Kaiser Permanente — medicare funds wasted
Was referred to Kaiser sleep facility in Penderbrooke Va. for sleep apnea
issues. Kaiser was aware of age (85 yrs. old) and Medicare benefits. Met
w/ Greg Carter sometime around Sept 2009, and a sleep study was issued.
Overnight sleep study was performed at 3rd party facility (Sleep Med /
Digitrace). Results required a second sleep study, which was performed in
11-2009 at different facility around Washington DC beltway. Results
required a 3rd sleep study, performed again around beltway. Test report was
read by Dr. Richey @ Kaiser, who composed conclusions of test and sleep aid
machine was ordered. That was Dec. 7th. During this adventure (late Oct.),
employer switched insurance for 2010 from Kaiser Permanente to CareFirst
BC/BS effective 1-1-10. In checking status of order later in Dec, the games
began. Machine was 1st ordered from wrong company. Then machine was
ordered from a company that actually could provide it. While trying to
confirm order, and status, Krista Bernier, Clinical Coordinator for Kaiser
at their Penderbrooke Va assured me that Kaiser had already authorized this
referral for a sleep aid machine, and it really didn’t matter at that
point when the machine was ordered, before or after Jan 1. I explained my
concern was if the correct machine was ordered BEFORE Jan 1, then there
should be no issues. She reiterated that Jan 1 meant nothing. After not
receiving anything, I found out the order was cancelled Jan 7th, as Kaiser
ordered incorrect machine. We were told machine ordered required 50% of
apnea to be central apnea, yet results show ZERO% of apnea is central.
Requirement is a Medicare requirement that Kaiser should have been aware of.
I have no idea of the hows and whys regarding why the machine was
cancelled, but if a mistake was made, no big deal, as I am not above making
a mistake. What does concern me is the Clinical Coordinator, Krista Bernier
and Kaisers response and attitude after Jan 1, 2010. I called Krista
Bernier and left messages every day for a week. No response. Upon
continuing to call her, I caught her at her desk one day, and she answered
her phone. She was rude and short, claiming she was busy, and did not have
any time to talk to me. I mentioned I had left many messages, none of which
were returned. She said she did not have time for me, and after Jan 1st
there was nothing she could do, and would have to hang up.
I believe that is a text book definition of “TWO FACED LIER”. How she
ever progressed to her management position is a mystery to me. My biggest
regret was that my phone conversation with her in Dec were not witnessed or
recorded. The only thing worse then my experience would be to have to work
for her I guess. This is my main concern / complaint. People like her have
no business in a management position.
My second concern or complaint is Kaisers lack of response. I called
members services several times, called a Tina Brown (complaint investigator
w/ Kaiser) several times, leaving messages, but never heard from her.
It is now 6 weeks into 2010, and we have nothing to fix the sleep apnea
issue. No machine, no test reports for another doctor to interpret, only
conclusions that are confusing to me and the new pulmonary doctor. So, as I
had expected, 2009 came and went with Medicare paying for 3 overnight sleep
studies, countless hours wasted driving to and from studies, and we have
NOTHING to show for it. No machine, no test reports to pass on to new
doctor. What a COMPLETE WASTE of time, money, and resources.
Again, sleep aid machine was ordered Dec 7th, and we have nothing as of
Feb. 16th. Plus repeated request to get sleep studies reports have resulted
in nothing. I feel Kaiser should reimburse Medicare for whatever they were
charged for the sleep studies, as that time and data was a waste.
My point in taking the time to generate this complaint is this: 1) To
obtain TEST REPORTS of 3 sleep studies so new physician can determine his
own conclusion. 2) To bring to light the need for Krista Bernier to be
retrained, and progress monitored. 3) To alert other consumers of the
Kaiser incompetence in this case, and waste of Medicare money, as new
physician will require new sleep study so he can finally get the test data &
reports, so he can make his own conclusion, and hopefully order a machine.
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