Night Elf Posted January 5, 2021 Share Posted January 5, 2021 I had returned to my eating disorder treatment center that I was at earlier this year for more treatment. This time around I was in a higher level of care. I've been in program 2 weeks. I just found out today that Kaiser has decided they will no longer cover telehealth services so I was discharged from my program today. At a time when COVID is high and people aren't meeting in groups, or at least shouldn't be meeting in groups, Kaiser is feeling like Telehealth isn't necessary. Even they are doing more video and phone appointments right now! They're super cautious about who goes into their facilities! There is no other ED treatment center in my area. My only option is to go to a psych hospitalization program and they don't specialize in anything. They cover all behaviors and addictions. I have heard bad things about the place nearest me. My dd's stepsister was there for a while and it was a bad experience. I have my outpatient team still set up. I've continued seeing my outpatient therapist and my private dietitian also works for my treatment center so we just moved me out of her private practice. Now I'm going to have to go back to paying for her. I'm going to see about seeing my therapist twice a week and my dietitian once a week until we find out what Kaiser will do. Already my inclination is to not eat at all today. I've very emotional and I want to numb myself and get away from these feelings. My DH isn't accepting that as an option. He's going to sit down with me at lunch to make sure I eat. I'm a bit ticked off at that but I do understand his alarm. I went back into treatment because I was backsliding fast. Everyone was worried I'd get into full blown anorexia rather quickly so I agreed to more specific treatment. Now I feel the last two weeks were a waste of my time and money. DH thinks it has helped me get out of the rut I was in and I agree to a certain point. I've been struggling with my meal plan. I have an appointment tonight with my dietitian to discuss it but it's on my treatment center's time, so we may have to reschedule. I'm waiting to hear back from her. All Kaiser could tell me was to file a formal complaint/grievance. Yeah, ask me how much I believe in that as a solution to the problem. DH said next we'll formally appeal the decision, and if that doesn't work, he'll contact his benefits office at his work and ask them to intervene. So we have a plan. This just sucks. 19 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 5, 2021 Share Posted January 5, 2021 @mathnerd I am angry for a different reason and I am not under Kaiser https://abc7news.com/kaiser-permanente-san-jose-medical-center-coronavirus-bay-area-covid-19-outbreak-hospital/9352548/ “SAN JOSE, Calif. (KGO) -- Kaiser Permanente is investigating a COVID-19 outbreak that has killed one and infected dozens of employees at a San Jose hospital after Christmas. The hospital told ABC7 News that the spread "may" have been connected to an employee who appeared briefly in the emergency department wearing an "air-powered costume" on Christmas Day. Forty-four staff members at Kaiser Permanente San Jose Medical Center's emergency department tested positive for COVID-19 between Dec. 27 and Jan. 3, Irene Chavez, senior vice president and area manager of the hospital, said in a statement. The staff member who died passed away from COVID-19 complications and was working in the emergency department on Dec. 25, the hospital confirmed with ABC7 News on Sunday night. Out of respect for the patient's family and privacy, hospital officials are not releasing more information.” 1 2 Quote Link to comment Share on other sites More sharing options...
mathnerd Posted January 5, 2021 Share Posted January 5, 2021 (edited) @ArcadiaI used to pick up lunch at a local deli next to a Kaiser and a lot of their medical staff used to walk in for lunch in their scrubs and hang out and chitchat. I found that very scary because these people wore those same clothes to interact with infectious patients before heading out. I still see them walking out to these places to pick up lunch in their scrubs though they have only takeouts now, thankfully! I thought that they should have had stricter rules at least during a pandemic. (Not saying other medical staff are not doing this, and I know that the CDC says that surface transmission is not an issue, but still I don’t think that it is a sanitary practice ). Edited January 5, 2021 by mathnerd Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted January 5, 2021 Share Posted January 5, 2021 (edited) I'm sorry. I just got off of them. (for the last three years). Filing a grievance with your state insurance commissioner has been known to get insurance companies to ask how high do you want them to jump. eta:(no guarantees, and it may be more dependent on your state.) Edited January 5, 2021 by gardenmom5 3 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 5, 2021 Share Posted January 5, 2021 31 minutes ago, mathnerd said: @ArcadiaI used to pick up lunch at a local deli next to a Kaiser and a lot of their medical staff used to walk in for lunch in their scrubs and hang out and chitchat. I found that very scary because these people wore those same clothes to interact with infectious patients before heading out. I still see them walking out to these places to pick up lunch in their scrubs though they have only takeouts now, thankfully! They go in their scrubs to Grocery Outlet (same compound as AoPS academy). 1 Quote Link to comment Share on other sites More sharing options...
rebcoola Posted January 5, 2021 Share Posted January 5, 2021 I'm so sorry night elf. I hate Kaiser the hurdles and just general headaches of insurance have been so much worse they took over our old insurance company. 1 Quote Link to comment Share on other sites More sharing options...
Katy Posted January 5, 2021 Share Posted January 5, 2021 Go online to your state's insurance commissioner and file a complaint today. 3 Quote Link to comment Share on other sites More sharing options...
sassenach Posted January 5, 2021 Share Posted January 5, 2021 1 hour ago, Arcadia said: @mathnerd I am angry for a different reason and I am not under Kaiser https://abc7news.com/kaiser-permanente-san-jose-medical-center-coronavirus-bay-area-covid-19-outbreak-hospital/9352548/ “SAN JOSE, Calif. (KGO) -- Kaiser Permanente is investigating a COVID-19 outbreak that has killed one and infected dozens of employees at a San Jose hospital after Christmas. The hospital told ABC7 News that the spread "may" have been connected to an employee who appeared briefly in the emergency department wearing an "air-powered costume" on Christmas Day. Forty-four staff members at Kaiser Permanente San Jose Medical Center's emergency department tested positive for COVID-19 between Dec. 27 and Jan. 3, Irene Chavez, senior vice president and area manager of the hospital, said in a statement. The staff member who died passed away from COVID-19 complications and was working in the emergency department on Dec. 25, the hospital confirmed with ABC7 News on Sunday night. Out of respect for the patient's family and privacy, hospital officials are not releasing more information.” Word on the street is that Kaiser is pushing the employee in a costume narrative but the real reason for the outbreak is that they have had inadequate testing for employees and very cramped break rooms and crappy leave allowances for infected employees. That outbreak was already underway at SJ. 4 Quote Link to comment Share on other sites More sharing options...
BlsdMama Posted January 5, 2021 Share Posted January 5, 2021 Maybe they'll rethink it now that they know they spread Covid like wildfire through that silly Christmas costume?! Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted January 5, 2021 Share Posted January 5, 2021 46 minutes ago, sassenach said: Word on the street is that Kaiser is pushing the employee in a costume narrative but the real reason for the outbreak is that they have had inadequate testing for employees and very cramped break rooms and crappy leave allowances for infected employees. That outbreak was already underway at SJ. This. Quote Link to comment Share on other sites More sharing options...
Harriet Vane Posted January 5, 2021 Share Posted January 5, 2021 That's ridiculous! I am firmly in your court, Beth. Their policy makes no sense. I'm glad you've got a plan--appeal their rotten decision in every way possible. 1 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 5, 2021 Share Posted January 5, 2021 2 hours ago, Night Elf said: All Kaiser could tell me was to file a formal complaint/grievance. Yeah, ask me how much I believe in that as a solution to the problem. DH said next we'll formally appeal the decision, and if that doesn't work, he'll contact his benefits office at his work and ask them to intervene. So we have a plan. This just sucks. 2 hours ago, gardenmom5 said: Filing a grievance with your state insurance commissioner has been known to get insurance companies to ask how high do you want them to jump. Concurrently filing with HR (benefits office) can move things along faster. Had to do that for Aetna and Blue Cross for other issues. Too many employees filing complaints with the benefits office led to better health plans even with the same provider. I am covered under my husband's insurance so he blasted them on the phone until the issue was resolved. 1 Quote Link to comment Share on other sites More sharing options...
iamonlyone Posted January 5, 2021 Share Posted January 5, 2021 (edited) I'm not a fan of Kaiser either. I hope you get a good resolution, and I'm very sorry you are dealing with this! Edited January 6, 2021 by iamonlyone Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted January 5, 2021 Share Posted January 5, 2021 I am related to an ED doctor at Kaiser in CA. I might be able to help you with this. Let me know here if you want me to try, and I will figure out how to get ahold of you. 2 Quote Link to comment Share on other sites More sharing options...
Night Elf Posted January 6, 2021 Author Share Posted January 6, 2021 1 hour ago, Carol in Cal. said: I am related to an ED doctor at Kaiser in CA. I might be able to help you with this. Let me know here if you want me to try, and I will figure out how to get ahold of you. I tried sending you a message but got an error message saying you are not receiving messages right now. I'm in Georgia, just let me know what information you need. I'd love clarification of the policy as well. Member services acted like they had no idea what I was talking about. Is it just mental telehealth or all outside telehealth? Kaiser does not have any resources for me for an E.D. which is why they are affiliated with my treatment center. I didn't even need a referral. So now I have no idea what will happen. I'm hoping someone admits it was a mistake and I can get back into treatment asap. Quote Link to comment Share on other sites More sharing options...
Night Elf Posted January 6, 2021 Author Share Posted January 6, 2021 UPDATE! GREAT NEWS! I got a call from my treatment center today. Apparently the upper management of Kaiser met this morning and decided they should adhere to CDC guidelines and they'll continue paying for telehealth visits after all, so I'm back in the program. They said I could log in tomorrow but I'd like a confirmation and information about my level of care. I was only approved through Monday the 4th and that was when my case manager faxed the information to Kaiser to get me another week of upper level care, when on Tuesday they contacted Walden and said they were not approving me for anything. So now what is going on? No clue! I'm hoping my case manager calls me soon with information. So I might not start tomorrow but at least I can start back soon!! The funny thing is I've been questioning being readmitted, especially at the higher level of care than last time. Everyone is so worried about me and I must be in denial because I think I'm fine. Honestly! I think everyone is overreacting. But when I was forced to leave, I was very upset and now that I'm back, I'm very excited. My therapist wants me in for another 3.5 months which I think is overkill but we'll see what gets approved. Yay!! 9 Quote Link to comment Share on other sites More sharing options...
YaelAldrich Posted January 6, 2021 Share Posted January 6, 2021 Beth, I'm so so glad that it looks like Kasier is coming to its senses regarding telehealth for ED and all MH issues. It's the only moral option right now. I hope you will start again very soon and that you will get the help you need to be healthy and happy! Quote Link to comment Share on other sites More sharing options...
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