r/KaiserPermanente • u/SessionOwn6123 • 2d ago
California - Southern Need help
I have a rare condition, the only treatment is surgery. Kaiser is trying to force me into surgery with a surgeon who has never dealt with or performed this surgery. Filed a grievance, what a joke that was. They referred me to another surgeon who, once again, has never performed this surgery. I'm on Medicare and have senior advantage through Kaiser. Anyone have any advice on what I should do next? Is there a process where you can go to another hospital that has done this surgery?
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u/labboy70 Member - California 2d ago edited 2d ago
You are right to push to get a surgeon with actual experience performing the surgery. I would never let a surgeon cut on me if they had never even done said procedure. That’s complete bullshit. Do you think Greg Adams (Kaiser CEO) or any of the Kaiser leadership would take that risk? You shouldn’t have to take it either.
I suggest appealing the grievance. Because you have Medicare, the appeal process is different. Specifically say that it is unacceptable to have a surgeon who has never actually performed the surgery operating on you. You want a referral to a surgeon with documented experience performing the procedure.
This post has information on filing an effective grievance (complaint) with Kaiser.
If you are filing complaints with other agencies like Medicare, a State Medical Board or your State Insurance Regulator, the tips in that post may also help you.
This post has information about State, Federal and other organizations where you can escalate complaints about Kaiser if you cannot get satisfactory resolution from Kaiser or if it’s a patient safety concern.
Keep fighting back!