Posts tagged Kaiser

Question : Kaiser denied my Daughter’s Pediatrician’s request for a referral to an outside Dr @ Stanford Medical? Help.
My 20 month old daughter may have Rheumatoid Arthritis. We need to go see Kaiser’s pediatric rheumatoid specialist. He is located at Kaiser’s Oakland facility but is only there 1 day a week. According to my daughters pediatrician we need to get my daughter in for an appt within a week or two since the swelling in her knee is so severe it might cause permanent damage to her leg if left untreated too much longer.

Due to the Dr only being in Oakland 1 day a week our appt is not scheduled for a month. If we want an appt sooner Kaiser said we need to travel to Sacramento (where the rheumatoid pediatrician is stationed). Sacramento is 3 hours away!

My daughter’s pediatrician put in a referral for us to see a Dr at Stanford Medical which is only 45 minutes away and they can see us within the two week timeframe. Problem is Kaiser denied her referral. I am going to appeal it. Please give me some pointers on going about the appeal process and what I should say.
I do not live in Oakland, I live 20 minutes south of San Jose.
kaiser permanent

Best answer:

Answer by Wildman2043
Kaiser can be a pain in the butt!! If they sent you to this pediatrician and he refered you to the Dr. at Stanford, I would first get a copy of that referral, to confront them with at the appeal. also a copy of the ped’s reports on the severity of the condition. If that dosen’t help prepare to see a attorney to file a law suit against Kaiser. Sorry I could not be of more help …..good luck.