Question:
I got this letter ... what's next??

Yesterday I got a letter from Kaiser that said my "condition meets all the criteria for consideration for Gastric Bypass Surgery at the South San Fransisco Medical Center." Can I call this an approval letter? At this point, what could keep me from getting the surgery? Thanks for any help!!!    — Shrinking M. (posted on April 2, 2004)

April 2, 2004
Congratulations!!! You have met criteria for medical necessity. I would call your customer service number on your insurance card and make sure you have benefits available for the procedure. Make sure the facility and surgeon are in network.
   — issymudd

April 3, 2004
Mary: You must be Kaiser patient that lives in the Northern California area. The South SF (SSF) Kaiser is currently the regional center for all Gastric Bypass surgery for Kaiser in the Northern California area. Getting this letter means that you have been approved. Congratulations! From this point, you will either be scheduled for an orientation and a appointment with the surgeon in SSF, or you will receive a letter telling you that you have been transferred or assigned to either the Kaiser Richmond or Kaiser Fremont Gastric Bypass surgery centers. When you meet with the surgeon, he or she will review your medical history, etc. and determine if there are any other tests/evaluations or goals you will need to complete before you are ready for surgery. If so, before you can have surgery, you will need to have met those goals or have those tests/evaluations completed. At the minimal, you will be given a goal to lose 10% of your weight as of your orientation date or the date of your surgeon appointment - whichever comes first. I received my approval letter from SSF Kaiser in April 2003, was assigned to Kaiser Richmond via letter in June 2003, and was finally scheduled for my orientation and surgeon appointment in late July and early August 2003. After my pre-op weight loss goal, I was scheduled for surgery on 3/30/04 and I am now home recuperating from open surgery.
   — Paulette B.