Kaiser Permanente of WA - Denial?

[tmm89 1]

It sounds like I just need a psych evaluation? They sent me 2 copies of this denial letter lol. Does anyone else have Kaiser or can help me decipher this letter.

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[tmm89 1]

I am just in the beginning step of this process.

----- Message -----
From: Lauren
Sent: 10/13/17 11:15 AM
To: Toni
Subject: RE: Referral question

Good Morning Toni,

My name is Lauren and I am a Registered Nurse with MD's team.

Thank you for using secure messaging. I understand your request and concerns. It would be best for you to update your doctor and review options for care over the phone. This service is free of charge to you.

Please call the appointment center at Everett Medical Center - 425-261-1500 option 1 or visit Kaiser Permanente member website to schedule a telephone appointment with your doctor to review your request and together make the best plan of care for you going forward.

What Happens After You Request Bariatric Surgery
If you are considering bariatric surgery for weight loss, this overview can help you understand the process at Kaiser Permanente.

Requesting Surgery

Your first step is to tell your primary care physician that you are interested in bariatric surgery. Your physician can refer you to Bariatric Surgery at our Kaiser Permanente medical offices location in Bellevue.
The bariatric nurse will process your referral through Kaiser Permanente's Clinical Review Unit. The Clinical Review Unit evaluates the referral request to determine if you meet the medical criteria for bariatric surgery and if the surgery is covered by your health plan.
Be sure that your doctor knows what diets you have been on in the past. It is required that at least two be listed by name.
You will receive a letter approving or denying the surgery request. If denied, you will be told why and possibly have an opportunity to appeal that decision.

Steps After Approval

If the request is approved, the approval letter will tell you that you will be receiving a new patient intake packet in the mail from the bariatric nurse. The packet should arrive within 30 days after you receive the approval letter. If you don't receive the packet in 30 days, contact the Bariatric Clinic at 425-502-3454.
There will be an out-of-pocket expense of $500 for nutrition counseling that is not covered by insurance. This will be explained in the packet. The packet includes our program booklet explaining the process and answering many questions. You will receive a checklist of the medical work up, information about the pre-op class and the support groups, as well as the nutrition requirement and diet.
Your packet also will include a psychosocial questionnaire and health history questionnaire for you to complete and return in enclosed envelopes. After those are received, you will receive a call to schedule a psychological assessment.
The bariatric case manager will review results of lab tests, studies, and consultations as they are completed. If necessary, the bariatric nurse will order additional medical assessments.
Surgery Is Scheduled
Once you have completed all required tests, studies, and referral appointments — and you have complied with any other requirements based on those assessments — you will contact the bariatric case manager to schedule a pre-op consult with the surgeon and the dietitian. Your surgery will be scheduled following these two consults.
Post-Surgery Visits and Support
After surgery, you will have regular follow-up appointments with the bariatric team for 5 years and be encouraged to continue to attend one of the 7 bariatric support groups around the Puget Sound area.
If you live in Eastern Washington, Kaiser Permanente can direct you to support groups in your community.
Also check the Kaiser Permanente Bariatric Patients page to read the monthly bariatric newsletter with helpful advice and support, and to find a support group.
If you have additional questions or concerns, contact the bariatric nurse, Julie Grimm, RN, at 425-502-3454.


Thank you for choosing Kaiser Permanente.

Best,

Lauren

Supporting M.

----- Message -----
From: Toni
Sent: 10/12/2017 10:16 PM PDT
To:
Subject: Referral question

I am interested in weight loss surgery and would like a referral.


Sent from my SM-G950U using BariatricPal mobile app

[zoxie 27]

Go to the seminar they have every first Wednesday of the month. You'll gather a lot of info. I didn't need a referral.

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