multiple patients for her incompetence, condescension, and laziness. Our family member had initially received medical care from Dr. Yu Sung K, but switched doctors as Ms. K always returned our calls several weeks late (with no apologies, just orders for the patient to take XYZ medication, to set up an appt, etc.), talked over the patient, and was overall an inattentive, poor medical "expert" who really should reconsider why she's in the field to begin with. If you look up her name, you might still be able to see some of the bad reviews from previous/current patients.
Pure disappointment. We are most likely going to cancel or switch out of Kaiser, thanks to our stressful and frustrating experiences with the facility, the providers, and member services.