Question:
Can anyone tell me what to do next?
Can anyone tell me the next step. I have seen my PCP and he agreed to refer me but he seems clueless. He has scheduled me for a sleep apnea test thats coming up soon and he has scheduled me for the 10 week diet class(which I really dont want to attend). I have no idea of what to do while I'm waiting. I also want to know if the surgeon's send you to have a psyc. evaluation or do kaiser or both? someone please help me take the appro. steps. — [Anonymous] (posted on March 27, 2001)
March 26, 2001
Hi - I am currently pre-op...here is what I did. Once I made the decision
to have surgery, I discussed it with my PCP....he agreed to refer me...but
wanted to check out surgeon's talk to other PCPs. A week later I went to
see him again...The PCPs he spoke to were clueless, so I gave him a copy of
all of my research. I chose a surgeon...called his office. He had a
mandatory 4 hour seminar, so I scheduled for that (it was free). I asked
the Surgeon's office if he required a psych eval...he did. I went ahead
and scheduled it. I had it the day before the information seminar. As I
walked out of the seminar, I told Kim (Surgeon's Office Manager) that I was
a "Go." Fortunately I have Aetna and Kim was able to get me
approved via the telephone. I would go to the insurance section of this
web....go under your State and see how responsive your insurance is. Call
them or look for their website and see what their reequirements are. Good
Luck, Karan
— chance2lv
March 26, 2001
I have Kaiser is San Diego. One thing I can tell you is there is NO
standard protocol for referral. My PCP had me go for a psych eval, which
I had to do a personality test and see an actually MD psych Dr not the
counselor/therapist. A evaluation with the dietician. I then attended the
seminar for the surgeons office that would do the surgery and they gave me
the lab work sheets, I faxed those to my nurse and they let me pickup the
slips the next day, did major lab work got the referral for the gallbladder
ultrasound same day. Did a urine test & EKG. Then with all this in my
PCP sent the referral to the liasion for Kaiser who then forwards all this
to the board for approval. Once the board receives your package it takes
3-4 weeks usually.
You have to keep on top of things, my PCP did the referral wrong had I not
had the phone number for the liasion I would be twirling my thumbs about
now wondering what was going on. I check with the liasion once a week to
see where I stand. Please feel free to email me and I will help you in
anyway I can.
— Crystal B.
March 26, 2001
Hi, I am 2 weeks post-op, and when I started with this WLS, I researched
doctor's that specialized in WLS and when I went to my primary care doctor,
he was very supportive with the surgery and he referred me to a doctor and
I asked him about the surgeon that I researched and really would like to go
to, and he referred me to him. I called the surgeons office and made my
appointment, which was like a 4 month waiting period. The surgeons office
also made me call the weight management center that this surgeon worked out
of to set up a physc. eval and to see a dietician for evaluation. I had my
appointment with all of them when the time came and my surgeon had me do
some blood work prior to his appointment and after seeing him I had to have
a sleep study test done and after my surgeon got the results, he submitted
everything into my insurance, and I was approved 4 days later! I am now 2
weeks post-op, and I am soooo glad I did this surgery! I hoped I helped
you, and good luck to you!
— Valerie D.
March 26, 2001
I used to have Kaiser...notice the past tense. My suggestion would be to
get your Kaiser brochure, the one they send you in the mail, and check it
out. Push comes to shove, see if you can find a Patient Advocate or
Patient Coordinator...some title like that. Call and see if they can steer
you in the right direction. Also, if Kaiser has a website like Blue Cross
you'll be able to check the surgeon's listings. I've seen a few people
here that have had WLS thru Kaiser so perhaps a posting on the Message
Board will get different responses. Best of luck! Don't give up.
— Lynn E.
April 23, 2001
Hi there! I also have Kaiser and am currently going through the approval
process. I will tell you what I have done and what I have been told...
First of all, take the weight management class. I know that my Kaiser (in
Fresno) requires 6-12 months of documented dieting programs, and since this
is through Kaiser they get to really see how motivated you are to lose
weight! Second, do the sleep apnea testing now. If they suspect sleep
apnea they will make you be tested before surgery, so might as well get it
over with now (not like me... I am just now getting ready for the testing).
Third, have your doctor submit a letter to the gastric bypass committee.
This is what actually starts your whole consideration process at Kaiser in
Fresno, so this might be the first item on your list! Make sure your
doctor has documented any of your weight related health issues! If your
bmi is 50 or higher Kaiser Fresno will approve you with no other health
issues. If it is 40-49 you must have 2 documented weight related issues.
And if it is 35-39 you must have a life-threatening weight related issue.
I know that Kaiser Fresno offers a gastric bypass seminar once a month.
Call your health education office and see if yours does as well. I answer
this only as a person dealing with Kaiser Fresno, so if you are in a
different area their proceedures might be different. Kaiser set up my
nutrition appt. and they will also set up my psych if I am approved. I
find out this week if I have been approved! I will let you know how it
went! I wish you luck! And keep pestering the staff! Call health
education and have then give you as much info as possible! Good luck!
Amiee
— Amiee O.
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