Janknitz wrote:
This is how Kaiser works.
Oh. OK. Whew!
I thought maybe sleepyhead printed something private in the sleepyhead reports that I showed above.
I wonder how the OTHER insurance companies do it then?
Anyway, here are my first two night's reports, so far:
Friday May 20th to Saturday May 21st 2016:
Page 1.
http://i.share.pho.to/d5dce325_l.png
Page 2.
http://i.share.pho.to/4b5d345b_l.png
Page 3.
http://i.share.pho.to/89d1a9d9_l.pn
Janknitz wrote:
There is a doctor you will never see. The sleep lab techs do it all under the "supervision" of the sleep doctor (who basically rubber stamps what they do after the fact). However, IMHO the techs are pretty good and unless you have some sort of complex issues there's really no need for the MD.
You are 100% correct that there is a doctor's name on the paperwork, but I have never seen that doctor, even though I've been there three times now.
The tech told me she'd give me a machine in a week to keep, so the one I have now is just a 1-week loaner machine.
I just want to make sure I request the right stuff.
1. I don't know if cpap or bipap is appropriate (nor do I know how to tell).
2. I don't know if they will give me a machine that records data (but I want one)
3. I don't know if they give me an automatically adjusting machine - but that's probably what I want.
Janknitz wrote:
You do need to understand that Kaiser is your healthcare provider and your insurer and your DME. They contract with a supplier, Crapria, to provide your equipment and supplies, but the buck starts and stops with Kaiser. That means a total lack of choice on your part unless you want to pay 100% out of pocket--in which case you can get whatever you want from wherever you want at your own expense. Kaiser will NOT reimburse you for out of network or off prescription purchases.
Ouch. I didn't know that.
I've never had Kaiser before.
Does that mean I can't ASK for the three things above?
1. Bipap (if that's better)
2. Data recording
3. Automatic pressure
Janknitz wrote:
Even mask choices are limited and prescribed (you can only get the mask prescribed for you from Crapria) but their formulary has most of the best and most popular masks.
That is good to know.
MY insurance runs out in two months, so, I won't get a chance to get a second mask from them, so whatever they give me as the first mask needs to be durable as the tech said they only last six months (and I won't have any insurance in six months unless I find a new job by then).
Janknitz wrote:
So Kaiser will decide what type of machine you need and prescribe the exact make and model they decide you will get. You have no say or choice in the matter. That's not necessarily a bad thing. The machines they prescribe are all fully data capable because they will monitor you as needed to help you optimize your therapy. Although compliance is a concern, they also care about efficacy and optimization of treatment because they get that it's in Kaiser's best interest as your insurer.
If they give me an automatic machine with data monitoring then I should be fine, right?
Janknitz wrote:
They used to deal exclusively in Philips Respironics machines but this February I needed a replacement machine and it was the top of the line ResMed Airsense Auto. It may be that they are still using the PR's for home titration in your region, or you may be in a region still prescribing PR machines.
The tech only said that the machine that I get will be "better" than the one I have as a loaner, so, I'm not sure what brand it will be yet.
