Kaiser Ins and Apria

[chunkyfrog]

I wonder if Kaiser's Medicare plans are that way too.
NO WAY I would go with them if that were the case.

[Janknitz]

As far as I know, Kaiser Advantage (Medicare) works the same way except they may "rent" the machine rather than purchase outright. But choice is not an option.

[chunkyfrog]

THEIR choice is not MY option.

[Janknitz]

Yeah, one other common term describing this Medicare "option" was Medicare "choice" (for "Part C"). NOT

Kaiser is a mixed bag. They handle some things very well (their system is OK for run of the mill OSA, they do a good job with asthma management, their electronic system rocks) and some things suck. You must either be a strong self-advocate or have a family member who is. I've also found the only way to succeed with greivances is to "know somebody"--I've been fortunate to have that work in my favor personally and professionally, but it should NOT be that way.

When my DH got this job which offers ONLY Kaiser insurance, I urged him to quit because of it--they gave him a raise to keep him on and we've been stuck with Kaiser since. Until recently, I would have jumped at the chance to get off Kaiser, but they've so infiltrated the local medical economy that there's not much left outside of Kaiser. Physicians have either left the area or joined Kaiser because there were no other options (so at least some very good physicians from the practice I went to for 25 years are now Kaiser doctors). People who are not Kaiser can't find doctors, and wait weeks for tests and specialists. The few doctors left are hanging on until their imminent retirements.

[MAXDRI]

Hi Janknitz,
I think Kaiser will prescribe more than one brand of equipment. I had a Respironics for several years and two months ago the Sleep doctor who analyzed my latest Titration study ordered a ResMed S9 Vpap Adapt. It caused me some problems at first and when I complained, she ordered a different one. Then I decided I liked the Vpap Adapt, so the doctor said to just decline the new one. Very flexible and accomodating, I thought. Kaiser has always rented the machines for me (at $400.00 a month). When I asked the Kaiser DME why they rent instead of buy, the person I asked said that if they rent, Apria will take care of any repairs or replacements needed. No doubt easier book-keeping for everyone? I agree that Apria is indeed Crapria. But they seem to be the company with the most offices. Maybe that is why Kaiser contracts with them?

[Janknitz]

I think Kaiser will prescribe more than one brand of equipment. I had a Respironics for several years and two months ago the Sleep doctor who analyzed my latest Titration study ordered a ResMed S9 Vpap Adapt.

It may depend on the region you're in--seems like different regions have different policies. I think there's also a possibility that Northern California may have recently switched to ResMed, but I'm not positive.

Crapria is a big, national company and they can accomodate Kaiser with a volume discount. It's not necessarily all bad--it does save money if you have to pay out of pocket (depending on your Kaiser DME coverage or lack thereof), and my 20% co-pay was pretty low.

[kaiasgram]

I think Kaiser will prescribe more than one brand of equipment. I had a Respironics for several years and two months ago the Sleep doctor who analyzed my latest Titration study ordered a ResMed S9 Vpap Adapt.

It may depend on the region you're in--seems like different regions have different policies. I think there's also a possibility that Northern California may have recently switched to ResMed, but I'm not positive.

Crapria is a big, national company and they can accomodate Kaiser with a volume discount. It's not necessarily all bad--it does save money if you have to pay out of pocket (depending on your Kaiser DME coverage or lack thereof), and my 20% co-pay was pretty low.

Holy moly, nobody at Kaiser including the Benefits dept. told me that I could buy my machine through Kaiser for less even though I have to pay out of pocket. Score another one for Kaiser.

As of June, KP in Sacramento CA was ordering PR machines for everyone, but I don't know what model. Interesting because they use ResMed autos for home-titration.

[Java]

As of June, KP in Sacramento CA was ordering PR machines for everyone, but I don't know what model. Interesting because they use ResMed autos for home-titration.

I was sent home with a System One RemStar Auto with A-Flex (550P) for my home-titration, and it's also the model they used in the mandatory group class to show us how to clean it and such... Maybe that is what they will give me. I'm waiting for UPS to bring my mystery machine.

[Janknitz]

Kaiser Santa Rosa has all Respironics machines for titration and I still see dazed people walking around the clinic with Respironics bags.

[kaiasgram]

Kaiser Santa Rosa has all Respironics machines for titration and I still see [img]dazed%20people%20walking%20around%20the%20clinic[/img] with Respironics bags.

Except for the Respironics bag, that would be me!

[Java]

I just got my mystery machine! It's a System One RemStar Plus with C-Flex. It has the humidifier as well. So I hope I got a good machine.

[Pugsy]

I just got my mystery machine! It's a System One RemStar Plus with C-Flex. It has the humidifier as well. So I hope I got a good machine.

Turn it over and look on the bottom for a sticker with the model number on it.
250 or 260...That is the PR System One Remstar Plus with CFlex and it only gathers compliance hours of use on that SD card.

For full efficacy data you need minimum of 450 model number.

If it is a 250 or 260...they gave you a brick.

[Terresac]

Thank you for all the posts from last Sept. I am new to CPAP, machines, masks and yet another department in Kaiser, northern Ca. I was "diagnosed" by the PAT device, two finger probes. A sleep doctor (who works in the ER) called with the results. I really liked speaking with him, he seemed to understand the severity of my sleep apnea (70 AHI). Then I had an appointment with a respiratory therapist, I thought I was going to see a doctor. NOT. Although she was nice, it seemed as though she had little experience with CPAP machines and masks. I found out more in a week on the Internet than she ever knew about fitting. She sent me home with a Remstar Auto A-Flex with a humidifier. When I asked if I could have access to the data (after she told me that in 3 mos I'd be mailing the SD card back to her), she laughed and said, "No that's not necessary, people get hung up on numbers." So I came home, used the machine for a few days, then took out the card and downloaded the data on my computer. With the online Onkor software, I managed to hack the data. Now I have to learn what it all means! I've asked several times for a copy of the data from the baseline PAT test. Nothing. I keep getting the same tests results from her. She has locked the machine from me accessing the data on it.

So here's the issue - Kaiser's entire sleep department here consists of 2 part time therapists, no doctors involved at all. How can a therapist write a prescription? When I asked for a copy of my prescription, I was told to go to my primary doctor. The therapist gave me a free Eson mask that I really love, but don't know if Apria carries it or not. The formulary is secret, even this office doesn't know what's on it. When I asked I was told that Kaiser contacts the DME (also Kaiser) and they determine what you "need." Then Apria ships it to you. THERE IS NO PATIENT INPUT AT ALL.

For something as important and life saving, why isn't there a better system?

[cosmo]

Thank you for all the posts from last Sept. I am new to CPAP, machines, masks and yet another department in Kaiser, northern Ca. I was "diagnosed" by the PAT device, two finger probes.

I've asked several times for a copy of the data from the baseline PAT test. Nothing. I keep getting the same tests results from her. She has locked the machine from me accessing the data on it.

The formulary is secret, even this office doesn't know what's on it. When I asked I was told that Kaiser contacts the DME (also Kaiser) and they determine what you "need." Then Apria ships it to you. THERE IS NO PATIENT INPUT AT ALL.

For something as important and life saving, why isn't there a better system?

I was given a copy of the results from my PAT test. They handed it to us when we went for the 2nd class, the titration class where they gave you the cpap tester machine to bring home.

My Kaiser Respironics 560S machine is also unlocked, I've adjusted it. For the mask, I asked for nasal pillows, they said ok. They asked about my size even though the package has all the sizes. I was even able to pick Swift FX and Swift LT. I don't know what else they carried but Kaiser does know and they have always been good for me. They are very hands off but gives me what I want and are there when you need them

Are you under Medicare, employer sponsored insurance or self purchased?

[Pugsy]

Check out the links that I have in my signature line...especially the Glossary to help you understand the terms.

You might also check out the PR S1 software options thread.

SleepyHead and EncoreBasic are much easier than using Onkor.

Look on the bottom of your machine for a 3 digit number that is the model number...if 60 is the last 2 numbers you will need the Patch file to get SleepyHead to work with your machine...the 60 means it is a 60 series machine.
If it has 50 as the last 2 numbers you don't need the Patch file.
Patch file discussed here
viewtopic/t83551/SleepyHead-Series-60-Patch-Avail.html

Welcome to the forum...when you have figured out exactly which model machine you have please take the time to add your equipment to your profile.
For the Remstar machine you have...look for the grouping that starts with PR System One.xxxx.
wiki/index.php/Registering_Equipment_in_User_Profile