Switching to Kaiser So Cal

[Breathe Jimbo]

No choice. I have some questions for anyone currently covered by Kaiser So Cal.

If one has already had a sleep test and is already on CPAP, does Kaiser accept the status quo or require a new sleep test?

Which DME does Kaiser So Cal use?

Problems getting a fully data-capable machine? (My current one is good but will not last forever.)

Any special tricks for manipulating the Kaiser bureaucracy?

[chunkyfrog]

You may be able to find out on their web page.
At least, call them up.

[2 B Sleeping Soundly]

No choice. I have some questions for anyone currently covered by Kaiser So Cal.

If one has already had a sleep test and is already on CPAP, does Kaiser accept the status quo or require a new sleep test?
I don't know about how Kaiser deals with incoming patients who already have their SA/OSA being treated. You would probably have to ask your primary doctor, go to the website, or call them like Chunky Frog suggested. For me, Kaiser was the one who diagnosed me and used a in-home system called Alice PDX for determining my SA/OSA diagnosis: http://www.healthcare.philips.com/us_en ... efault.wpd. This was done on one overnight and returned the next morning. A week or so later a in-home titration followed using a PR System One Auto CPAP 550P for three nights. From what I have seen, Kaiser only gives out PR System One machines, and mine was a Auto CPAP 550P machine just like the one I used in my titration.

Which DME does Kaiser So Cal use?
Kaiser is its own in-house DME. I call Kaiser to order my supplies when my Insurance plan with them designates which is every 6 months (yours might be a different interval depending on your Insurance plan or replacement needs) and Apria is the supplier who ships out the supplies to you.

Problems getting a fully data-capable machine? (My current one is good but will not last forever.)
Not for me. If I remember right, in my pre-titration appointment where they show you how to do the set-up of the machine at home, adjust the mask, etc..., the RT said that all of us (there were about 7 - 8 other patients that were also in the room) would be receiving the same model/type of machine that we were taking home to titrate with, and every one of them were PR System One Auto CPAP 550P

Any special tricks for manipulating the Kaiser bureaucracy?
No, nothing other than the normal things like having to be proactive in your own therapy (Kaiser had a lot of people coming and going with the in-home Alice PDX bags and the in-home titration machines, when I was there over a year ago, so I think they are good with the initial diagnosis, good with the set-up, and just like most of the other medical providers, very poor with follow-up. I guess they figure if you have any problems that you will contact them and set up an appointment (or go to somewhere like this forum to get some 'real' help ). I also have to call Kaiser to get my supplies every 6 months as they have not shown that they will call me to remind me that it is time (I have only had two opportunities to re-order supplies since starting PAP therapy, so there isn't a long track record to show that this is how they will be every time... but they probably will <sigh>

[Janknitz]

I have Nor Cal Kaiser and I must say they've been pretty good. I email the sleep lab RT when I have a problem and they'll see me pretty quickly. They check the card to see what's happening and have lots of sample masks to try on and take home if its a mask issue.

[Breathe Jimbo]

Thanks. I was worried that the forced switch to Kaiser would be a death sentence, but from what I've been hearing and reading they are not so bad. There may even be unexpected benefits from the tight integration across the board.

[cosmo]

z

[Leland]

No choice. I have some questions for anyone currently covered by Kaiser So Cal.

If one has already had a sleep test and is already on CPAP, does Kaiser accept the status quo or require a new sleep test?

Which DME does Kaiser So Cal use?

I switched to Kaiser NorCal two years ago and they accepted my earlier CPAP results. When I wanted nasal pillows instead of a mask, I had to go to the Sleep Lab for a fitting. Now I simply call Apria and they send out replacement masks/tubing/chin-strap. My old CPAP broke last week so I called Kaiser's DME number and they are shipping me a new machine using Apria's listed setting values. The only problem is that the System 60 CPAP they are sending me does not have a humidifier, so I had to call the Kaiser's Sleep Clinic and they are asking Apria to now ship a humidifer with heated hose. Kaiser said I may have to pay part of the humlidifer bill, depending on my insurance contract.

[Janknitz]

Kaiser has it's good points and bad points. As a professional working primarily with seniors, I see many things that are troublesome. And in general you must be a strong advocate for yourself (and family members) for things that are not routine.

But the integration is good. I can email my doctor anytime, and he's very responsive in getting back to me (BTW, it's IMPOSSIBLE to get that kind of response by phone, so seniors who are not web savvy lose out). I like being able to access lab results and visit notes online, make appointments online, and I order my med refills right in the bathroom on my smartphone as I refill my weekly medi-set.

Here's something surprising. If you have an unusual condition that requires specialist care, you often have to fight, HARD for the referral, but once you get a referral, I can't believe how quickly I get in to see specialists. With my daughter it's especially noteable. She sees several pediatric specialists and I can often make same week appointments--outside of Kaiser it could take months to see a pediatric neurologist, for example. The downside is that we have to travel as much as 2 hours to other Kaiser facilities to access some specialists. When we arrive at these clinics we are often the ONLY ones there, and the specialists have plenty of time to spend with us. I think that it's so hard getting a referral in the first place, that the specialists tend to be underutilized. But once you get in to see one, it's to your advantage. And they don't seem to hesitate to spend oodles of money on diagnostic tests for specialists, but I can't get some very basic tests from my PCP because Kaiser doesn't want to spend the money on them (e.g. Free T3 and Free T4 thyroid hormone tests). Another example: instead of the routine echocardiogram from the cardiologist, they did a cardiac AND brain MRI. Seemed like overkill to me.

And because they have routine protocols for everything, it can be a problem if you don't fit their protocol. I have great cholesterol numbers except for LDL, which is calculated incorrectly by their labs. So they are really pushing statins on me based on that incorrect number--my cardiologist loses "quality assurance points" if he doesn't prescribe them for me. Meanwhile there's another medication I need to take more of but it doesn't fit their protocol so they refuse to prescribe the therapuetic dosage. I haven't done this yet, but it's easy enough for me to ask my SIL who is a doctor to prescribe the medication that I can buy at Walmart or Target pretty cheaply. Sometimes you just have to do your own workarounds.

I'm also going to pay out of pocket for a NMR lipid profile and CRP test, because Kaiser won't do either, but they are much better indicators of cardiac risk then their routine lipid panel.

[Tunapalooza]

No choice. I have some questions for anyone currently covered by Kaiser So Cal.

If one has already had a sleep test and is already on CPAP, does Kaiser accept the status quo or require a new sleep test?

Which DME does Kaiser So Cal use?

Problems getting a fully data-capable machine? (My current one is good but will not last forever.)

Any special tricks for manipulating the Kaiser bureaucracy?

I just went through this last month. Kaiser has more than one sleep lab, so my experience may not be the same as yours. At my initial meeting with my new Kaiser physician I explained that I had been usinf CPAP for seven years. He referred me to the sleep lab. I arrived at my sleep lab appointment with a full data card from the Respironics machine I had been using for a couple of years. The data was recovered and it showed excellent compliance and an average AHI of about 5.5. While a treated AHI would appear to validate my sleep apnea, I was nevertheless given a take home device for a sleep study (Itamar WatchPAT) without CPAP. It was a horrible night's sleep, if any. AHI=77. No REM or deep sleep noted. Oxygen min=81, avg=92. That study, in my view, was medically unnecessary. And if a study was required (for whatever reason), it should have been monitored and not at home.

My advice: If you've been on CPAP and they want to do a sleep study, insist that the study be monitored and not at home.

On my return visit, I was provided with a new Respironics Series 1 with a heated humidifier. In NorCal, Kaiser uses Apria for supplies, but I dealt directly with Kaiser for the machine. After one week, my average AHI is still about 5.5. However, I found that the heated humidifier did not work well. I'm accustomed to a setting of 1 or 2. On the new unit a setting of 5 was needed to get anything close to warmth under the water tank. I've now been provided with a new model humidifier with a heated hose on a trial basis. However, still no joy on the heating. I suppose the fault may lie in the main unit.

Kaiser has been very reasonable on the provision of equipment.

Marc

[Janknitz]

That study, in my view, was medically unnecessary. And if a study was required (for whatever reason), it should have been monitored and not at home.

My advice: If you've been on CPAP and they want to do a sleep study, insist that the study be monitored and not at home.

To my knowledge, that just doesn't happen with Kaiser unless you have the home test and continue to have problems.

Tuna, the new Respironics humidifiers don't put out a lot of heat, period. You can switch them to "classic mode" in the clinical menu, that helps. But the way the humidifiers re designed, they re able to prevent rainout without too much heat, so they don't warm up much. It will take some getting used to, and at least it got you the heated hose model.