Kaiser reimbursement - out of network

In Dec 2024 we moved temporarily to Missouri, since the move was temp we didn’t switch any medical providers, considering we contacted Kaiser to ensure we would be covered- they said only for ER and Urgent Care visits, which was perfect for us. Come Fed 2025 we had 2 ER visits. The first one the hospital had issues billing Kaiser- why? I’m unsure. We provided them everything needed. But this post is to just give a timeline as to how the reimbursement process works, since I couldn’t find any details online. I’m posting this to possibly help someone in the future who may have questions about timelines.

So in March we got a bill for both visits totally about 7k. We contacted KP claims, one person suggested sending them the bill or paying out of pocket and submit for a reimbursement. We did send the info to KP and never got an update. So in May we ended up just paying since we would get our money back anyways… Kaiser ended up “voiding” the original claim because the claim person didn’t read all the papers I provided after a week of submitting it. We got in contact with a supervisor and she worked on it for us for about 2 weeks, and called on. Tuesday and said the claim was approved. On Friday morning we got a TEXT MESSAGE not an email like we kept being told to look out for to accept payment. We accepted it with instant payment and the money in our account within minutes. Our turn around time was a total of 28 days from submitting the claim and receiving payment in our account. When you submit the claim online it says it can take 30-45 days for approval.

I hope this helps people with questions like I had and could never find any details online.