Question:
Does anyone know when the Northern Ca, Committee Meets?

I have just been told that my paperwork is about to be submitted to the committee. Does anyone know how often they meet? and if so, how long does it usually take for them to approve?    — AliciasMommy (posted on January 11, 2002)

January 11, 2002
I was told they met every week, but I wondered about this. My particular case took 3 months to go to committe and get approval...my case had to go to the special "Deferred" committee that meets every 3 months, because they didn't have the x-rays on my knees in my file. (it didn't matter that I got them done right away and re-submitted). My doc listed "knee pain" as one of my co-morbids. I didn't see the sense in this because I already met the requirements by having documented sleep apnea, which they consider a "life-threatening" co-morbidity. Anyway, from what I can gather, if you file is not <b>complete</b> they sort of shove your file over to this "Deferred" pile, and that committe meets every 3 months. So make sure your file has all the documentation/test results that go with each of your co-morbidities listed. They don't just take what your PCP lists as truth...they want to see documentation and test results. Much good luck with this! Hugs, Joy
   — [Deactivated Member]

January 12, 2002
In brief, I started this process in april, my paperwork went to the committee in August, three weeks later they told me that they could not make a decision on me having the surgery, and they would meet again in January. At this time they would make a decision on whether or not I could have the surgery. Instead of waiting, I contacted the DMHC, as of 12/28, I was told that I was approved. I met the requirments that Kaiser has set for this surgery, I couyld not understand why they could not make a decision. I decided that I would not wait an additional four months just to be told "no". I also provided fifteen years of medical history, and documented diet history. I also attended a 10 week Weight Management Class that was required. I did everything by the book, however my HMO did not. Be sure to have all your documentation in order, with Kaiser it may or may not help. Try to work directly with them, however if over time if your not getting anywhere, contact the Department of Managed Health Care, they were great.
   — [Anonymous]