State Report Gives Kaiser Call Centers Green Light to Continue
Kaiser Permanente's call centers do not permit unlicensed workers to provide medical advice to Kaiser members, according to a California Department of Managed Health Care report posted online Friday, the Sacramento Bee reports (Dahlberg, Sacramento Bee, 5/5).
The investigation centered on Kaiser's use of scripts that call center personnel follow when taking calls from members. Call centers are staffed with non-medical professionals as well as nurses and doctors.
DMHC's investigation was sparked by a nurse voicing concerns that call center staff were not handling calls appropriately, increasing the possibility of members receiving inaccurate information and having their care delayed (California Healthline, 1/21).
DMHC Report Details
For the report, DMHC spokesperson Lynn Randolph said that department staff:
- Interviewed three senior phone representatives at Kaiser;
- Listened in on nine calls; and
- Reviewed Kaiser documents, including training and policy manuals.
The report concluded that Kaiser staff do not deviate from their scripts to provide medical advice to members.Â As a result, call center operations can proceed as usual.
However, the report said the department "does have some level of concern" because Kaiser telephone representatives can decide which script they deem most appropriate for each caller.
DMHC will review Kaiser's audit reports of call center performance for the next six months.
In its investigation, DMHC did not address whether Kaiser Permanente was in violation of a 2003 law that bars people without health care credentials from using patients' answers to questions to determine how quickly someone receives medical care.
Randolph said DMHC's investigation was focused on "examining a complaint that people were unfairly or improperly giving medical advice." She added that because the investigation determined that no improper advice was given, DMHC "did not raise the investigation into that higher level" of Kaiser's compliance with the law (Sacramento Bee, 5/5).The report is posted on DMHC's Web site (.pdf). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.