Kaiser Lancaster - Nightmare in the Antelope Valley

imara56

Good Morning Everyone.  I was diagnosed 6/22/11.  Since diagnosis I have had to call Kaiser pretty much every other day to get referrals, request a second or third opinion outside of Kaiser, which I had to pay out of pocket, undergo tests that could not be scheduled any sooner than over a week to up to a month in advance, and bureaucracy in obtaining my medical records.  I am so angry and frustrated that I am going to be writing letters to anyone that will listen.  If I could wait until October for open enrollment to switch to a PPO I would do so in a hearbeat.  I would love to hear from anyone that has had a good experience with Kaiser and can recommend a breast specialist and oncologist.

My prayers to all of you for your support.

Imara

revkat

Imara, I'm sorry you are having a bad time with your insurance. I had a good experience at Kaiser Riverside (Baril for surgery, Ruby for Oncology) -- everything proceeded along in a timely manner and my treatment was exactly as other women here had in other systems for the same diagnosis. I have also had good responses when I contacted Member Services for issues I have had with how care was delivered. The second opinion thing is a pain; because Kaiser is a self-contained HMO you do have to pay out of pocket to go outside it. I choose not to do that this round, but I certainly will if my cancer recurs. 

On thing I have discovered with Kaiser is that the offices in different areas are available to you, but you have to push to get out of your geographic area. You can get a second opinion in LA or Pasadena, or Fontana, for example at no additional cost. You might think that since they are going off evidence based medicine protocols they would all say the same thing, but each person is different and has their own specialty so you would at least get a different perspective. My daughter gets her chronic headaches treated in San Diego even though she lives in LA because they have a pain specialist who will give her the nerve blocks she needs. I felt like my cancer care in Riverside was fine, but for my lymphedema I had to scout around to find a fully trained therapist and the closest one was in Fontana, so I go there. I'm not sure what tests you are having that are taking so long to schedule -- from diagnosis to surgery was 4 weeks for me (not an atypical time span no matter what your insurance is) and then from surgery to chemo was about another month during which I had a CT, bone scan, muga scan.

I'm sorry you are so frustrated. I know many women with other types of insurance who have frustrating experiences as well. It seems wrong that we have to fight our way through red tape to get the treatment we need!

Edited to add: I just read some of your other posts and it sounds like you have a complicated situation. If I were you, I would see if you could get ahold of the breast care coordinator in Fontana or LA and talk to them about who they would suggest you see for a second opinion there. (Do you have a breast care coordinator in Lancaster? She might be helpful in getting it set up too.) Be sure to explain that it appears you do not have run-of-the-mill breast cancer, but rather an occult cancer (I think that's the correct term when you can't find the originating tumor). Also, if you are able to get a second opinion at USC or Cedars (and sometimes it's done for a flat fee) you can take that information back to Kaiser and my experience has been that if you ask for the recommended treatment you will probably get it. Good Luck. 

weety

I am also a kaiser member.  I actually use both the Bellflower Kaiser and the Harbor City/Long Beach Kaiser since I am kind of in the middle of both of them.  I have not had any trouble with either of them.  For my cancer treatments, I used Bellflower almost exclusively and was very pleased with the treatment and support I got there.  Everything was done in a timely manner and I did not have any issues.  I did have to pay for a 2nd opinion, however.  My onc put it this way--Kaiser will pay for 200+ "2nd" opinions as long as they are at a Kaiser facility with one of the 200+ oncs they have in Southern CA.  But, if you want an outside provider, you  have to pay.  BUT. ..she said if they come up with a treatment plan that Kaiser either doesn't have available or is not able to provide, then Kaiser WILL pay for the treatment elsewhere.  She is the one who actually encouraged me to get a 2nd opinion at UCLA.  I'm HER2+ and UCLA houses the expert on HER2+--Dr.Slamon.  I didn't see him, but all of the oncs there work with him.

As far as records go, it has been extrememtly easy for me to get mine. I just have to go to member services and request them.  They print them right out there for me to walk out with.  I wonder why your kaiser handles this differently.  I am constantly getting my records--during active treatment I was there at least once a week--LOL!!!!  I couldn't stand having to wait to hear about anything--even my bloodwork results!  Oh and also, they are all free.  I didn't pay a penny.

 Edited to add:  My onc retired or I would have recommended her in a heartbeat!  (Dr. Carole Most) I don't see my new onc for active treatment since I have finished and am just seeing him every 3 months, so I  haven't really had him or seen him enough to know enough about him.  I've only seen him 2x so far.

imara56

I cannot believe the difference in my experience and those of you that wrote in.  I was told I would have to PAY for my medical records, it would take 10 days AND drive out to Panaorama City to get my films.  My first oncologist tried to railroad me into chemo and mastecomy without explaining my pathology report and not having all my tests done.  Needless to say I won't be going back to him and  from there I have been calling the specialist every day to every other day for referrals.  This has been going on for almost a month now and still no closer to finding an oncologist or making a decision on treatment.  I am making calls now to find a lawyer and also an advocate to assist me in getting the care I deserve.  I have no faith in Kaiser at this point in regard to my healthcare. I am so glad that those of you that wrote in didn't have the problems I had and wish you all the best.

revkat

imara, I was just checking back to see if you have gotten any help moving forward with your treatment. I hope so. Let us know.

LisaLisaLisa

Imara,

I have had a very positive experience with Kaiser Fresno.  They have a wonderful Breast Care Coordinator there who has helped manage, schedule and guide me through the entire process.  She got me my med records the next day after asking for them, including disks with my MRI and mamograms.  I have met with all of the dr.'s involved in my care (onco, breast surgeon, plastics surgeon, and gyn) all within a matter of 2 weeks.  I have a second opinion scheduled out of network to validate all of the info and unfortunately, have to pay out of pocket but you have to ask yourself, aren't you worth it? 

Antelope Valley is probably a smaller Kaiser facility.  You may be better off, driving to a nearby larger city for your care and treatment, if not for the larger selection of qualified dr.'s, do it for you because you deserve the best care. 

I wish you the best and hope that you can get your medical care with Kaiser back on track.

exbrnxgrl

Imara, I am so sorry you have been having a bad time of it. I am in Northern CA and am not familiar with Kaiser in So.CA. I am being treated at Kaiser Santa Clara and have nothing but praise for them. When a diagnostic mammo and biopsy were going to be scheduled with longer wait times than I wanted, I just said, "No, I need it done sooner." and they found earlier appointments for me. I paid for a second opinion at Stanford and was easily and quickly able to obtain all slides, films( on CD) and path reports (the day after I requested them so I could hand deliver to Stanford). Is it possible for you to go to a larger Kaiser facility for your care? Kaiser Santa Clara is a nationally recognized breast cancer center (may have gotten the exact title wrong). MIght there be one in southern CA? Wish you all the best. -Caryn