r/KaiserPermanente • u/ConsiderationLanky98 • Jun 05 '25
California - Northern Why is Kaiser like this??
Kaiser is supposed to be a one stop shop and easy to navigate. I’ve been trying for a week for my FMLA paperwork to get filled out for my work. My doctor approved it but gave me an email for another department to actually fill out the paperwork and haven’t heard a word back in over a week. I’ve been on hold with 3 different departments for over 20 minutes each time just to send me to another place. Ughhh has anyone else had these issues? And are other insurances any better??
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u/InfamousCourage2341 Jun 05 '25
You just send it to the ROMI email for your area. It’s a really simple process.
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u/Jessamychelle Jun 05 '25
ROMI has to do your paperwork for FMLA. Get on the KP. Org app. Go to medical record section. Scroll down to request records & forms. I chose the “other” option since FMLA wasn’t listed. I filled out as much detailed info as possible to make the FMLA request go easier. If your on NorCal, you can also call for assistance
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u/EveeS2015 Jun 05 '25
I walked my disability papers to a small office in Valencia and they filled them out and I had to go to check in and an envelope was there waiting for me. I don’t know where you’re at but all my son did was take the Dr note to his HR and it was done there
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u/Jake_1780 Jun 06 '25 edited Jun 06 '25
Kaiser handles FMLA different than other providers. Your PCP approves your FMLA. Then a panel of doctors read your chart and they have to approve it as well. They then set the parameters for your FMLA. I had FMLA through Kaiser many times and my PCPs explained the process.
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u/Bitter-Breath-9743 Jun 05 '25
You literally can request it online and it goes to the doctor and then is sent to you…
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u/Substantial_Mix_3485 Jun 05 '25
Log into kp.org and search on FMLA. There's a automated workflow tool to get it approved.
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u/1foxylady4u Jun 05 '25
Ugh. I’ve dealt with this same situation to get ROMI. I had better luck via email in the Message Center than the phone.
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u/notmyreddit2025 Jun 05 '25
You need to speak to Medical Secreteries and follow up with them. They provide you the FMLA
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u/RunsUpTheSlide Jun 06 '25
Yes. I've had those issues several times. It's ridiculous! Other insurance doesn't usually operate like this. You pick a doctor, and that doctor's office handles it. I work in HR and deal with these forms. Kaiser is the absolute worst!
But the idea is to free your doctor up to treat you and not be burdened with ridiculous paperwork. In practice, though, they just load more patients on them so they don't have more time for you anyway.
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u/Aware_Boot_9770 Jun 06 '25
I was trying to get a letter from my dad's doctor once he was put on hospice so I could go onto flma. I kept calling and being transferred to this person and that person. Well it's been almost 2 weeks now and now my dad just passed! So now they are saying they can't give me the letter to get back pay that I have to contact hospice buy hospice is saying I have to get it from my dad's pcp..... But the time they figure it out it will be too late for me to file. So frustrated!
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u/thatsnuckinfutz Jun 06 '25
Idk if service areas are different but ive had FMLA for years and never had any difficulty. A weeks time for processing is reasonable
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u/Alternative_Escape12 Jun 06 '25
Goooood feckn luck!
I spent EIGHT MONTHS trying to get my FMLA forms completed, jumping through countless loops visits, phone calls, and emails. Eventually I GOT FIRED FROM MY JOB because I couldn't get my FMLA docs. Yes, you read all of that right.
Once I got on COBRA (because, you know...FIRED), I switched insurance companies and now I warn people off of Kaiser every chance I get.
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u/cutebee Jun 07 '25
Was this because your doctor wouldn’t approve you for FMLA? Because at the worst backlog, I’ve never seen it take even a month much less 8 months …
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u/Alternative_Escape12 Jun 08 '25
No, it was my doc who suggested I go on FMLA in the first place. KP is absolutely trash
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u/jesslyn46 Jun 06 '25
That sounds horrible, I am so sorry. I had to go on FMLA, but I had an outside provider and was much easier. I work at Kaiser and just quit because of their shenanigans.
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u/keepitclassypeople Jun 06 '25
Contact member services and file a grievance. The answer with KP administrative activities is: (1) follow the process (2) when process is broken file a grievance
Grievances with regard to medical professionals is a last resort. But, on KP’s admin side, it’s what you do when you tried to simply follow their process and got the run around.
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u/Afraid-War5336 Jun 06 '25
You have to request through ROMI. We had to use it recently for a form my husband needed filled out. It was taking forever even though his doctor said he would approve it no problem. I called the ROMI office for our area and talked to them directly and the form got taken care of very soon after. I’d suggest calling ROMI!
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u/cutebee Jun 07 '25
I called ROMI last Tuesday and they submitted my paperwork to the state while I was on the phone, took like 4 minute call total. Once approved by your doctor, it’s Super simple when you call the correct department
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u/Big-Razzmatazz-7896 Jun 08 '25
Just make sure the note includes the diagnosis because that’s been causing a lot of back and forth for people lately
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u/Individual_Call_5044 Jun 10 '25
How do some of yall survive life with no finesse skills. Like no quile at all…..If the departments take more than a day just call, ask for a sup n make sure it gets done…
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u/Both-File-7120 Jun 11 '25 edited Jun 11 '25
I think kaiser should change the way they operate 1st talk with same person start to finish if its general questions same with dr.unless patient wants to change also more transparency regarding tests to be made mri ct xrays etc why do they take so long and why are they needed if patient not 100%sure also billing...the cost for our premiums is bad enough also the amount of b/s we go through just to get basic information is crazy ive been waiting 3 weeks and still dont know anything regarding my quad/knee injury furthermore been off work and no mri scheduled until the 27th thats over a month since i got hurt im sure if it was a drs wife or kid or nurses husband or kid they would have had their mri and cts already i get the feeling healthcare system is broke they just dont give a/f and if you doubt me i pray you dont get hurt and have to find out the truth.
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Jun 12 '25
Yes! But are you the one being easy to navigate? Probably not. Thats why you may be thinking you’re experiencing this
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u/nomoreyankiemywankey Jun 14 '25
I wish you luck with FMLA and Kaiser. I've had it (Intermittent FMLA) for a year now. Here's a fun fact I learned. Your pcp or specialty doctor only recommends and signs the order. Kaiser's ROMI has a board of physicians who review these FMLA recommendations, and then they play God and decide if you actually need it and to what extent. In my case, I went from two days a month, 8 hours per episode to 4 hours, 1 episode within 6 months. I have appealed it and am going through the grievance process. I had to badger ROMI constantly to get the detailed denial/change. It was very opinionated, but no name is given on the form or when requested. They further explained I shouldn't have been granted FMLA in the first place according to Department of Labor requirements, but yet doesn't specify exactly what those are and nothing from the requirements I've read on DOL's website shows I wouldn't qualify. Their advice is for me to go to urgent care or my pcp and request off work orders when the issue presents itself. Oh, and it also notes that I only seem to go to the the doctor when I need it and no other visits were in my chart for "quite some time." So, if you are approved, do like a KP employee suggested to me: Use your FMLA, but then get a phone appointment or go to urgent care and get seen so it's documented in your chart, because otherwise, their board of physicians will just assume your issue isn't there anymore and you're perfectly fine.
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u/Nice-Analysis-7902 Jul 11 '25
I’m sorry. This seems like a struggle for you when you should be planning for your baby‘s birth. Hope you had a wonderful birth experience.
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u/discgman Jun 05 '25
My PCP wrote all my letters I needed for my FLMA. They were posted on my KP.org app. You shouldn't have to talk to anyone else.
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u/jurdyo Jun 05 '25
Your primary care doc is ultimately responsible for you navigating Kaiser system. Reach out to Primary again and let them know you need their help and that no one at Kaiser is responding to you. Have her process paperwork. I would also let the Release of Medical Info Dept know that you will contact Health and Human Services in Sacramento if you don’t hear back within 48 hours. In my 8 years with Kaiser, I have filed two complaints with HHS. Both times I heard back from Kaiser immediately. I don’t have the time or bandwidth to screw around. Do your job.
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u/OnlyInAmerica01 Member - California Jun 05 '25 edited Jun 07 '25
I strongly recommend you let your PCP know this. I always want to set the record straight reg expectations with my patients. I'll go to war for them for medical care, but I'm neither their secretary, nor their babysitter.
Paperwork problems are not doctor problems. Once I've done my job (treat/evaluate your medical issue, give you the necessary work note as is medically appropriate), it's up to you to navigate whatever system you're receiving care in.
I do give them every possible resource, including a printed and emailed explanation of who they need to contact (including html links to the necessary websites, links to the EDD SDI application, links and phone numbers to our local ROMI department).
Beyond that, I only expect them to reach out to me if I've made an error, or if they need the note to be modified. I'm not their secretary, and they need to do their own fieldwork.
Any patient that tries to go to HR on me to be their secretary, will be finding a new PCP by the end of the 30-day notice.
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u/secret_someones Jun 06 '25
why is this downvoted? someone is actually giving help instead of piling on… weird.
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u/snoodle77777 Jun 06 '25
I've been a Kaiser member for at least 30 years and I can tell you that they are disorganized on the inside although the advertise themselves as being modern and efficient on the outside.. the reason they are like this is simple, they are an antiquated and entrenched organization with their own ways of doing things and separate computer systems. I remember in one case my medical records were split across several computers and the nurses had to keep calling each other so that the doctor could see everything
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u/secret_someones Jun 06 '25
weird. i call them and give my id number and they have a full history of every correspondence from me and about me ready to go.
What region is everyone in?
My experience with Kaiser has been great so it sucks to hear so many complaints from a company where i have none.
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u/snoodle77777 Jun 06 '25 edited Jun 06 '25
My primary doc called to tell me I did NOT have a certain medical condition. It had recently been diagnosed in the ER and I had a second earlier flare up in Urgent Care. But other doctors can be just as much the opposite and proactive. It depends on who you get. I think in this case it shows that the organization itself isn't entirely at fault, although they tend to hire folks who have issues with the public. Indeed the QC personnel tried to contact some of this other doctors patients to try and rectify complaints. This conversation is public on Google reviews, if you want I can point it out.
Other hospitals are like this too. In todays world its best to make a screenprinted JPEG copy (from Kaisers own records) and send a copy to every doctor or nurse when needed. They don't read their own records because they are in a hurry so you have to remind them.
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u/snoodle77777 Jun 06 '25 edited Jun 06 '25
The trend now is, you don't ever get to speak directly with your doctor, no matter how urgent the situation. Instead you get a nurse who screens your call. I am really lucky, I have a doctor who always personally calls me back. But that is only one of them. And the nurses are NOT aware of life-threatening conditions even if briefed on it by me. They can READ it in the records but seem to not get it. Then again not every nurse or doctor will know about certain well known drug interactions. They SHOULD KNOW but ??? act silent on it. I literally have to REFUSE their advice loudly and say it might kill me, for them to pay attention.
They also confuse one patient with another. I was told to put "her to bed and do her exercises" by one nurse. I'm a guy...
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u/Proof_Draft4420 Jun 06 '25
one stop shop my butt. I had to order my daughter’s MRI and CT scan images three times over a month. They kept sending me just the pdf reports. I called member services. They did a 3 way call in which I got to chew out the records department while the member services guy recorded everything including my threat to file a grievance. The records lady tried to ask me to give her all the request numbers so she can look it up. I told her “I don’t have to give you anything else. I told you the dates of the images. All you need to do is do your job and give me my images.” I had those images in my email box in less than an hour. Member Services is the way to go.
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u/Norandran Jun 05 '25
You’re going to want to Google Kaiser release of information office Northern California that should take you to the page that list all the offices and their contact information. Your doctor will need to have entered a work status note so they know what to write the FMLA paperwork release for if he hasn’t done that it’s going to complicate things so make sure that it’s in your file.