Weight loss surgery is just the start of the process. It requires a commitment to change in your life and lots or preparation prior to surgery. You should consult with one of our weight loss surgeons and weight loss surgery specialists to learn more about these changes, as well as your options including laparoscopic or gastric banding revision surgery.
Contact Us for More Information About Surgical Weight Loss Preparation and Options
The Steps to Weight Loss Surgery
STEP 1: Complete Initial Patient Worksheet Questionnaire
STEP 2: Send the Initial Patient Worksheet Questionnaire to the Weight Management Program Office
STEP 3: Insurance Coverage for Weight Loss Surgery
STEP 4: Medical Qualification for Weight Loss Surgery
STEP 5: Appointment for Weight Loss Surgery Patient Workshop
STEP 6: Weight Loss Surgery Workshop
STEP 7: Visit With the Weight Loss Surgeon
STEP 8: Medical Consultations and Weight Loss Surgeon Assessments
STEP 9: Acquiring Insurance Approval
STEP 10: Scheduling the Weight Loss Surgery Date and Pre op Surgeon Visit
STEP 11: The Weight Loss Surgery
STEP 12: Follow-up Visits
The first step in your evaluation for weight loss surgery is to complete the enclosed initial patient worksheet questionnaire. As with all patient records the information that you provide us is highly confidential. We would greatly appreciate your efforts in completing all the weight loss surgery questions and to answer them to the best of your knowledge. If you can’t remember exact dates where needed, please provide approximate dates.
Do not leave any sections blank. If a section does not apply to your situation, please state “does not apply.”
The information you provide is very important in helping us learn more about you, your general health and weight control issues. Our goal as weight loss surgery specialists is to provide you the highest quality of care tailored to meet your health needs. The completion of this worksheet will take approximately one hour.
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IMPORTANT: When you have completed your Initial Patient Worksheet Questionnaire, please mail it to:
Cleveland Clinic Bariatric and Metabolic Institute
Department of General Surgery (A-80)
ATTN: Jennifer
9500 Euclid Ave.
Cleveland OH 44195
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Please contact your insurance company and verify that your policy does cover weight loss surgery!
Ask your insurance company if the following weight loss procedures are covered at Cleveland Clinic by your insurance plan:
- Roux-en-Y gastric bypass (CPT Code 43644)
- Adjustable laparoscopic band (CPT Code 43659)
- Cleveland Clinic accepts all major insurance carriers, including Medicare and Medicaid.
A VERY IMPORTANT NOTE: Most insurance companies require the following:
- medical documentation of a five-year weight history
- any actual documentation of diet drugs and medically supervised diets prescribed
- any commercial diet program records (Weight Watchers, Jenny Craig, etc.)
- any exercise program records (YMCA/YWCA, gym membership, etc.).
You will need to begin gathering these records NOW so that these are available when we communicate with your insurance company. It is NOT enough for you to simply list these items on the initial patient worksheet questionnaire. The insurance company will require official documentation.
If you have a weight history and weight treatment history at Cleveland Clinic, we will gather that weight information and weight loss drugs prescribed by Cleveland Clinic doctors from your Cleveland Clinic medical record. For weight history outside Cleveland Clinic or its satellite offices, you will need to contact the doctor who weighed you and/or prescribed weight loss drugs for a copy of that documentation. A summary letter of dates, weights, medications prescribed and supervised diets from that doctor or weight loss surgery specialist is acceptable. You may need to contact commercial diet program offices and exercise facilities for records if you do not have these.
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After your insurance coverage has been verified, your Initial Patient Worksheet Questionnaire will be evaluated by our staff to determine if you qualify for weight loss surgery according to the National Institutes of Health guidelines. In addition, other medical problems may be revealed, which could require evaluation by other specialists.
If you do not meet the criteria for weight loss surgery such as laparoscopic, gastric bypass or gastric banding revision surgery, you will be contacted to discuss non-surgical options.
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Once your initial patient worksheet questionnaire has been reviewed, you will receive a call to schedule a weight loss surgery patient workshop. You will also receive a mailed appointment reminder.
If this appointment cannot be kept, please call the program office at 216-445-2224 or the General Surgery appointment office at 216-444-6664. If you are calling long distance, call (800) CCF-CARE and ask for extension 52224 or 46664.
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STEP 6: Weight Loss Surgery Workshop
Please plan for an approximate three-hour workshop program. At that time, we will measure your height and weight. We would like to obtain your photograph, with your consent, during this workshop. You will be presented with information from our program staff and bariatric surgeons regarding weight loss surgery options, risks and benefits. You will be given an opportunity to ask the surgeons questions about our weight loss surgery programs and weight loss treatment options.
Please come prepared for the workshop by:
- Reviewing all material provided to you.
- Bringing the following items to assist you:
- Pencil or pen
- A list of your questions
- Reading and/or distance glasses
We encourage all of you to bring a family member or a friend for support. Again, please plan to be here approximately three hours when you attend the weight loss surgery workshop.
At the end of the workshop, you will receive a certificate of attendance for your files.
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After you have attended a weight loss surgery workshop, you may schedule an office visit with one of our weight loss surgeons to discuss a weight loss surgery plan. At this office appointment, the surgical staff will review your history and examine you briefly. You will have an opportunity to discuss surgical weight loss options with your bariatric surgeon and ask questions. At the conclusion of your visit, a preoperative testing and consultation plan and worksheet (called the green sheet) will be given to you by the weight loss surgery specialist. This plan includes a list of diagnostic tests and consultations that you will be required to complete before proceeding with your weight loss surgery treatment.
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You must complete all testing, assessments and consults that are ordered and discussed with you at the end of the surgeon’s office visit. Please note that all patients are required to have a nutritional and psychological evaluation done at Cleveland Clinic. The need for other weight loss surgery consultations and evaluations will be determined by the history you provide, physical exam and our discussion with you. You will be provided with the names and phone numbers of consultants and testing areas so that you can make appointments that will be convenient for you.
It is necessary that you keep copies of your test results, consultations and other records of treatment if performed outside Cleveland Clinic. Any records of care provided at Cleveland Clinic's main campus or satellite offices (Family Health Centers) are available to us. Although we do not need copies of records of care you receive at Cleveland Clinic or satellite offices, you may want to ask for a copy of these records for your own file at the time of your tests and consultations.
When all testing and evaluation is complete, please mail the completed worksheet and copies of all outside (non-CCF) testing results, evaluations and other documents to our program office. Mail to:
Cleveland Clinic Bariatric and Metabolic Institute Program
Department of General Surgery (A-80)
ATTN: Jennifer (RECORDS)
9500 Euclid Ave.
Cleveland OH 44195
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Once your test results, consults, weight history, diet and exercise program documentation and other records have been received and reviewed by our office, we will submit a letter of recommendation to your insurance carrier requesting approval for the weight loss surgery. Your medical records are forwarded to your insurance company with this letter. The insurance company will let us know if there is any additional information they will need to make the decision to approve or deny your weight loss surgery. Again, as described in Step 3, having your weight and weight treatment history at this time is very important. Failure to include this information may result in a delay of the decision for approval or a denial for insurance coverage.
Some insurance companies will make the decision about your weight loss surgery within a few weeks. Some insurance carriers take several weeks or months to return a decision. We will contact you when we have heard from your insurance company. You may contact your insurance company to check on the status of your insurance approval.
If your insurance company denies the request for weight loss surgery, our financial counselor will discuss appeals and self-pay options with you.
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Once your insurance approval is obtained, you will be provided with a pre-operative clinic visit date and a date for surgery. At your pre-operative visit you will meet again with a Weight Management Program nurse for preoperative education. A Nurse Practitioner or Physician’s Assistant will review your testing and complete a weight loss history and physical exam. You will also meet privately with your bariatric surgeon who will review all aspects of your upcoming surgery.
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In most cases you will be admitted to the hospital the morning of surgery. Whether you are having laparoscopic, gastric bypass or gastric banding revision surgery, the actual time you will need to arrive will not be known until the day before the procedure. Most surgical weight management patients are in the hospital for 2-3 days. Most patients return to work approximately four weeks after bariatric surgery.
There are many more questions that you will have about this step. Many of these questions will be answered during Steps 6 and 7.
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We look forward to working with you in reaching and maintaining your health goals. Compliance to a follow-up schedule after weight loss surgery is very important. Regular follow-up visits are essential to help you achieve your personal and health goals, and will help us evaluate your compliance with lifestyle changes.
Your required follow-up visit pattern after weight loss surgery is as follows:
- 5 to 7 days - nurse visit for surgical drain removal
- One month – physician evaluation; psychological and nutritional follow-up as needed
- Three months – assessment of diet, vitamins and exercise routine; psychological follow-up as needed.
- Six months – physician evaluation and blood to be drawn
- Nine months – assessment of diet, vitamins and exercise routine
- Twelve months – physician evaluation and blood to be drawn
- Yearly for life – physician evaluation and blood to be drawn
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