Insurance Frustrations + CPAP purchase

[123.Shawn T.W.]

Hmm, I might try lower pressure tonight. I'm stuck between a rock and a hard place as the mask's vent is pretty annoying at 9. It's pretty much silent at 6, but I feel like I'm suffocating.

I would use the lowest pressure that is comfortable ... Right now you just got to get use to the machine and mask!

Even if it shows an ahi of 15 ... You need to be comfortable before you can sleep with this new device ... Then after a week or so gradually increase the base pressure.

I too went the do it myself route, as I got tired of waiting ... I wanted instant results, and I learned that one night does not set a standard ... Get use to the mask and machine and make small changes over time, give yourself atleast 3-4 days before you make a change!

I just re-evaluated using A-Flex ... Originally when I first got my machine off Craig's List I decided that I liked A-Flex 2 but in less than 10 days, I was still having lots of centrals, and decided to try no A-flex, my centrals cut back, and my overall ahi dropped! I just tried it again ... For four days ... High centrals all four nights! Last night I turned A-Flex OFF, and slept better, and most of my centrals went away!

[Fizzled]

Haven't been able to fall asleep with the thing. I even ordered a new medium cushion for the PR EasyLife Mask Pugsy sent me. It's comfortable, but I guess I just don't like anything on my face. My nose itches and I can't scratch easily. My face starts to sweat where the mask meets my skin (or it's the humidifier).

Can't even do it with OTC sleep aids (I know they can make apnea worse).

Bleh! On to nasal pillows I guess.

And 1 month later Kaiser finally sends me written notice of their intentions to be frustrating.

1 Appointment for initial doc
1 appointment for blood draw
1 appointment for sleep apnea class
1 appointment for sleep study equipment review/take home
1 return trip for equipment
1 appointment to pickup titration equipment
1 trip to return equipment
1 trip to pick up prescription/CPAP machine

That's literally about 150 driving miles from me and I'll be getting bled out with copays every step of the way!

[Janknitz]

I didn't have any co-pays for any of the appointments (I never saw a sleep doctor). The only co-pays were for the machine and supplies, but they have been very low. However, your plan may be different.

I HATED their system--they set appointments without asking and yes there are many annoying hoops to jump through--in a group--in order to get diagnosed and treated. I did not appreciate the group class where they show you your results. You don't have to share them, but it was still upsetting.

Kaiser doesn't seem to care if you have a job that doesn't allow you to drop everything for THEIR schedule. It made me very angry and resistant, but I was having such health problems at the time that a respiratory therapist refused to let me leave the pulmonary testing lab without a cpap. Once I started sleeping without apneas, I calmed down a lot, and then I put up with a lot more. In the end it was worth it, but I didn't think so at the time.

[mgaggie]

150 miles is nothing in one day. Try 485!

[49er]

150 miles is nothing in one day. Try 485!

It is if you feel it is going to be a big time struggle get there safely by driving.

49er

[123.Shawn T.W.]

I drive 170 just for one sleep study ... 85 miles away, but I don't like living in the city!

[Fizzled]

I sent in a complaint in via their web form.

I received a response fairly quickly.... but googling the body of the response reveals it was canned... word for word copy/paste.

Perhaps even entirely automated, but they did program in enough of a delay to make it seem like a human could have typed it.

Ughhhhh

My case is supposedly being referred to someone to invesigate on my behalf. Betcha it's canned to.

[Fizzled]

I didn't have any co-pays for any of the appointments (I never saw a sleep doctor). The only co-pays were for the machine and supplies, but they have been very low. However, your plan may be different.

I HATED their system--they set appointments without asking and yes there are many annoying hoops to jump through--in a group--in order to get diagnosed and treated. I did not appreciate the group class where they show you your results. You don't have to share them, but it was still upsetting.

Kaiser doesn't seem to care if you have a job that doesn't allow you to drop everything for THEIR schedule. It made me very angry and resistant, but I was having such health problems at the time that a respiratory therapist refused to let me leave the pulmonary testing lab without a cpap. Once I started sleeping without apneas, I calmed down a lot, and then I put up with a lot more. In the end it was worth it, but I didn't think so at the time.

I'll be paying/paid copays on the initial PCP visit, blood draw, diagnostic appointment, titration appointment and then coninsurance (50%) on the machine (I'm fine with my used PR 560 though).

[Janknitz]

I sent in a complaint in via their web form.

I received a response fairly quickly.... but googling the body of the response reveals it was canned... word for word copy/paste.

Perhaps even entirely automated, but they did program in enough of a delay to make it seem like a human could have typed it.

Ughhhhh

My case is supposedly being referred to someone to invesigate on my behalf. Betcha it's canned to.

Yeaah, good luck with that. They could care less if you don't like it. They are the "big box store" of medicine, and they do what's expedient for them. It's a numbers game--they can put a lot of people through the mill this way. If it's good for you, too, that's lucky--if not, too darn bad.

At least they sent you a letter telling you what to expect. I showed up at the "sleep clinic appointment" to find 15 other people there for a group meeting. HUH? And we were given machines to take home that night--I wasn't expecting it and had to return it by 9 a.m.--I had to be elsewhere in the morning.

I really hate having my personal health issues discussed in a group setting. I refused to ask any questions, but I had to sit through other people's question like--"well, what if I already smoked weed today?", "would it be OK if I just drank a little bit of booze tonight--otherwise I can't sleep?", "will this test meet DOT compliance?", ""I'm immunocompromised from a recent heart transplant, so how well do you clean the machines?" UGH, I didn't want to hear about a bunch of stranger's issues either (don't get me wrong, I listen to other people's problems all day long, but not during MY healthcare!). I was not a pleasant and happy person during this process.

[Fizzled]

Do they make you sign a form when you get the machine?

I might just keep mine.

[Fizzled]

Progress!

I managed to fall asleep with it on last night. I was later woken up by the large leak alarm after 3 hours. Sure enough there was air rushing over my face. I shut it off and forgot to put it back on.

From the limited window of data I saw I had a numerous hypopneas, but no obstructed airway events.

Also, Kaiser called me and there actually is someone looking into my complaint. She's not going to be able to do anything about Kaiser SOP I'm sure, but I was at least able to get someone there who if not genuinely concerned is at least good at faking it.

[forthguy]

Do they make you sign a form when you get the machine?

I might just keep mine.

I had to sign a form each time I took a piece of loaner equipment (2 WatchPATs and a titration CPAP). I don't think they told me what my estimated charges would be if I didn't return the WatchPATs, but they did have prices on non-return of the CPAP.

As I mentioned before, my process wasn't nearly as bad as what you've laid out, and at least for me, several of the appointments you've laid out were combined into single trips for me.

1 Appointment for initial doc
1 appointment for blood draw
1 appointment for sleep apnea class
1 appointment for sleep study equipment review/take home
1 return trip for equipment
1 appointment to pickup titration equipment
1 trip to return equipment
1 trip to pick up prescription/CPAP machine

I've never had an appointment for a blood draw (or any lab) from Kaiser, at either of the facilities I go to. I just show up when it's convenient (usually right after one of my other appointments) and have it done.

While my "class" ended up being one-on-one because the other person didn't show up on time, my class and pickup of the sleep study equipment (WatchPAT) happened at the same time. And finally, my return of titration equipment and pick up of my prescription and permanent machine were together in one appointment. Basically, it's not always that bad.

[Fizzled]

The blood draw wasn't really an appointment. As you said it's show up whenever you've met the fasting window. However, I consider waiting in line to check in and waiting 20 minutes in the lobby close enough.

I don't really fault the doc or lab for that visit and isn't really part of my opinion as there might have been some merit to the test.

But yeah, why not have the OSA/Snoring seminar the same time as the watchpat training/pickup?

There's too much back and forth BS and WEEKS between steps.