Question:
Would appreciate greatly any resource help to expedite this process.

I live in San Jose and I am covered by Northern California Kaiser. Have been researching this for about three months and decided it is the solution for me. My Doctor (over the phone) said I am a candidate for this operation, and we will get started on the approval process, , but not to get my hopes up for quick approval. He says it will take a year. When you are 42, have dealt with weight problems all of your life, have gone on every diet imaginable, not to mention my Astrological sign being Scorpian ...Well I am determined to find a way to expedite this process. I would really appreciate any advice, resource material, Kaiser contact information, etc. Anything that any of the Nothern Kaiser patients that were able to be approved in much less time have to offer...along with the encouragement and support of course. Looking forward to hearing from anyone. TL    — Terilyne R. (posted on August 15, 2000)


August 15, 2000
I cannot give you specifics about Kaiser Northern CA, but I had my open RNY through Kaiser Mid Atlantic (I live in VA). Whereas I have heard of people having approval difficulties with Kaiser, I had none at all. I began my process in late February and had surgery in May. As long as you have several of the co-morbidities (Kaiser has a specific list), then they cannot deny that it is medically necessary. If you want Kaiser's list, let me know and I will e-mail it to you. Your doctor may have said a year just to discourage you - not that he disagrees with it, but I can tell you in my experience that Kaiser does not encourage this type of surgery and highly discourages their physicians from even talking about it as an option. Whatever happens, don't give up because that is exactly what they want you to do. Your health is priceless and it's worth fighting for. Take care and best of luck to you. 3 months post op and 65 pounds gone forever!
   — Paula G.

August 15, 2000
My insurance is Aetna, I'm not sure who yours is through. Aetna is the worlds best at stalling & trying to lose documents. My advice, first call your insurance and ask for someone in pre-certification. Talk to them, and get a name. Next, fax or mail your papers directly to them! This finally put an end to 3 months of the run-around for me! Also, IMPORTANT!!!!!!! Keep a copy of all papers for your use! Keep in contact with the pre-cert rep by phone. Before I discovered this, I had worked, argued and complained for over 3 months. This ended the process in 3 days! Contact me at [email protected] if you need any help Good Luck, Kevin
   — hoosierkevin




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