Jump to content
×
Are you looking for the BariatricPal Store? Go now!

I found out I was turned down by Kaiser



Recommended Posts

I just got a call from Kasier that my appeal will be reviewed by the Bariatric team and should hear back with in 15 days.

:thumbup:Way to GO! Ok 15 days is not too long to wait. That is awesome news! I will say a prayer for you:redface1:. Keep me posted!!!

Share this post


Link to post
Share on other sites

See my new post!

Edited by humpty dumpty

Share this post


Link to post
Share on other sites

What a bummer! Do you have to have one or two co-morbidities if your BMI is 35-39? I don't remember. I thought that hypertension counted, but I haven't seen anything about high cholesterol. I could see that one as being iffy since obesity doesn't always mean high cholesterol and vice versa. Have you ever been tested for sleep apnea? I know that seems to be another of the big co-morbidities for consideration. You might not think you have some sleep/breathing issues, but you just don't know. If you had asked me a few weeks ago if I did, I would have said no way!! But, my husband has told me that I snore a lot. He never told me that before! It was usually if I was really tired or sick. Snoring doesn't mean you have sleep apnea, but it also doesn't mean you don't. If I wasn't considering this surgery, I would go ahead and have myself tested just to be sure. However, my BMI is over 40, so I qualify already, and I don't really have any comorbidities. Good BP, decent cholesterol, no major weight-related health conditions - a fairly healthy morbidly obese person.

While I don't know how to go about appealing, I do think you might want to talk with your PCP about being tested for sleep apnea. Are there any other weight related issues that you have? Do you see a specialist for any other conditions that weight loss would help improve?

Don't give up hope![/QUOte

hello well i just went to my 1on1 on monday i was told that kaiser "so cal" has changed there bmi to 35 with no comorbidities i ask because my bmi is 39 so i was worried that i would be denied as well i start my 12wk classes on 8/20/10 an i finish on 11/5/10 and she said that i should have my surgery in dec 2010 if i do everything like im suppose to the surgery will be done in sandeigo ca. well i hope this helps good luck

Share this post


Link to post
Share on other sites

What a bummer! Do you have to have one or two co-morbidities if your BMI is 35-39? I don't remember. I thought that hypertension counted, but I haven't seen anything about high cholesterol. I could see that one as being iffy since obesity doesn't always mean high cholesterol and vice versa. Have you ever been tested for sleep apnea? I know that seems to be another of the big co-morbidities for consideration. You might not think you have some sleep/breathing issues, but you just don't know. If you had asked me a few weeks ago if I did, I would have said no way!! But, my husband has told me that I snore a lot. He never told me that before! It was usually if I was really tired or sick. Snoring doesn't mean you have sleep apnea, but it also doesn't mean you don't. If I wasn't considering this surgery, I would go ahead and have myself tested just to be sure. However, my BMI is over 40, so I qualify already, and I don't really have any comorbidities. Good BP, decent cholesterol, no major weight-related health conditions - a fairly healthy morbidly obese person.

While I don't know how to go about appealing, I do think you might want to talk with your PCP about being tested for sleep apnea. Are there any other weight related issues that you have? Do you see a specialist for any other conditions that weight loss would help improve?

Don't give up hope![/QUOte

hello well i just went to my 1on1 on monday i was told that kaiser "so cal" has changed there bmi to 35 with no comorbidities i ask because my bmi is 39 so i was worried that i would be denied as well i start my 12wk classes on 8/20/10 an i finish on 11/5/10 and she said that i should have my surgery in dec 2010 if i do everything like im suppose to the surgery will be done in sandeigo ca. well i hope this helps good luck

OMG that explains it! I filed an appeal on 8/09 and on 8/10 I received the Options package, I thought ok the Dr must have been wrong. I called the Kaiser case worker on Wendesday and told her to pull back the complaint.

Thank you for letting me know.:biggrin2:

Share this post


Link to post
Share on other sites

Cool! So you are good to go?

I think so, I called to set up the options seminar but the nurse is out until Monday.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×