i had been considering vsg for a long time now. I went to talk to my doctor and he referred me to options (kaiser) after evaluating me they approved me and told me that i will be recieving a package in the mail soon, once i get that package i have to fill out a sheet thats in there and fax it in. I will then be on a aprox. 3 month waiting list. Then they will call me and schedule me to start the classes that will all take about 3 months...so in about 6 months if all goes well i should be getting this done...

I just wanted to know if anyone was in the same boat as me...

It could be a good thing to go on this journey together?? If you are on the same boat give me your email, or aim, msn, gtalk, yahoo messenger. Lol i have it all!

Thank you

by the way. I am 20 yr old female, new to this thanks

I just wanted to take a moment and welcome you to VST. I hope your journey goes smoothly, and hopefully you can find a buddy to work with through all of this.

Keep us posted, and if you have any questions or concerns, feel free to post away. We'll all be your cheerleaders ! ! !

Jenn20, I am also just starting the process. I went to a seminar in Oct and then to the monthly support groups, which is very good and informative if you can find one in your area. I was just waiting for Jan 1st to get here. That was when my new insurance started and I knew they were going to cover it just could not get anyone to tell me the requirements until then. Now I have picked a surgeon, the insurance person has called and got the requirements. So now the insurance person at the surgeons office is going to send me a letter with the requirements. Besides the regular requirements, BMI, High Blood pressure, sleep apena, I have to have 5 year weight history (no prob) 6 month doc supervised diet (I was on herblife for 6 months and my primary doctor said she made notes of my progress on it when I went in for other things) So I hope this is enough, and a psych eval.

I was really hoping this would go alot faster than it seems to be.

Anyway, once i see the psych and fill out all the forms and get records from my primary doctor then the will submit it to my insurance company and from there they said the insurance company has 30 days to approve or disapprove.

I was really hoping to get started on my journey this month but at this rate I sure hope it is sometime in Feb at least.

My husband I am always such a easy going person but says I am not being very patient with this. He is probably right. but I am so excited to get started.

Guess we just have to hang in there together.

Hello Jenn20,

Welcome to Options. I am having my surgery thru Kaiser, at the Harbor City location on Jan. 26. It's been a very long process to get to this point. Options classes used to be 24 wks long (I heard they were being shortened to 20 weeks). Then there is a few months to wait for the surgeon consultation. I started with my PCP in Feb, started Options in April, and finally got a surgery consult in Dec. While the Options classes aren't that great, it is good that you will have so long to make sure you are 100% on board with the surgery. Fortunately during mine I switched from wanting the LapBand to the sleeve. Thanks to this forum I was able to become better educated and feel I am totally ready for my surgery. So I hope you are a patient person, because it will feel like forever before you get it, but it will be worth it.

Good luck!

Jenn20, I am also just starting the process. I went to a seminar in Oct and then to the monthly support groups, which is very good and informative if you can find one in your area. I was just waiting for Jan 1st to get here. That was when my new insurance started and I knew they were going to cover it just could not get anyone to tell me the requirements until then. Now I have picked a surgeon, the insurance person has called and got the requirements. So now the insurance person at the surgeons office is going to send me a letter with the requirements. Besides the regular requirements, BMI, High Blood pressure, sleep apena, I have to have 5 year weight history (no prob) 6 month doc supervised diet (I was on herblife for 6 months and my primary doctor said she made notes of my progress on it when I went in for other things) So I hope this is enough, and a psych eval.

I was really hoping this would go alot faster than it seems to be.

Anyway, once i see the psych and fill out all the forms and get records from my primary doctor then the will submit it to my insurance company and from there they said the insurance company has 30 days to approve or disapprove.

I was really hoping to get started on my journey this month but at this rate I sure hope it is sometime in Feb at least.

My husband I am always such a easy going person but says I am not being very patient with this. He is probably right. but I am so excited to get started.

Guess we just have to hang in there together.

Thanks for the reply. Where are you located? I'm in the Los Angeles region. I'm not sure if OPTIONS if different in other places or if there is other locations in the first place, but I was thinking that your BMI must be under 40 if you have to go through all those requirements. I have BMI of over 40 and when it is over 40 you don't have all those requirnements. I was just referred and right away sent to evaluation and I was approved already.

Also, This might make you happy...I spoke to OPTIONS 2 days ago and they informed that they they did in fact shorten the weeks of the classes we need to take. They use to be 24 weeks of classes, but they cut it in half! now it's only 12 weeks (3 months) and you go once every 2 weeks. so basically 6 classes. then you have to do the pretest and shortly after you get your date =)

but the only bad thing is that, like I had mentioned before, There is a wait list for those classes. in my case they told me it was aprox. 3 month wait.

but I'm preparing by working out so I can try getting more muscle so that HOPEFULLYYY I wont have toooo much excess skin, especially around the arms and theighs =/ don't care too much about the stomach, I will eventually get tummy tuck. (If all goes as planned)

If you don't mind me asking, What are your stats? and how old are you? Where are you located?

Hi Jenn,

I wanted to welcome you! I'm going through the Kaiser in Northern California. Our program is a little different as we don't have the Options program. I started with a referral from my PCP in October. We have a five hour orientation, psych consult, Nutritional consult, surgeon consult. After reaching pre-surgery goal weight, there's a case manager consult, followed by class with the nutrition person. My doc said I'd probably have surgery in February or March. I need to finish losing my weight before we can continue.

Good luck to you!

Hello Jenn20,

Welcome to Options. I am having my surgery thru Kaiser, at the Harbor City location on Jan. 26. It's been a very long process to get to this point. Options classes used to be 24 wks long (I heard they were being shortened to 20 weeks). Then there is a few months to wait for the surgeon consultation. I started with my PCP in Feb, started Options in April, and finally got a surgery consult in Dec. While the Options classes aren't that great, it is good that you will have so long to make sure you are 100% on board with the surgery. Fortunately during mine I switched from wanting the LapBand to the sleeve. Thanks to this forum I was able to become better educated and feel I am totally ready for my surgery. So I hope you are a patient person, because it will feel like forever before you get it, but it will be worth it.

Good luck!

HI AND THANK YOU FOR YOUR RESPONSE. I HAD A QUESTION FOR YOU. IF YOU HAVE NOT ALREADY BEEN SLEEVED THEN HOW IS IT THAT YOU'VE ALREADY LOST 31 LBS? I KNOW THAT YOU HAVE TO LOOSE 10PERCENT FROM WHAT I'VE HEARD, BUT IS THAT MANDATORY? I MEAN WHAT HAPPENS IF YOU DON'T LOOSE 10 PERCENT. IT'S SO HARD FOR ME TO LOOSE THE WEIGHT HENCE THE PART OF WEIGHT LOSS SURGERY....

ALSO, HOW DO THEY FIGURE OUT WHAT YOUR GOAL WEIGHT SHOULD BE?

THANK YOU IN ADVANCE.:confused:

I lost the 30lbs in the Options program. We had to weigh in every week and yes, lose 10% of our weight before we could be referred. I just tried to stick to my 1500 calories a day and fortunately it came off. I think it came off so easy because I had just gained 30 lbs last year from quitting smoking. I must have been pigging out before and the 1500 calories was just a big deficit. I did a lot of walking too.

I'm not sure what they do if you don't lose the weight, except that my surgeon's instructions for pre-op was just 2 days of liquid diet, and I heard from someone else using the same surgeon 1 week before me that she was told to do a 2 week liquid diet. And she said she didn't lose the 10%. Our Options classes were like nutrition classes, all about how to eat, so we were expected to lose it.

And my goal weight? I just guessed! Nothing scientific about it...ha ha.

Hello,

At my Kaiser, I can't get an appointment with the case manager until I have weighed in at Kaiser at my pre-surgery goal weight. She'll be the one to give me a surgery date. I'm told that if I show up to that appt. she won't see me. If we show up over our pre-surgery goal on the day of surgery they cancel it. They're really serious about meeting our goals, whatever they assign us.

Hello,

At my Kaiser, I can't get an appointment with the case manager until I have weighed in at Kaiser at my pre-surgery goal weight. She'll be the one to give me a surgery date. I'm told that if I show up to that appt. she won't see me. If we show up over our pre-surgery goal on the day of surgery they cancel it. They're really serious about meeting our goals, whatever they assign us.

Hi Lee,

Looks like you're right on track to meet your goal already. Look at you, 13 lbs lost just like that! They tried to scare our class with lots of stuff like that too. I remember them saying many times that they check your blood for nicotine right before surgery and won't do it if you've been smoking... really?? Does Kaiser do that for every surgery?

Great job on the weight loss, keep it up!

Lee,

I am also at Kaiser Richmond.

I heard at support group that the sleeve was only available to a select few people in special circumstances (ie: malabsorption issues). It was not offered to me at my surgeon's appointment but now seems to be used more often. He did tell me that would approve either Lap-Band or Roux-n-Y but recommended R-n-Y. Has Kaiser ok'd the sleeve for you?

Thanks.

Tricia

Hi Tricia,

Kaiser started approving the Sleeve in November. Dr. Baggs thought it was the best option for me. My mom had Celiac Sprue and I'm starting to also show signs of it. I also had Rheumatoid Arthritis several years ago. Sleeve is better for people who have malabsorption issues and may need meds for other issues.

Who is your doc? When are you expecting to have surgery? I have a few pounds to go before I can meet with Liz (case manager), then after that it's a go.

Have I seen you at the support group? I was there in November, December and last week. PM me if you'd like to chat! I"m going to add you as a friend if that's ok with you.

Hello Jenn

I sent you a PM but I wanted to say hello here as well. Welcome to the board and best of luck in Options I just graduated in December and I have my sleeve set currently for April.

(Unless something changes)

i had been considering vsg for a long time now. I went to talk to my doctor and he referred me to options (kaiser) after evaluating me they approved me and told me that i will be recieving a package in the mail soon, once i get that package i have to fill out a sheet thats in there and fax it in. I will then be on a aprox. 3 month waiting list. Then they will call me and schedule me to start the classes that will all take about 3 months...so in about 6 months if all goes well i should be getting this done...

I just wanted to know if anyone was in the same boat as me...

It could be a good thing to go on this journey together?? If you are on the same boat give me your email, or aim, msn, gtalk, yahoo messenger. Lol i have it all!

Thank you

by the way. I am 20 yr old female, new to this thanks

Hi Jenn - I'm just getting started too. I made the decision to get the sleeve in Dec. I had originally thought I'd get banded but after reading the band forums and then after talking to a couple of people and then a doctor's office I started doing research on the sleeve and decided to have it done. I am self pay and going out of state. (Texas) I have family there and it is much less expensive. I have an appointment in April for the seminar and some pre-op stuff that they are going to let me take care of. Maybe meet with a nutritionist, I'm not sure...I'll do that the following day and then I'm going back in June for surgery. I can't wait. Good luck to you!!

I am so upset, but trying to stay calm until I talk to someone at the doctors office but it is not working.

I called the insurance company yesterday to see how my approval was going. Even though I thought it would be too early since they just submitted it on Tuesday. They told me it had been denied due to no Pych eval. OMG!!!!!

I went and had the Pych Eval on Monday and he faxed the results to the doctors office on Tuesday. I even talked to the case worker on Tuesday at the doctor's office and she said yes she had it and would be submitting it that very day.

Now the Insurance company says their was not Pych Eval submitted so they denied it. So if i did have the Pych Eval the doctors office will have to submit an appeal. OMG!!! I immediately called my case worker but she was not in yesterday. So now I am just waiting on her to call me back today.

Does anyone know what is involved in an appeal?

I am really hoping my case worker is going to say yes she did include it and maybe the insurance company just over looked it and maybe she can just fix it with a phone call. Maybe that is wishful thinking.

:mad::crying:

Shylady, I don't know anything about insurance companies or appeals because I have Kaiser, but I wanted to come and give you a virtual hug. This will all work out. You've done everything you were suppposed to. If I were you, I'd start a new topic about appeals or search the forum for information. You want to get as much response as possible. I'm sure there are others that went through the appeal process and are now sitting on the Loser's Bench. Hang in there!