Our experienced multidisciplinary weight-loss team includes surgeons, Physician Assistants (PA), Advanced Practice Registered Nurses (APRN), dietitians, social workers and exercise physiologists who work with you and support you throughout your journey to bariatric surgery and after surgery.
Your initial visit with your surgeon and/or nurse practitioner will involve review of your medical history and completion of a physical exam. You will also be asked to see our program dietitian and mental health professionals who will help evaluate your knowledge about nutrition and your commitment to change. These assessments are most often a requirement of insurance companies in the approval process and help prepare you for the lifestyle changes needed to help you meet your weight-loss goals. Telehealth appointments are available for some visits, for your convenience.
Our nurse navigators will review your medical history and arrange for necessary medical consults to help address conditions such as sleep apnea, cardiac issues and diabetes prior to surgery. This allows you to have the surgery in the safest manner and reduces your risk of complications related to your medical conditions.
Medical health problems are often caused by or aggravated by severe obesity and increase the need for weight-loss surgery. Our nurse navigators will review your medical history and arrange for necessary medical consults to help optimize conditions such as sleep apnea, cardiac issues and diabetes prior to surgery. This allows you to have the surgery in the safest manner and reduces your risk of complications related to your medical conditions.
Select a primary care physician if you don't already have one and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current, such as pap smear, breast exam or prostate specific antigen test (PSA).
Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
Bring any pertinent medical data to your appointment with the bariatric surgeon — this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
Bring a list of your medications with dose and schedule.
Patients must stop smoking at least two months before surgery. Smoking increases the risk of all complications after surgery. We can refer you to a smoking cessation program to help you achieve this. Please contact us and ask for this referral if you need it.
There are many different levels of coverage for weight-loss surgery. Our staff will help determine what your specific policy covers. Here are some key steps you should take to obtain information from your insurance company. Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight-loss programs. Document "other" weight-loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts.
Payment may be denied because there may be a specific exclusion in your policy for weight loss surgery or "treatment of obesity." Such an exclusion can often be appealed when the surgical treatment is recommended by your bariatric surgeon or referring physician as the best therapy to relieve life-threatening obesity-related health conditions, which usually are covered. If you are told that your policy has an exclusion, you should always ask for a copy of your plan and read the benefit section yourself. Our staff can also assist you to determine what your options may be based on your plan.
Insurance payment may also be denied for lack of "medical necessity." A therapy is deemed to be medically necessary when it is needed to treat a serious or life-threatening condition. In the case of severe obesity, alternative treatments - such as dieting, exercise, behavior modification, and some medications - are considered to be available. Medical necessity denials usually hinge on the insurance company's request for some form of documentation, such as 1 to 5 years of physician-supervised dieting or a psychiatric evaluation, illustrating that you have tried unsuccessfully to lose weight by other methods.
Gather all the information (diet records, medical records, medical tests) your insurance company may require. This reduces the likelihood of a denial for failure to provide "necessary" information. Letters from your personal physician and consultants attesting to the "medical necessity" of treatment are particularly valuable. When several physicians report the same findings, it may confirm a medical necessity for surgery.
Even if your initial request for pre-authorization is not approved, you still have options available. Insurers provide an appeal process that allows you to address each specific reason they have given for denying your request. It is important that you reply quickly. It is also recommended that, at this point, you enlist the help of an experienced insurance attorney or insurance advocate to properly navigate the complexities of the appeal process. Some insurers place limits on the number of appeals you may make, so it is important to be well prepared and that you clearly understand the appeal rules of your specific plan.
Generally, patients are treated with sequential leg compression stockings and given a blood thinner prior to surgery to minimize risk of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE). These therapies will continue throughout your hospital stay.
We also work with patients to get them out of bed and moving around as soon as possible after surgery. We do this to help restore normal blood flow in the legs to prevent DVT or PE.
Although it can vary, the hospital stay (including the day of surgery) is typically 1-2 days.
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What to expect after bariatric surgery.
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