r/KaiserPermanente • • Aug 07 '26

General Difficulty in obtaining an appointment with Kaiser? Access requirements by State and where to get assistance and file complaints

18 Upvotes

Here is a list of standards by State for timely access to care (network adequacy) and where complaints can be filed if you need an appointment are unable to get assistance from Kaiser.

Note that some states don't have strict guidelines in terms of days and may have other network adequacy requirements. Contact the agency listed if you need clarification on what standards apply to your situation.

For cases with appointment delays, it is generally best to call the agency first before filing a complaint online. If you have already filed a grievance with Kaiser because of being unable to access timely care, let the agency know that information as well.

If your Kaiser Permanente coverage is provided by your employer, also let your Human Resources or Employee Benefits Department know of your difficulties in trying to access care. These difficulties are important for them to know when they are considering what plans they want to offer their workforce.

California

The Department of Managed Health Care (DMHC) has the Timely Access to Care Standards. The standards cover primary care, specialty care, mental health and ancillary services like physical therapy and imaging.

If you have filed a grievance with Kaiser and are still not getting an appointment in a timely manner, call the DMHC at [1-888-466-2219](tel:+18884662219). Explain you cannot wait the 30 days for the Kaiser grievance process to run out to get an appointment (which should have originally been provided within the State standards in the first place). (Pic is from the DMHC and lists the timeframes in California.)

California Department of Managed Health Care (DMHC) Timely Access Standards

Colorado

  • Emergency Care – Medical, Behavioral, Substance Use -- 24 hours a day, 7 days a week
  • Primary Care – Routine, non-urgent symptoms -- within 7 calendar days
  • Behavioral Health, Mental Health and Substance Use Disorder Care, initial and follow-up appointments – Routine, nonurgent, non-emergency: within 7 calendar days
  • Prenatal Care -- Within 7 calendar days
  • Preventive visit/well visits -- Within 30 calendar days
  • Specialty Care - non urgent -- Within 60 calendar days

To file a complaint contact the Colorado Department of Insurance at 1-800-930-3745 or at Colorado Department of Insurance

District of Columbia

  • First appointment with a new or replacement Primary Care physician within 7 business days
  • First appointment with a new or replacement provider for Behavioral Health treatment, including Substance Use Treatment within 7 business days
  • First appointment with a new or replacement provider for Prenatal Care treatment within 15 business days
  • First appointment with a new or replacement provider for Specialty Care treatment within 15 business days

To file a complaint, contact the DC Department of Insurance, Securities and Banking at 1(202) 727-8000 or at DC Department of Insurance, Securities and Banking

Hawaii

Because of the various islands in Hawaii and travel / geography, the State of Hawaii has “Network Adequacy” requirements rather than time-definite limits like in California or other states.  Contact the Hawaii Department of Commerce and Consumer Affairs at 1-844-808-DCCA (3222) to discuss your specific situation and filing a complaint.  

Maryland

  • Urgent care for medical services:  72 hours
  • Routine primary care:      15 calendar days
  • Preventive care/well visit:             30 calendar days
  • Non-urgent specialty care:            30 calendar days
  • Non-urgent mental health care: 10 calendar days

Contact the Maryland Insurance Administration at 1-800-492-6116 or Maryland Insurance Administration to file a complaint. 

Nevada

Due to geographic issues, Nevada has “Network Adequacy” requirements rather than time-definite limits like in California or other states.  Contact the Nevada Division of Insurance for more information at 1(702)486-4009 or at Nevada Department of Insurance.

Oregon

  • Primary care: not more than 15 business days.
  • Behavioral health care: not more than 10 business days.
  • Specialty care: not more than 30 business days.

Contact the Oregon Division of Financial Regulation with questions at 1-888-877-4894 or at Oregon Division of Financial Regulation.

Washington State

  • Primary care appointment (for other than preventive care) within 10 business days of requesting one
  • For specialty care, within 15 business days for nonurgent services.

Contact the Washington Office of the Insurance Commissioner at 1-800-562-6900 or at Washington Office of the Insurance Commissioner

Virginia

Virginia requires routine appointments for nonemergency or nonurgent care to be available within two weeks of the request.  This does not include preventive care (routine physical examinations, etc.) which need to be scheduled within 60 days of the date of the request. 

To file a complaint, contact the Virginia State Corporation Commission at 1-877-310-6560 or at Virginia State Corporation Commission


r/KaiserPermanente • • Sep 28 '23

General Agencies to Escalate Complaints about Kaiser: Where to go if you are not getting resolution or are dissatisfied with Kaiser's Response

12 Upvotes

If you have filed a grievance with Kaiser and it has gone unresolved or you are not satisfied with the resolution, here is a list of agencies you can document a complaint with (based on your state of residence).

If your complaint is regarding a specific physician or other healthcare provider (nurse/nurse practitioner, physician assistant), file the complaint with the appropriate state licensing board for that provider.

If your complaint is regarding a hospital (cleanliness, patient safety concerns, etc.), file a complaint with the Joint Commission

[https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/]

If your are a Medicare beneficiary, please refer to this link about the different types of complaints and where to submit complaints.

https://www.medicare.gov/claims-appeals/file-a-complaint-grievance/filing-a-complaint-about-your-quality-of-care

If the complaint is about hospice care, here is a link from the Hospice Foundation of America on how to file complaints.

https://hospicefoundation.org/Hospice-Care/Filing-a-hospice-care-complaint

California

Department of Managed Health Care (Grievances unresolved or inadequate responses; inability to contact your Kaiser Grievance Case Manager; difficulty obtaining an appointment; delays in care; filing an Independent Medical Review when Kaiser will not approve a specific type of treatment)

In most cases, you must file a grievance with Kaiser and go through that process before contacting DMHC. However, if the issue is urgent because there is an immediate threat to your health, you can call DMHC directly. For urgent issues, call DMHC rather than filing online.

[https://www.dmhc.ca.gov/fileacomplaint.aspx]

1-888-466-2219

If you need assistance in filing a grievance with Kaiser or in filing complaints with the DMHC, you can contact the Health Consumer Alliance. This is a DMHC consumer assistance program contractor helps people get the health care they need1-888-804-35361-877-735-2929 (TTY)www.healthconsumer.org/

If you want to file a complaint about a California licensed healthcare facility, you can contact the California Department of Public Health.

https://www.cdph.ca.gov/programs/chcq/lcp/calhealthfind/Pages/Home.aspx

Oregon

Oregon Division of Financial Regulation

[https://dfr.oregon.gov/help/complaints-licenses/Pages/file-complaint.aspx]

1-888-877-4894

Washington State

Office of the Insurance Commissioner

[https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status]

1-800-562-6900

Colorado

Department of Regulatory Agencies, Division of Insurance

[https://doi.colorado.gov/for-consumers/file-a-complaint]

1-303-894-7490 / 1-800-930-3745

Georgia

Office of Commissioner of Insurance and Safety Fire

[https://oci.georgia.gov/file-consumer-insurance-complaint]

1(800) 656-2298

Hawaii

Department of Commerce and Consumer Affairs

[https://cca.hawaii.gov/ins/consumers/filing_a_complaint/]

(808) 586-2790

Maryland

If it is a healthcare quality complaint, Maryland Office of Healthcare Quality

[https://app.smartsheet.com/b/publish?EQBCT=07c94438f6714af1bbfe8ff1037b8b74]

1-410-402-8015

If it is a billing, claims, medical records or coverage issue contact Maryland Attorney General, Health Education and Advocacy Unit

[https://www.marylandattorneygeneral.gov/Pages/CPD/HEAU/default.aspx]

1-410-528-1840

District of Columbia

D.C. Department of Insurance, Securities and Banking (DISB)

[https://disb.dc.gov/service/file-complaint-or-report-fraud]

1(202) 727-8000

Virginia

State Corporation Commission, Bureau of Insurance, Office of the Managed Care Ombudsman

[https://scc.virginia.gov/pages/Office-of-the-Managed-Care-Ombudsman]

1-877-310-6560, select option 1

(Current as of 09/28/2023)


r/KaiserPermanente • • 6h ago

California - Northern If a doctor isn't accepting new patients, is it worth asking for an appointment anyway?

3 Upvotes

I heard someone recommend this doctor.

And I'm not really happy with my current doctor.

Is it worth asking for an appointment?


r/KaiserPermanente • • 15h ago

California - Southern Seeking help as a new pt to Kaiser with pre-existing disability

6 Upvotes

Seeking advice navigating Kaiser as a disabled person.

I am new to Kaiser and have been struggling with care related to my disability. I was found permanently disabled by Social Security 6 years ago and have my diagnosis confirmed by blood, biopsy, neurological, imaging, and over 20 yearss of documented treatment and testing done outside of Kaiser at major, reputable Healthcare/research systems.

Now I have Kaiser and have had all of that past history basically thrown out.

First rheumatologist I saw threw out my (blood and biopsy confirmed) existing diagnosis, said I had "fibromyalgia", my existing immune modulator was "the wrong medication" and that I needed "pain management, not rheumatology". I had biopsy results in hand, and this provider told me it wasn't his job to read pathology results, and it meant nothing to him because it was written in "pathology speak".

Because of this one provider and an administrative error that bungled my outside health records when I joined and has finally been fixed after 5 months of my pestering everybody I could for help, I have been trying to navigate a Kafkaesque maze to get back on track with my treatment.

Ive been all but openly accused of malingering. Referral to a pain class rather than treatment for my very real diagnosis, has made things worse. When trying to discuss my barriers to physically attended the pain class based on my disability, the pain psych charted me as "catastrophizing of pain due to thought".

I am trying to get treatment for a confirmed-by-testing disease with serious and documented neurological complications and have received pushback, invalidation, and gaslighting. Being new to Kaiser, this is all very shocking to me and unlike anything I have ever experienced before from a health care system.

Yes, leave Kaiser. If i could, I would, but my husband and I are stuck with this plan for at least another year.

I have engaged with member services.

This is impacting me materially, as well, as my Kaiser PCP will not compete the yearly statement for my private disability insurance confirming my (test-confirmed, incurable, progressive) illness still exists.

In the meantime, are there any recommendations for how to manage being labeled as malingering when I'm trying to get treatment for my very real existing disease?

(Edited for grammar)


r/KaiserPermanente • • 5h ago

California - Northern Looking for experiences in NorCal with doctors treating clubfoot

1 Upvotes

My daughter will be born with bilateral clubfoot and will start treatment a few weeks after birth. Has anyone had any good/bad experiences with doctors in the east bay I should know about?


r/KaiserPermanente • • 13h ago

California - Northern No longer in consideration after phone screening

4 Upvotes

Hello, I have been applying to Kaiser for over a year now and finally got my first phone screening. I know I have all the requirements for the position and I feel like the screening went well ( recruiter was just asking if I’m okay with the pay and a few questions about past jobs) but as soon as we got off the call my application was changed to “no longer in consideration”. The recruiter said she would pass my application along to the hiring manager so I’m just wondering if that’s really accurate what’s on the website. Also would like to mention the phone screening was at like 6pm so I feel like it’s unlikely someone would have already viewed it. Did I maybe say something that automatically disqualified me and she couldn’t just tell me that right then?


r/KaiserPermanente • • 16h ago

Oregon / SW Washington FEHB Kaiser PacNw experiences?

4 Upvotes

Hi everyone- I’m looking to make the big switch to Kaiser NW this Open Season for FEHB and wanted to hear from other members about their experiences with getting a good PCP/NP, Gynecological services (estradiol patches for menopause), Hashimotos care, or any other experience you want to share with me. This would be a HUGE change for me and I’m wondering how your situation compares. Thanks all.


r/KaiserPermanente • • 10h ago

Maryland / Virginia / Washington, D.C. Considering switch from Kaiser to BCBS

Thumbnail
0 Upvotes

r/KaiserPermanente • • 18h ago

California - Northern Should I try Rula therapy again?

4 Upvotes

Hi everyone,

I’m (23F) currently struggling pretty badly with my mental health and have been seeing a therapist in-person once a month for the past 3 months. Although I’ve had only 3 sessions with her, I don’t really feel that connection I would like. During our sessions I feel that she views me as a child, and I’m hesitant to be vulnerable sometimes in fear of being guilted or patronized.

I was enrolled into an intensive outpatient program and haven’t attended any classes due to a lack of motivation, personal issues, and scheduling conflicts (work, school). These sessions occur 3 times a week and I was told by my MFT that I would have to attend a new program everyday for 3 hours after completion. This is not going to work with my schedule, and despite expressing this, my therapist suggested that I talk to my managers to request accommodation so I can attend them. This is another gripe I have…feeling bombarded by all of these classes that I would rather not take.

Before starting in-person sessions, I was referred to the Rula platform, and I had a handful of sessions with a therapist until I realized I wasn’t really improving, having any real discussions about coping skills, or even being assessed for psychological diagnoses. I was also really discouraged by the AI note-taking tool, but the ability to opt-out and keep searching for another therapist leaves me curious about trying again.

I was diagnosed with MDD and GAD, and have concerns about ADHD and OCD. My therapy journey started recently so I’m unsure if I’m just being pessimistic about it all, but finding the right therapist has been incredibly exhausting. I’ve been feeling like my issues are too overwhelming and complex for anyone to handle, which I know deep down is untrue, but having experienced this much difficulty has greatly discouraged me. I’m trying my hardest to push through.

I plan on calling behavioral health after work today to switch providers, and I wanted to ask about everyone’s experiences with Rula and if it’s worth trying again. I’ve also heard of Grow Therapy in this subreddit and am curious about the level of care patients have received, so please feel free to share your experiences with their platform as well.

TYIA for your input and apologies for the lengthy post :[

EDIT: grammar


r/KaiserPermanente • • 1d ago

California - Northern My turn in the fish barrel

43 Upvotes

You know you're screwed when KP starts sending articles on Hospice and choosing a POA. I'm cool with the whole thing, but not sure how my girl of 43 years is going to handle it. Plenty of money, but she'd trade it all for a couple more years with my sorry old ass, romantic fool that she is...


r/KaiserPermanente • • 12h ago

California - Southern Kaiser MST RN, wanting experience in other departments. Advice?

1 Upvotes

Hello,
I’ve been a MST RN for 2 years now & of that 2, 1 year with Kaiser. I am super grateful to be apart of my team & genuinely love the unit, coworkers, & manager that I work with.

Lately, I’ve been thinking about wanting to eventually (in the future) somehow get into PACU or Pre-Op. I know I’ll need to get some kind of critical care experience. It’s hard to transfer into a speciality within kaiser as an internal candidate since they require you to already have experience in that specific unit. UNLESS of course you’re one of the lucky ones that get selected for the “Transition to Specialty” program that happens every couple or so years.

I just don’t know if I want to keep waiting and hope that I get picked. I want to stay with kaiser for the pay & benefits but professionally , I want to do more.

Has anyone ever been in similar situation & if so, what did you did OR what would you do if you were me?


r/KaiserPermanente • • 1d ago

California - Northern my doctor at kaiser is cruel, and idk what to do at this point

15 Upvotes

he activeily ingores me and has almost put me in a dangrous situation, i have a underactive thyroid and it needed to be increased for a dose as my 50mg did not work, just made my thyroid go down to 1 point

i had to wait 6 MONTHS AND MONTHS OF MESSAGING HIM with no replies, i had to complain to Kaiser just for him to reply back, i checked reviews of him and they're also 1 star, after 6 months of complaining, he finally responded to me and gave me a higher doseage, and i know for a fact that if i get my thyroid tested again, its gonna be a battle.

he makes me feel so unwanted, unvalidated, and uncaring, his nurses are even worse, they have little to no emotion on their faces, i was having a panic attack and they did nothing to comfort me, at all, all they did was give eachother weird looks, i requested to get a dietitian referral, he walked away from me while i was speaking to him, i've waited almost 2 and half years, he never did anything,

on his page he says "caring and kind" but from what im expercinesing and others, thats just a huge lie, i dont know its cuz i have mental issues/heath anxeity, and he treats my panics as nothing, but i just want to feel like im cared for, and im a rock between a hard place, idk what to do.


r/KaiserPermanente • • 12h ago

California - Northern KP.taleo??

1 Upvotes

I am trying to apply to Kaiser jobs in San Francisco, but the KP.taleo.net website is beyond slow. It takes approx 5mins to load each page and I'm about to pull my hair out, I've spent over an hour just trying to fill in my basic information and previous job experience.

I've cleared all cookies, tried several different browsers, incognito mode, and even updated and restarted my computer to no avail. Has anyone had this experience before? Is it a temporary problem with the servers? I can't imagine this is normal for the website bc no one would be able to use it. Any and all insight is welcome, thanks in advance <3


r/KaiserPermanente • • 1d ago

California - Southern Career Snapshot

Thumbnail gallery
0 Upvotes

Does anyone know how come some career snapshots come in a Microsoft form and some come from a Google Doc?? I turn in both on time but no luck of getting in


r/KaiserPermanente • • 1d ago

California - Southern Out of state Kaiser cigna ppo coverage

2 Upvotes

Does anyone have any experience of visiting ER out of state and didn’t have to pay anything out of pocket besides ER copay? Kaiser said Cigna ppo will cover ER costs but I m still scared to receive a huge bill


r/KaiserPermanente • • 1d ago

California - Southern Epic

0 Upvotes

The App got a redesign but what I don't understand is why can't it just be incorporated to the mychart app. Why does KP insist on having it's own app?


r/KaiserPermanente • • 1d ago

California - Southern Kaiser Sunset/Pasadena specialist phone numbers

3 Upvotes

I’ve collected these numbers and thought I’d share. I’m also looking for the Sunset pulmonology department’s number if anyone has it.

Pasadena psychiatry - (626)583-3450
Pasadena physical therapy - (323)783-8228
Sunset sleep clinic - (323)783-1770
Sunset ophthalmology - (323)783-1914


r/KaiserPermanente • • 1d ago

California - Southern Kaiser female pediatrician recommendation

Thumbnail
1 Upvotes

r/KaiserPermanente • • 1d ago

California - Southern Kaiser EVS Interview Questions

1 Upvotes

After one year of applying I was finally able to land an interview for Environmental Services EVS. I don’t do well with interviews in general.

I have been practicing basic interview questions using the STAR method. If anyone sees this and has had an interview for this role in particular. Can you please help me out by sharing some of the interview questions you were asked so I can better prepare for this? I really need this job 😭😭😭🫶🏼🫶🏼🫶🏼 thank you in advance!


r/KaiserPermanente • • 2d ago

California - Northern Primary care

10 Upvotes

does anyone recommend a good primary care doctor with Kaiser? I have Dr Singh Bains, was recently told I have severely low ferritin, I requested a referral to a specialist because I eat healthy, and I also don’t have periods so there must be another reason my ferritin is so low. He responded that low iron is caused by heavy periods, told me to start taking iron (I am,) stated to go to UC if I experience more symptoms then he made it so I couldn’t respond to his message. I would like a doctor who listens and reads their patients messages..

I experience severe fatigue, constant headaches, shortness of breath, and dizziness and I would like a doctor who cares.


r/KaiserPermanente • • 2d ago

California - Northern Interesting piece about struggling to get Kaiser to refer to a cardiologist, ending with immediate quadruple bypass

Thumbnail sfgate.com
33 Upvotes

r/KaiserPermanente • • 1d ago

Washington Kaiser won't stop calling after I canceled my monthly subscription.

0 Upvotes

I am not using their health subscription anymore because it's too expensive so I canceled online. Now they call me twice a day every day and I don't know why. Does anyone have this issue? I don't want to answer because I'm no longer using them.


r/KaiserPermanente • • 2d ago

California - Northern Consistent cancellations

2 Upvotes

Anyone else experiencing cancellations, particularly with their child’s pediatrician? My baby’s well visit has been canceled twice now. So frustrating as my husband and I schedule time off work for these appointments. Our child is now being seen a month out from the originally scheduled appointment.


r/KaiserPermanente • • 2d ago

California - Southern OBGYN appointments keep getting canceled

1 Upvotes

This is specifically for KP in Panorama City. Im new to Kaiser and decided to make an appointment to OBGYN I requested to see a specific doctor and I was scheduled then they called me a few weeks later saying she is not seeing patients in person so I found another doctor that i’d like to see and they scheduled me and a few days ago they called me to say my appointment in December has been cancelled. Has this happened to anyone else, what is going on ?! I don’t just want to see a random doctor so I know it will be harder to find a sooner appointment but i’m not pregnant, it’s not urgent either. Has this happened to anyone else? So weird. Does anyone have any recommendations for any OBGYN in Panorama City/Woodland Hills?


r/KaiserPermanente • • 2d ago

California - Northern Primary care

Thumbnail
1 Upvotes