Each Deaconess Surgical Weight Loss Center patient follows a 14-step clinical process to prepare for surgery. The following information includes the services of the center, the patient process and expectations. We want you to know what will happen every step of the way as you begin the exciting journey to better health and a "New You, Real You.™"

 

Program Fee - $150

Because weight loss surgery is a very complicated field that requires an entire team of professionals dedicated to your care, most programs (including ours) charge a program fee which is not reimbursed by insurance. The program fee pays for things such as web site maintenance, educational materials, nutrition classes and seminars, the expertise of our insurance/accounts personnel, and other members of the team. It is estimated that is takes a total of eight hours of office staff time per approval we receive! Your program fee is due at the time of your initial consult. Paying your program fee is not a guarantee that you will have surgery. All fees are non-refundable.

Our 14 Step Clinic Process: (click on steps for detailed information)
Step 1 - Patient Education Session
Step 2 - Psychological Evaluation
Step 3 - Letter of Medical Necessity
Step 4 - Insurance Approval
Step 5 - Support Groups
Step 6 - Physical Activity
Step 7 - Pre-operative/Surgical Consent Visit
Step 8 - Pre-operative Nutritional Teaching
Step 9 - Selecting a Support Person or "Coach"
Step 10 - Medical Clearance (One to three weeks before surgery)
Step 11 - Pre-op liquid diet
Step 12 - Pre-admission Testing (One week before surgery)
Step 13 - Hospitalization
Step 14 - Post-operative Clinic Visits

Step 1 - Patient Education Session
During the first visit, you will meet our surgeons, who will assess and discuss your current knowledge of bariatric surgery, and provide an in depth information session about surgical weight loss as well as answer any questions you may have about the procedures available. You will also meet our program coordinator, who will provide education about steps to surgical weight loss and answer any questions about surgical weight loss. Our registered dietitian will perform an initial screening for a thorough dietary evaluation, and our insurance coordinator will discuss issues related to insurance approval or procedure financing.

This visit is usually, but not always covered by insurance. You must take the responsibility yourself to find out if you have surgical weight loss benefits and if Deaconess and your surgeon are in-network. You will be responsible for any co-pays, and if your insurance denies payment for the visit you will be responsible for the initial consultation charge. Throughout the rest of the steps, we have listed "OUT OF POCKET EXPENSE" to identify fees that your insurance will not pay.

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Step 2 - Psychological Evaluation
To be accepted into our program, one of our requirements is that you make an appointment with a psychologist for a complete psychological evaluation to explore your readiness for surgery. If you are already seeing a mental healthcare provider, you may want to have him or her complete your psychological evaluation. Your emotional and mental outlook are very important as you consider surgical weight loss since you must be able to adjust to a major lifestyle change associated with surgical weight loss. If necessary, we can assist you in selecting a mental health professional. You can even have this step done before you come in for your initial consult.

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Step 3 - Letter of Medical Necessity
If you are a good candidate for surgery and we have all necessary documentation, after paying the first installment of your program fee, a detailed letter will be sent to your insurance company requesting pre-authorization. Some insurance companies require six-month physician directed weight loss program including behavior modification, exercise therapy and nutritional counseling by a registered dietitian. Pre-authorization is usually the longest phase and may take weeks to months to get approval.

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Step 4 - Insurance Approval
Our insurance coordinator will notify you in approximately four to eight weeks about your insurance approval. If you have Medicaid, you will be notified in approximately six months. If you have any questions, please call us at 513.559.2545.

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Step 5 - Support Groups
For our local patients one of our program requirements is that you attend at least two support group meetings prior to surgery and monthly until one year after surgery. A registered dietitian holds meetings on the second and fourth Thursday of each month at Deaconess Hospital. The meetings are very helpful and serve as a resource for questions or concerns about surgical weight loss. Out of town patients may attend surgical weight loss support group meetings in your local area. Call us at 513.559.2545 for a current schedule.

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Step 6 - Physical Activity
Another program requirement is that you make a commitment to an exercise program before and after surgery. In fact, all patients must agree to get up and walk every two hours the day of their surgery to prevent the formation of blood clots.

Exercise should become a part of every patientÂ’s life. Exercise is a great tool to improve health and wellness and help meet your weight loss goal. Deaconess has exercise partners who offer patients special membership rates (Curves and Fitworks). Our long-term program requirement is for our patients commit to 60 minutes of continuous, uninterrupted aerobic activity daily, such as dancing, walking, biking, and/or running in place. Find a fitness partner or buddy and make daily appointments with yourself to help you stay committed to physical activity!

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Step 7 - Pre-operative/Surgical Consent Visit (co-pay's and/or deductibles)
After you have been approved for surgery and paid the second installment of your program fee, you will come back to the clinic to select a surgery date and to schedule any pre-operative testing that might need to done.

Potential testing may include:

• Cardiopulmonary fitness evaluation
• Complete history and physical by a primary care physician
• Cardiac clearance by a cardiologist
• Sleep Apnea Study
• Upper GI (x ray test)
• Upper endoscopy (a scope of the stomach)

As soon as your surgery date has been set, plan your weeks/months ahead. Let your employer know about your leave. Your human resources department will be able to help you with the paperwork required for a medical leave. Although you do not need to tell your employer that you are having weight loss surgery, you will need to tell them that you are having abdominal surgery. This will require about a one week recovery for the Lap Band and about a two week recovery for the Laparoscopic Roux-en-Y procedure.

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Step 8 - Preoperative Nutritional Teaching
After your surgery date is scheduled and you have paid the final installment of your program fee, you must attend nutrition classes prior to surgery. Our registered dietitian will contact you to make an appointment your nutrition class. You will be required to do homework that must be completed before surgery; otherwise, your surgery will be cancelled.

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Step 9 - Selecting a Support Person or "Coach"

The pre-operative/surgical consent visit occurs within 30 days prior to surgery. You will meet with your surgeon and discuss in-depth the risks and benefits of the procedure. You will also meet with our program coordinator. Please bring a family member or close friend to assist you with this process.

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Step 10 - Medical Clearance (One to three weeks before surgery)
Your primary care physician must give you medical clearance to have surgery. You must have an appointment scheduled with him or her three to four weeks before surgery for a complete history and physical. There is a Deaconess form your doctor can fill out which our office can provide to you. If your insurance carrier is Medicare/Medicaid, you medical clearance must be done one week before surgery. We must have a copy of the clearance history and physical on the day of your preadmission testing visit or your surgery will be cancelled. The easiest way to accomplish this is to physically bring the papers with you, although you can have them fax it at 513.559.2107.

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Step 11 - Pre-op liquid diet
All patients must follow a strict liquid diet beginning 10 days prior to surgery. The purpose of this is to reduce the size of the liver to maximize the chance that your procedure can be done via a minimally invasive technique. If your starting weight is high (BMI above 60) you may be asked to do the liquid diet for longer than 10 days. Our dietitian will fully educate you on this plan at the time of your nutrition class or sooner if needed.

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Step 12 - Pre-admission Testing (One week before surgery)
You will be scheduled for pre-admission testing approximately one week before surgery. Please bring your insurance cards, a list of current medications with dosages and schedules, and if desired, an advance directive/living will. Pre-admission testing will perform a nursing assessment, EKG, blood work and an anesthesia consult. You will be instructed what medicine you can take with a sip of water the morning of surgery.

Practical Matters

You may want to go to the grocery store before surgery. By this time you will have met with the dietitian and will know what to have on hand at home. Some basic utensils that you will need for proper food preparation include:

• Blender
• Strainer
• Measuring spoons
• Water bottle with no straw
• Ice cube tray
• Baby spoon

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Step 13 - Hospitalization
You will likely stay at the Deaconess Hospital for 4-24 hours for the Lap Band and 24-48 hours for Laparoscopic Roux-en-Y. The rooms at the Deaconess Hospital are private and equipped with sleeper sofas for your convenience. You may want to arrange to have your coach stay with you during your hospitalization.

To prevent infection and promote rest for our patients, children under 14 years of age are not permitted on the surgical weight loss unit.

If you live more than an hour away, we may ask you to stay in the greater Cincinnati area for a period of one to three days following discharge from the hospital.

You can make reservations at:

• Vernon Manor 513.281.3300
• Marriott Kingsgate 513.487.3800.

We have contracted rates at both hotels, so be sure they know you are a Deaconess patient.

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Step 14 - Post-operative Clinic Visits
After either procedure you will return to the clinic one week after surgery for an initial checkup. In routine cases your next visit will be 4 to 5 weeks from the date of surgery. Band patients will receive their first fill or adjustment at this visit, and bypass patients will be advanced to soft solid food. It takes band patients an average three to five fills before significant weight loss occurs. Once the fill process is started, they can be carried out every two to four weeks.

If you have diabetes or high blood pressure you should make an appointment to see your primary care physician 10-14 days after surgery to monitor these disease processes.

Thank you for your interest in the Deaconess Surgical Weight Loss Center! To make an appointment, call 513.559.2545.

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