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.