I have a question that I'm hoping someone can advise me on... I'm 5'7" and in February 08 after being on phentermine to try to shed a few pounds I had a bmi of 38.7. My PCP recommended a sleep apnea test & the results came back as "mild" so my Dr. sent a referral to Kaiser's Bariatric Dept. Because the apnea was only mild and the bmi was not 40 at the time with no other co-morbidites, I was denied acceptance to the program in April 08. I stopped taking the phentermine because I didn't like how it made me feel and I have gained back all that I lost plus a couple. I believe I'm now back at 40bmi which should allow me to now qualify.

Should I ask for the referral to be resubmitted now? My PCP is supportive and is happy to do it but I am nervous that Bariatrics will deny me because 4 months ago my bmi was too low. Will I qualify no questions asked since my bmi is at 40 or will I run into trouble?

Has anyone had the experience of being denied by Kaiser & then put on the weight and been accepted?

Any advice?

Thanks!

Are you familiar with Keiser in the Maryland area, specifically Laurel area which is right outside Washington DC so that area would be fine if you know someone there. I don't even know how to start.

I belong to Kaiser in Northern California so I only know how our process works but I assume the process has to be similar. So first things first... have you discussed a WLS referral with your PCP?

Here is my situation...I had a PCP that was on board highly recommends my surgery, thought her office accepted Keiser HMO however she only accepts Keiser PPO. so she can no longer be my dr. however she has been monitoring me for the past 6 months done the nutrition thing everything. Now I'm meeting with a new PCP under Keiser, hoping I will not have to start all over and can transfer my records and possibly have my old Dr. have a conversation with my new dr and be able to keep the process moving. I've been trying to find Drs on the Keiser website that do the lapband however I don't see them, and didn't know what department they may be listed under. So to answer your question I will be having this conversation with my new PCP on July 21st. If you've gone as far as I already have how long under keiser does it take to get a surgery date? What else after my PCP recommends me?

I have Kaiser and live in Southern California. I was not aware until a few days ago that they did the Lap Band procedure. I knew about the bypass surgery but not the other. This is my dilema. I went out to a private doctor and am paying cash for the procedure. I started in May and have done classes, psych eval and I am scheduled for my procedure for July 30. BMI is at 50, but really have no other health realted issues. Has anyone had experience with the Kaiser in my area. How long will it take etc. I am considering waiting and seeing what Kaiser will do. However, I do not want to wait another day to have my surgery. I need some advice. Thanks

I am not sure about southern california . . . I am from northern cali. Well the process for me so far is ...

1. I asked my PCP to send my a referral June 25

2. Went to orientation on July 15 (5 hour class)

3. My next appt is with the psych on Sept 17 , so Im going to start working on my 10% body weight loss , so that way when I meet with the surgeon hopefully I won't have to much further to go....

I have Kaiser and live in Southern California. I was not aware until a few days ago that they did the Lap Band procedure. I knew about the bypass surgery but not the other. This is my dilema. I went out to a private doctor and am paying cash for the procedure. I started in May and have done classes, psych eval and I am scheduled for my procedure for July 30. BMI is at 50, but really have no other health realted issues. Has anyone had experience with the Kaiser in my area. How long will it take etc. I am considering waiting and seeing what Kaiser will do. However, I do not want to wait another day to have my surgery. I need some advice. Thanks

Hi there! I don't know if Kaiser No. Cal is different than Kaiser So. Cal but it seems to me that up here, Kaiser's process takes about 5-6 months on average and worst case is probably 8-9 months. It really does depend on the individual & how much that person needs to lose before they will do the surgery. I can't afford to pay out of pocket so I'm committed to doing whatever I need to do in order for insurance to cover it. I would suggest calling Kaiser and start asking questions about the program. Maybe even talk with your PCP about the process. Good luck!

I am not sure about southern california . . . I am from northern cali. Well the process for me so far is ...

1. I asked my PCP to send my a referral June 25

2. Went to orientation on July 15 (5 hour class)

3. My next appt is with the psych on Sept 17 , so Im going to start working on my 10% body weight loss , so that way when I meet with the surgeon hopefully I won't have to much further to go....

Your orientation was 5 hours? I was told mine on 7/27 in Fremont would only be 2 hours! Yikes I wonder why there is such a big difference...

Here is my situation...I had a PCP that was on board highly recommends my surgery, thought her office accepted Keiser HMO however she only accepts Keiser PPO. so she can no longer be my dr. however she has been monitoring me for the past 6 months done the nutrition thing everything. Now I'm meeting with a new PCP under Keiser, hoping I will not have to start all over and can transfer my records and possibly have my old Dr. have a conversation with my new dr and be able to keep the process moving. I've been trying to find Drs on the Keiser website that do the lapband however I don't see them, and didn't know what department they may be listed under. So to answer your question I will be having this conversation with my new PCP on July 21st. If you've gone as far as I already have how long under keiser does it take to get a surgery date? What else after my PCP recommends me?

Hi! I would think that your Kaiser records would definitely be transferable so you won't have to start from square 1 again. If you read back on this thread from the beginning, you'll get lost of great information about the process we California Kaiser patients have experienced. Also, if you enter

"Kaiser MD" or "Kaiser Maryland" in the Search box, I think you'll come across posts from lapbanders in your specific area. Good luck!!

What gives??? The Kaiser patients in No. cali have all the good luck. And it seems as if they have been covering the Lap Band procedure up there for quite sometime huh??? Well not to rain on anybody's parade, but what about us down here??? (So. Cali) Does any one have any good stories about being accepted by Kaiser in So.Cali?? I know we have to at least have one patient who has been banded that can give us the hook-up on the in's and outs. I need to know what questions to ask and what the first step is. My dr's appt is tomorrow and I'm lost:confused2: Sorry for being so foward, but I need assistance, and answers:biggrin2:

I know Kaiser in So Cal does Gastric Bypass. I am a self pay because I did not realize that Kaiser would do a lap band procedure. I do know that your primary care doctor needs to refer you to the bariatric facility near you. I am in Riverside County and they have a facility in Riverside. Then you have to wait for the appointment. Go to a seminar. Then you are required to lose 10 or 15% of your body weight before they will schedule an appt with the surgeon. I hope this helps. I went to Dr. Krahn in San Bernardino. I will be one month post op on Aug 30.

KATHERINEM200 so they do cover lap banding in So. cal with a referal???? Im confussed because no more than 30 minutes ago I just called member services at my Kaiser, Woodland Hills (out here in the San Fernando Valley) and they told me they dont cover it, but as stated earlier I have a PCP appt tomorrow and should I demand that he refer me to a Bariatric Dept out in San Bernadino? Which is no problem, I used to live out there :~) if not somewhere closer. It could be at the moon for all I care, so long as they cover it:biggrin2:

When I called customer care with Kaiser, I was told that they do cover the lap band procedure. I know someone who had Gastric Bypass in the Riverside facility, not lap band. Good Luck. If they can do it in No Cal, they can do it in So Cal.

Well I guess Im SO, cause the member services rep said they only cover Gastric Bypas which is a no-no for me... So what Ill do is keep my dr's appt tomorrow and just make sure all my history and records are up to date and i's are dotted and t's are crossed, so when I switch to United Health Care next month, everything will be up to par. Because by the grace of God all ends well with them.... I'd love to stay with Kaiser but I cant if they dont cover the procedure. Any body can feel free to comment :~)

Ok so this is the deal, I had a PCP appt last Thursday @ Kaiser Woodland Hills, I made him send a referral to Health Education (hes cool like that) . Anyways so I waited this long holiday weekend and made my calls this morning. I called the Health Education Dept, made sure that they received my referral and had them set me up for labs, Im having that done first thing in the morning, and then they (Hlth Edu Dept) Will call the Panorama City (The Valley) Kaiser and have my orientation set up. Which is 6 looooooonnnnnggggg months!!!!They also said that they do cover Gastric Bypass (Hell To The Naw) Lap Banding, and the Gastric Sleeve. So thats where I am in this long journey, even though they are little bitty baby steps :blushing: I believe South Bay Kaiser is the other place where classes are held. The bottom line is, Yes Kaiser does cover the Banding, you just gotta stay on them and it will be at least 6 month I guess give or take a few days... Hope this helps Ill give the play by play as I get it

Boopie

Boopie you are awsome. I saw your last couple of post and you have given me HOPE !! I have an appt to see my PCP on 09/10 and I hope that I get the results you did. My BMI is over 40 .. i think its 46. So I think I am a shoe in for this procedure. I am so happy that you are 1 step in front of me, so that I can learn from what you do. Thanks for blogging !!

hi ladies:

My friend who just got banded through richmond this week said her process went like this:

"you will be asked to weigh in normally before the first "orientation class/seminar". At kaiser richmond, they just had us check in and hop on the scale. Dressed, some people took off their shoes, but you were not allowed on barefoot (socks ok). It was off to the side with only the facilitator able to see the scale, and a really long line. Some people came in late and were weighed at the end, but it had to be done at that class as that was considered your starting point weight.

The seminar then was all about the program, the pros/cons of surgery. The especially harped on about the limitations and the things to be worried about. Probably trying to get the flaky folks to drop out. Then, after the lecture portion, they had all "support folks" like your husband, parent, friend leave the room and gave us a 7 page highly personal, confidential questionaire to complete and then we left. Questions about past dieting habits, traumatic experiences, issues about your sex life, issues with eating disorders, etc.

In the handouts you left with was a copy of the diet they suggested you start to get you going!

That was it, and it was about 2-3 months after that before i got my next appointment which was a 5 hour seminar. Then the psychologist appt, a meeting with the surgeon where they check you out and give you your preop goal weight, which is normally around 10% of your body weight at the first orientation weigh in.

Once you make weight... Appointment to weigh in, appointment with case manager where a surgery date is set and then pre op class and nutrition class and then pre op physical and then after a few labs, you are good to go.

Hang in there. It feels like a really long process, but if you think about it, my first seminar was the end of january and here i am today...done! And remember, this is richmond... Maybe fremont is quicker."

remember that at your first orientation, they weigh you & that is your starting weight. Almost everyone is asked to lose at least 10% of that starting weight. My friend had the stomach flu right before she went & her weight was down 8 lbs. She had to lose 10% based on the lower # but when she went home and started to feel better she of course gained the 8 lbs back which meant she had to lose even more than they advised! Basically, you want to be at your heaviest weight on orientation day. Don't diet ahead of that appointment because the pounds lost won't count. Good luck!

wow you rock, your so informative, congratulation on your surgery, may i ask you after you were done with the class, can you fill me in as to what happened next? Did you have a psych evalution and if so what did they ask you?

Thanks,

s.v.