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Tag Archives: self pay surgery

Mentally Preparing for Weight Loss Surgery

Posted on March 02, 2020 by

Getting your mind in the right place before undertaking any weight loss plan is a good idea but it is especially important when considering a surgical weight loss procedure.  Awhile ago, I interviewed Dr. Dawn Reese for one of my podcasts.  We’ve transcribed the recording to post for you today.

Dr. Clark:  “Dr. Reese, tell us a little bit about your background and how you got involved with me.”

Dr. Reese:  “Thanks for having me back. I love being here. I love talking with you. We’ve been together now about 10 years. I met you in the hospital and we talked about doing this. I have a PhD in clinical psychology. My specialty is behavioral health (health psychology). I try to help people live healthier lives and do more with their lives then what they want. When you and I first met we talked about what you wanted to do with these surgeries and medical weight loss program. That was right up my alley. We can help people live healthier and take better care of themselves. This is what we need to talk about today when getting ready for surgery or a medical program.”

Dr. Clark: “We have to change our mindset. What do we need to work most on when we start contemplating a weight loss plan or having surgery?”

Dr. Reese: “People have to take care of themselves first. That’s the biggest thing with all of this. That’s the umbrella that we’re going to put everything else under. You have to start taking care of yourself first and start thinking about yourself first. One of your goals for weight loss is to change your mindset. How are you going to view yourself differently? How are you going to view yourself as a priority?”

Dr. Clark: “That priority and that mindset are very important. Eighty five percent of my surgical clients are women. They’re often worried about taking care of everyone else first.  They put themselves on the backburner. We need to start planning for shifting that mindset before surgery. Make yourself a priority.”

Dr. Reese: “We start people having a mind shift (fake it til you make it).  For example, you start using the smaller plate. Join the gym. I had a patient come in to my office and tell me he was going to join the gym after surgery. I told him we were going to start tomorrow. You start doing these things now and behaving as if you’ve started your medical or surgical weight loss. Think about how you’re going to plan and cook differently. Get mentally and behaviorally prepared.”

Dr. Clark: “A huge part of this is planning. You alluded to this when talking about the person going to the gym. You need to start implementing that plan even if you’re not able to do much at the gym. Get comfortable with walking in the gym and walking by the class you would like to do. Watch it for a couple minutes. Setting that time aside makes it much more likely that it’s going to happen afterwards. We want to develop skillsets before and after surgery. It could be eating skills or activity skills.”

Dr. Reese:  “Planning is going to be key. How are you going to live your life differently? What are you going to change every day in your life so that you make yourself a priority? Make a list of what your goals are for that day. Preparing people around you is important. If you’re the cook of the family, how is that going to change? Mentally prepare on how this is going to impact other people and how that will make you feel. We have a joke in psychology:  it doesn’t take 20 days to create a habit. It takes a little longer than that. Getting mentally prepared and behaviorally implementing it is so very important. For anything, planning is the key.”

Dr. Clark: “If my norm is getting together with my best friend on Friday nights and going to a movie, that might also include getting a big bucket of popcorn or other snacks. That’s a great part of life. We want to keep doing it, but we have to change some of the aspects. It isn’t that simple to make that change.”

Dr. Reese: “What you’re talking about is really important in terms of mentally rehearsing.  You can imagine yourself at the movies but not having that popcorn.  How is that going to look? How is that going to feel? When we are preparing athletes for an event, we have them imagine themselves in their role.  If you’re an offensive lineman in football we have you imagine doing what you’ll be doing on the field before you even go on the field. That’s a great thing we can do here. How is it going to be Friday night at the movies? What is that going to look like? Mentally rehearsing is wonderful.”

Dr. Clark: “You have to mentally walk yourself through daily situations. Most of us have a routine we go through. I have a routine. I get up in the morning and shower and shave. I can literally write it out. What I find is that if my routine gets thrown off, my whole day starts to fall apart. I might have just told a patient who just had surgery to change their routine. You then have to think about how that will change everything else in your day. A lot of times people don’t think about a disruption or change in schedule. Then, when their routine changes (which causes stress) they revert back to old comfort levels. What does a person do?”

Dr. Reese: “You’re absolutely right. It’s stressful when we don’t have a normal routine. When people get stressed, we’re going to fall back into old patterns. We go back to things that are comfortable to us. We have to start planning. We need to think about what it is that we’re going to do even if we get stressed. How can I not fall back into that pattern and admit to ourselves that it happens? It’s not bad. It’s not good. It’s not anything. It’s just what happens. It’s not a failure. If you plan for it, you’re less likely to fall back into old patterns. You’re more likely to be able to get a new routine going.”

Dr. Clark: “You want to practice these things ahead of time so you’re ready for surgery. It sounds good and you have your plan in place. However, sometimes things don’t work out quite like we want them to. What you do is discuss how to handle things at this point. A major part of what you do is help people figure some of this out. What do we do? How do we change? It really still goes back to the mindset. This is a lot of what you do, right?”

Dr. Reese: “Absolutely! We want you to be successful. If you’re going to start a behavior change, especially weight loss, we don’t want you to be a failure.”

Dr. Clark: “The big message here is changing that mindset. We want to plan for it and practice it ahead of time. It doesn’t matter whether we’re talking about having surgery or starting on your weight loss plan. Things have to change. Change will never occur if you don’t actually change. You can’t wait for change to happen to you. You’ve got to be an active part of all this. Typically the change that happens to us is usually not a good change. We would like to be an active participant. We really want you to think about that message.”

What If I Can’t Find a Qualified Bariatric Surgeon or Comprehensive Program in My Area?

Posted on July 16, 2018 by

2017-03-29_16.59.40_smallerIf you cannot find a qualified bariatric surgeon or comprehensive follow up program in your area, you will have to either compromise what you want/ need or continue your search until you find the surgeon/program that will meet and/or exceed your expectations.

A few experienced surgeons offer a travel program for surgery.  At the Center for Weight Loss Success, we offer such a program for appropriate surgical candidates.  Not only does the program include surgery with arguably the most experience bariatric surgeon in the United States who has performed over 5,000 weight loss procedures, but it also includes our comprehensive Weight Management University for Weight Loss Surgery™ program.  In addition, it is one of the most affordable options available in the United States.  You can learn more about it at www.cfwls.com

The bottom line is that you have to be comfortable with your choice.  We are fortunate to have many excellent bariatric surgeons in the United States.  Your long-term success is the most important thing under consideration here.  I hope this book has helped to inspire you, answer your questions and better prepare you for an amazing journey.  Only you know if this journey is something that is right for you.  If we can be of further assistance in any way, please let us know at success@cfwls.com.  If you desire additional information and would like to view helpful videos that address each of these questions, please visit our main website at www.cfwls.com or at www.myweightlosssurgerysuccess.com.

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Rhonda’s Opinion:  Travel to the surgeon/program of your choice – it’s all worth it!

What if my insurance doesn’t cover weight loss surgery?

Posted on April 09, 2018 by

If your insurance doesn’t cover weight loss surgery, you are not alone.  Unfortunately, according to the American Society for Metabolic and Bariatric Surgery, less than 1 percent of those who meet the criteria for surgery actually have surgery5.   A big reason for this is lack of insurance coverage.

If you find you do not have insurance coverage, there are self-pay surgery options available (some more affordable than others).  The self-pay cost of weight loss surgery procedures varies by the type of procedure and geographical area in which it is offered (urban areas tend to have a higher fee).  Generally speaking, the average cost for a gastric bypass ranges from $18,000 to $25,000, while the adjustable gastric banding surgery costs anywhere from $17,000 to $30,000.  The sleeve gastrectomy procedure is newer and a price range is not as readily available.  A ball Park Range is anywhere from $14,000 to $22,000.  The price range is also influenced by the supportive program aspects that may or may not be included, the number of follow-up visits, and for the laparoscopic adjustable banding, whether or not any adjustments are included.

The self-pay cost of weight loss surgery generally includes the cost of anesthesia, the hospital facility fee and the surgeon’s fee.  There may also be additional costs for diet and fitness plans, behavioral modification therapy and nutritional products before and/or after surgery.  However, some fees include these services.  For example, at the Center for Weight Loss Success, our comprehensive weight loss surgery pricing including the costs for anesthesia, the hospital and the surgeon is as follows:

  • Gastric Sleeve – $13,995.00
  • Laparoscopic Adjustable Gastric Band – $16,995.00
  • Gastric Bypass – $18,995

However, in addition, an exclusive comprehensive 12 month program is included with these fees.  It is called Weight Management University for Weight Loss Surgery™ and includes the following:

WMU4WLS

You may be surprised that all of these products/services are included, but it’s the right thing to do for optimal long term results and has resulted in a high degree of patient satisfaction and improved outcomes.  For those that travel for surgery, some services are offered online instead of on-site.  No matter who you choose as your bariatric surgeon, make sure that there is a comprehensive program available and ongoing support prior, during and after surgery.

Also, most experienced bariatric surgeons/centers have financing options available.  You will want to verify this and explore your options.  How much is adding 5-7 years of quality life worth to you?

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Rhonda’s Opinion:  You will find a way to pay for it…I did and I did not make very much money at the time at all.  You are worth it and Dr. Clark’s program is one of the most comprehensive and affordable programs available anywhere. 

 

Self-Pay Weight Loss Surgery is common – we offer the most comprehensive and affordable options on the East Coast!  Learn more at: Self-Pay Surgery

Will My Insurance Cover Weight Loss Surgery?

Posted on April 02, 2018 by

Insurance coverage for weight loss surgery varies by state and by the insurance provider.  While some insurers may cover the entire bill, many public or private insurance companies will pay a percentage (usually around 80%) of what is considered “customary and usual” for the surgery as determined by the insurance company.  The first step if you are considering weight loss surgery is to contact your insurance provider (use the provider number on your insurance card) and ask “Is weight loss surgery a covered benefit under my policy?”  Many policies require that the employer providing the policy purchase a “Ryder” for weight loss surgery.  Thus, you might also want to ask “Do I have the Ryder for weight loss surgery on my policy?”  The employer must purchase this Ryder for everyone that is covered under the plan, not just a select few.  There are a number of factors that play into this decision for employers.  However, generally speaking, employers who understand the value of weight loss and the employee benefits (improved/resolved co-morbidities, lower health care and medication costs, less time missed from work and increased productivity to name a few) are more likely to purchase the weight loss surgery Ryder.

"My insurance didn't cover Weight Loss Surgery, but I didn't let that stop me!" Allen Fabijan,  'Some Guy Named Allen' from 106.1

“My insurance didn’t cover Weight Loss Surgery, but I didn’t let that stop me!”
Allen Fabijan, ‘Some Guy Named Allen’ from 106.1

If your initial attempt to authorize coverage is denied, you can appeal, and you should initiate your appeal immediately.   Your experienced bariatric surgeon/center will assist you with this process.  It makes good fiscal sense for your insurer to foot the bill for your weight loss surgery.   According to the Obesity Action Coalition, the upfront costs of weight loss surgery are paid off in three and a half years, due to hospitalization cost savings.  What’s more, the cost of drugs for people with diabetes and high blood pressure plummet following weight loss surgery.  Many are able to stop taking such medications altogether as their blood sugar and blood pressure return to normal levels after weight loss6.

Medicare, the U.S. government health plan as know today for people 65 years of age or older states it will pay for three types of weight loss surgery for patients who are treated in “high-volume” centers that achieve low mortality rates.  The three types of surgeries as we know it today include:

  • The Roux-en-Y bypass
  • Open and laparoscopic biliopancreatic diversions
  • Laparoscopic adjustable gastric banding

An experienced bariatric surgeon/center can guide you through the Medicare requirements that need to be documented prior to scheduling surgery.  Medicare does not pre-authorize weight loss surgery so you will need to make sure all requirements are met prior to surgery and submitted properly with your claim.  Some private insurers require a letter of medical necessity from a doctor before they will agree to pay for weight loss surgery.  However, Medicare does not require pre-certification and does not pre-authorize weight loss surgery.  As a result, many surgeons may ask Medicare patients to sign a contract stating that they will pay for any costs that Medicare does not cover after processing the claim.  You can find out your specific requirements regarding diet history by contacting your local Medicare provider. However, at the time of this publication, weight loss surgery is an option for Medicare beneficiaries if they have a body mass index (BMI) of 35, with at least one health problem related to obesity such as heart disease or diabetes.  As you are aware, governmental insurance is currently under debate and potential revision.  Thus, you will want to work closely with your experienced bariatric surgeon/center.

6Obesity Action Coalition website. Fact Sheet: Why it makes sense to provide treatment for obesity through bariatric surgery.

Rhonda’s Opinion:  It wasn’t covered by my insurance – that’s ok – just do it and move into the future.  As I said earlier, you should qualify yourself instead of letting a stranger at an insurance company make your health decisions for you.

Dr. Clark and the Center for Weight Loss Success offer the lowest cost options on the East Coast.  Learn more at: Self Pay Surgery