Salutations!

[DianaCox]

How is it that you were NOT notified of the approval? Jeeze! I hope you're right about what you've been approved for.

 

[DSRIGGS]

How is it that you were NOT notified of the approval? Jeeze! I hope you're right about what you've been approved for.

For my original DS I knew I was approved before the surgeon's office because I called the insurance company every couple days to follow up. I called the day they approved me so I knew then, but I wouldn't have know for another 3 or 4 days until I received the approval letter in the mail. That is just how my BCBS works (no phone call just a letter of approval), but maybe with Kaiser it is different.

Anyway, congrats @Zarabear - I think.

 

[galaxygrrl]

Hoory!!!!

 

[Zarabear]

Rachal,

The authorization for your consultation with Dr. Rabkin just arrived and I have asked my coworker, Annalyn, to contact you tomorrow to get it scheduled.

Thanks,
Matt

Hooray!
Went to the meeting last night in SF, and got to meet Galaxygrrl again and LorraineC too!

Spoke with Liz last week, from Kaiser Richmondwho handles the referrals and she said that this will be the progression:

Referral came routed through another department (DONE)
She sent referral code to Dr. Rabkin (DONE)
Dr. Rabkin's office will set up the appointment. (Tomorrow)
Then I will meet with my PCP to fulfill all the pre-op requirements. (Bloodwork, EKG, etc, etc.)
Once those are done, the final referral will be asked for and she will send my medical records to Dr. Rabkin for surgery!

Dr. Rabkin indicated last night that once we got the initial referral that he doesn't foresee any problems moving forward.
HOWEVER, I'm still waiting for the rug to be pulled out from under me, and to have to fight. I'll be prepared for it, but will keep moving forward as I can.

 

[Butterfly]

Glad things are moving forward!

 

[DianaCox]

By the way, do NOT trust Liz. Double check and follow up on EVERYTHING she says. She's been - let's just say disingenuous - in the past. She is NOT your friend - she is a Kaiser apparatchik.

 

[Zarabear]

Really appreciate the heads up.

I've got a logbook, and I log every call and what is said to me so I have it to refer back to.
Along with conversation points, I record time/date/person I spoke with.

I am determined to stay on top of all of it, ready for the fight if it comes to it.

 

[LorraineC]

Hooray!
Went to the meeting last night in SF, and got to meet Galaxygrrl again and LorraineC too!

Spoke with Liz last week, from Kaiser Richmondwho handles the referrals and she said that this will be the progression:

Referral came routed through another department (DONE)
She sent referral code to Dr. Rabkin (DONE)
Dr. Rabkin's office will set up the appointment. (Tomorrow)
Then I will meet with my PCP to fulfill all the pre-op requirements. (Bloodwork, EKG, etc, etc.)
Once those are done, the final referral will be asked for and she will send my medical records to Dr. Rabkin for surgery!

Dr. Rabkin indicated last night that once we got the initial referral that he doesn't foresee any problems moving forward.
HOWEVER, I'm still waiting for the rug to be pulled out from under me, and to have to fight. I'll be prepared for it, but will keep moving forward as I can.

It was so nice meeting you!

 

[Larra]

Good job on the record keeping. Keep us posted.

 

[Zarabear]

April 3rd consultation with Rabkin!
darn the waiting.... Hehehe
Ready to get this show on the road!

 

[galaxygrrl]

Awesome! It will be here before you know it.

 

[Larra]

Sounds like things are on track with Kaiser, but keep on documenting until you're in the recovery room.

 

[Zarabear]

Got an email full of great information and wanted to share for others that may need more info on the process of going to Rabkin from Kaiser.

Rachal,


Now that Kaiser's authorization for your consultation is on file, I wanted to touch base and give you a rundown of how things typically work from this point forward.


Many patients come to us with the false impression that their surgery is already authorized, but at this point, only your consultation with Dr. Rabkin is authorized. After your consultation, I'll send Dr. Rabkin's report to Liz McLaren at Kaiser and request the authorization for your surgery. Kaiser usually issues the surgery authorizations about 8-12 weeks after the consultation. They use that time to work with you to make sure all of your pre-surgery medical tests are completed. I can't schedule surgery until Kaiser gives me the authorization number for the surgery. Liz sometimes gives the authorization number directly to me in a timely manner, but she sometimes says she can't give me the number, in which case I would need you to forward to me your copy of the authorization letter once you receive it. Either way, once I receive the authorization number for your surgery, we will work out a surgery date based on your schedule, Dr. Rabkin's schedule, the assistant surgeon's schedule, and the OR schedule. Once your surgery is scheduled, our staff will work with you to make sure your pre-surgery appointments in our office and at the hospital are scheduled.


If you're in a hurry to have surgery and don't want to wait 2-3 months, please note that Dr. Rabkin and I have tried for years to speed up the process in hopes of getting Kaiser to issue the surgery authorizations sooner, but those efforts were to no avail. The only way we have found to speed up the process is for the patient to contact Liz (and Kaiser member services, if you don't hear back from her) after the consultation has been done and the surgery authorization has been requested, and demand that they speed up the issuance of the surgery authorization. The only other way to help speed it up is to cooperate quickly with the instructions Kaiser will give you with regard to preparing yourself for surgery (for example, if they need you to take a test, you should have that test done as quickly as possible).


Dr. Rabkin's fees for your consultation and surgery are billed to Kaiser after the surgery has been done; then, Kaiser pays their portion of Dr. Rabkin's fees and lets us know whether or not the patient owes any deductible or copay portion. If they determined that you did owe us a portion of our fees, we then would collect that amount from you. Once you paid us for any copay or deductible, the reimbursement for Dr. Rabkin's fees for your consultation and surgery would be complete. All but two of our past Kaiser patients have ended owing very little, if any, of our fees out of their pocket. It's possible that you would have to pay us a portion of Dr. Rabkin's fees, however, so it's best if you contact Kaiser member services and find out how much, if any, your out-of-pocket portion of Dr. Rabkin's fees would be.


Your first three months of post-surgery follow-up visits with Dr. Rabkin would be at no charge. Once those three months were up, Kaiser likely would not agree to cover any future follow-up visits with Dr. Rabkin unless you were having complications that Kaiser's own in-house doctors couldn’t handle, in which case they should specifically authorize a visit with Dr. Rabkin. Accordingly, you would have the option of: 1. obtaining your follow-up care from Kaiser after the first 3 months, unless they authorized a visit with Dr. Rabkin; 2. paying Dr. Rabkin's follow-up visit fees out of your pocket and having him render your follow-up care, or 3. some combination of 1 and 2. Our fees for follow-up appointments, whether they take place in our office or over the phone, currently are $100 to $300 per appointment, depending on the type of appointment, and the fee would be due from you upon your arrival for the appointment unless a written Kaiser authorization for the appointment was on file in our office. Please note that the amount of the fee is dependent upon how long it has been since Dr. Rabkin saw you: if you follow up on an annual basis, the fee currently is $100 per appointment. The fee increases to $200 or $300 once the patient hasn't been seen for over a year.


We would need you to initial and sign the attached payment policy prior to surgery, so it’s a good idea to read over it and make sure the info in it is understood before we got to that point, though there’s nothing else you need to do with it now.

8-12 weeks after consultation (April 3rd)means june pr july. I have had a trip planned (and paid for) to go to Nuevo Vallarta for my birthday and spend it on the beach. (July 7th - 14th) So... It seems like I will aim to have the surgery when I get back.
It will be the best 35th birthday present ever. LoL

Hope the info on the process helps others.

 

[Zarabear]

So happy to have the authorization in hand!!
March needs to hurry on out of here so I can get to my consultation! Hehehe

 

[galaxygrrl]

Yay!!!!!1 So happy for you!