ObesityHelp

Surgeon Info:
Surgeon: Mary Murphy, M.D.
Insurer Info:
Kaiser
9/02- Finally worked up the nerve to ask my PCP to refer me for Gastric Bypass Surgery. PCP told me I was a candidate and sent me for the required labs. 10/02- Some of the labs came back high and I was refered to an endocrinologist. After more labs, ultrasounds, cat scans and being tested for Cushing's Syndrome, I was told that I have Poly Cystic Ovarian Syndrome. 12/02- Went back to my PCP for the referral. Was told that Kaiser's policy is changing and that now I would be required to take a 12 week Bariatric Education and Evaluation Program at the cost of $150.00. 1/03- Called Preventative Medicine to find out when the class starts. Was told that my referral was sent back to my PCP because my BMI was under 50(49.8) with only 1 co-mobidity (Hypertension). Immediately called my PCP only to be told that she was on vacation for 2 weeks! I couldn't wait that long, I called Member Services and filed a complaint! Within 2 days, a representative called me back to get all the details. She also told me that I could present my case to the board for review or she could present it for me. I told her that she could present it for me. She said she would call me after the meeting on 1/22/03. 1/17/03- Received a call from Kaiser representative, after careful review of my medical chart with Preventative Medicine (and finding the #2 co-morbidity, Polycystic Ovarian Syndrome) it was determined that I was indeed a candidate for Bariatric Surgery. 2/3/03- Started 12week Bariatric Education and Evaluation Program. After class, introduced myself to the instructor and thanked him for his help in reviewing my chart. He told me that he didn't think that I should have to take the class because I had the referral before the new policy started in 1/03. 2/11/03- Called Member services and spoke to the Rep that was such a big help before and told her about my conversation with the instructor. Asked her if I could at least get the referral processed in L.A. so that I could go ahead and schedule the consults at Pacific Bariatrics. 2/17/03- Insructor asked me to stay after class to tell me that they are going to ga ahead and process my referral. Sent me for an EKG to be sent with the referral for final approval. 2/19/03- went for EKG. 3/21/03- went for Gallbladder ultrasound. 3/21/03- Called Preventative Medicine and was told my chart was sent to L.A. 3/18/03. 3/24/03- Called L.A. Was told to callback in a few days. 3/27/03- Left message on voice mail asking if the referral had been processed. No return call. 4/3/03- After several messages had been left and no calls returned, I called Preventative Medicine to find out if they had received the Authorization letter yet. Was told that my chart was sent back to them because there wasn't a psych consult in it from my PCP and that some of my labs needed to be updated. All of this could have been done immediately if my phone calls would have been returned by the assistant in L.A.!!! Did the labs and the psych consult was found and everything was sent back to L.A. on 4/8. 4/11/03- Called L.A. to make sure that they had received the paperwork, left message on assistant's voice mail again. No call back. 4/14/03- Called medical Requests and requested that all my labs and EKG's and ultrasounds be faxed to Pacific Bariatrics. 4/15/03- Tried calling L.A. again. Left another voice mail to go unanswered. 4/21/03- Last day of class! Received a phone call on my way out the door for my last class, from Pacific Bariatric's letting me know that they had recieved my Authorization from Kaiser and that they would call me in the next week to schedule consults. 4/23/03- Called Pcific Bariatric to schedule consults. Was told that they didn't have my labs yet and that they couldn't schedule consults until they received them. 4/23/03- Called and left a message with Medical Request to find out why labs weren't sent yet. Was told that it was in the process. 5/1/03- Received a call from Pacific Bariatrics, there were quite a few labs missing and they needed them before they could schedule consults. 5/1/03- Called Medical Requests again and left a voice mail wanting to know what was going on with the labs. 5/1/03- Pacific Bariatrics called me back that afternoon to say that they had just received the rest of my labs. 5/5/03- Scheduled my consults with Mary Murphy and others for 5/21/03. 5/21/03- Went for consults. Was very impressed with Mary Murphy, she said that I wasn't the only one that has said Kaiser takes forever! She also told me that I was a good candidate and that I could look forward to having surgery sometime in July. The patient coordinator will call me, when the reports from the psychologist and internist come in and the surgeon reviews them, to schedule surgery.