GETTING STARTED
Thank you for your interest in the LBS Weight-loss Program. The following information has been compiled as an aid
for new patients who are ready to begin their exciting LAP-BAND weight-loss journey.
Brief overview:
- Attend a Seminar or view EMMI
- Call your insurance to assure it is a covered benefit
- Complete patient information and provide medical history
- Make an appointment with our weight loss team for Psychological Evaluation and Nutrition Assessment
- Make an appointment with one of our Doctors
- Complete the two week pre-op diet or one week liquid diet
- Attend your pre-op teaching the week before surgery
Step One:
It is necessary to either attend a seminar or view an EMMI before you first appointment with the any of the LBS Weight Loss Team.
You can make a reservation by calling
or go to the Seminar page and click on the register button.
If you cannot attend a seminar you can sign up for an EMMI. An EMMI is an online tutorial that walks patients through exactly
what to expect before, during and after surgery. Even if you do attend a seminar we recommend that you acquire an EMMI password.
EMMI is an excellent tool for post surgical education. Patients who have troubles with the internet or do not have internet access
can come to the office and view their EMMI.
Step two:
Check to make sure that surgery and the treatment for obesity, and weight-loss, are covered benefits in your plan. It is very
important that they are not excluded in your specific policy. Criteria for coverage will vary from insurance company to insurance
company. Secondly, you may need to provide your insurance company with certain information and codes to determine if the procedure
is covered.
The following codes will assist you when calling your carrier to determine if these items are a covered benefit.
- Primary diagnosis is Morbid Obesity 278.01
- The CPT (procedure) code for the Lap Band® is 43770.
- The CPT (procedure) code for the Laparoscopic Roux-en-Y is 43644
- The CPT (procedure) code for the Open Roux-en-Y is 43846
Confirmed your coverage? If your insurance confirms that they will cover the bariatric procedure "If medically necessary" you're ready to move on to Step Three!
Denied coverage? If your insurance states that obesity surgery is excluded in your policy then the LAP-BAND surgery and the
weight-loss Program will not be covered by your insurance. But, we would like to help you with identifying other
financing options and have provided some very helpful information on our Financing page. Please click Financing for more
information.
Additional facility expenses: As with any other Outpatient Elective surgery, you may have co-pay, deductible, or out-of-pocket
expenses that your surgical facility may require you to pay.
Step Three:
Please help us by collecting the following information and sending it to us. The sooner we get your information the sooner we can
help complete your approval process.
Please provide copies of the following information:
1.
Patient Information Profile: ease complete these forms before your office visit.
Insurance Verification,
Disclosure Consent,
Patient Profile.
2.
Medical Information: Please provide copies of any letters or medical records from other health care providers. Medical records for the past 5 years are necessary to file for
insurance and to give the doctors a complete medical history.
3.
Physician Recommendation: If filing for insurance, please provide a written recommendation for weight-loss surgery from
your primary care physician.
4.
Diet / Weight-Loss Info: Any documentation proving you participated in any diet / weight loss attempts. (This includes
office notes, receipts or prescriptions)
5.
Insurance card: Back and front please.
6.
Driver's License
7.
Physician Referral: If your insurance plan requires a referral for this consultation, please contact your primary care
physician and have one faxed to the LBS office before your appointment.
Please Note: Insurance companies have 90 days to make a decision regarding their approval. Once we have submitted your
paperwork we have no control over how fast, or slow, they deliver their decision. If you would like to check on your case status
please contact Nancy (by email only, if possible) or call your insurance company. In many cases the insurance company will notify
the patient before notifying the physician’s office. You will need to provide approval in writing from your insurance company to
begin Step Three.
Step Four
For the health and safety of our patients, we follow the National Institute of Health (NIH) guidelines for Bariatric Surgery.
These guidelines require a Psychological Evaluation and a Nutrition Assessment before LAP-BAND Surgery. Once we have received
written approval from your insurance company, or you have chosen an alternate method of payment for the procedure, you will need to
make appointments for your Psychological Evaluation and Nutrition Assessment. Please call the office to make these appointments.
Step Five
Once we receive these reports it’s time to make your appointment to meet with Dr. Smith or Dr. Ferrara. After this appointment you
will be contacted by Pat Wagner to schedule your appointment.
Step Six
You and your doctor will decide which pre-op diet is best for you. You may choose between the 2 week Pre-op diet and the one week
liquid diet. These diets are designed to make your surgery safer by reducing the liver size.
Step Seven
Approximately one or two weeks before your surgery you will have your last appointment for pre-op teaching. At this appointment you
will learn what to expect in the coming weeks before and after surgery. Please bring all your prescription bottles so the Nurse
can explain any alterations that may need to be made.
Any questions you have after reading this summary should be directed to the following Team members. Call the main office number
and ask for them by name or click on their names and send an email.