Re: Pre-op nutrition sessions survey

[Guest guest]

Hi Andi,Our center does do both the 3 month and 6 month pre-op nutrition education appointments. We would even like this to be a part of the program for those patients who do not have the pre-op visits as an insurance requirement, simply because we feel the appointments help the patients become more successful in the long run and also helps them implement healthy lifestyle changes prior to surgery. 

Hope this helps!Ashlee On Mon, Mar 5, 2012 at 11:37 AM, AndiB <andibukowski@...> wrote:

 

Hi All-

Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.

Andi

[Guest guest]

We only do the 3-6 month pre-op educationif insurance dictates it is needed.  Everyone else just gets 2 mandatory pre-opvisits.  From experience, the individuals with the pre-op education seem betterprepared for surgery as they can gradually learn and prepare for surgery.  From: [mailto: ]On Behalf Of AndiBSent: Monday, March 05, 2012 11:37AMSubject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainlyto help some patients meet insurance requirements. Our office manager is notconvinced that this would be a good idea. I am wondering if I can as manypeople as possible to respond to this message telling me if you are or are notdoing something similar. I would like to take this info to our manager as agood representation of what other clinics are doing. Thanks in advance.Andi_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[Guest guest]

Our program could be described exactly like ’s. Mandatory 2 visits. 3-6 month diet visits as required by insurance. From: [mailto: ] On Behalf Of Sorg, Sent: Monday, March 05, 2012 11:35 AM' 'Subject: RE: Pre-op nutrition sessions survey We only do the 3-6 month pre-op education if insurance dictates it is needed. Everyone else just gets 2 mandatory pre-op visits. From experience, the individuals with the pre-op education seem better prepared for surgery as they can gradually learn and prepare for surgery. From: [mailto: ] On Behalf Of AndiBSent: Monday, March 05, 2012 11:37 AM Subject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[Guest guest]

We are not, but I am considering it also. Simler, MS, RD, Manager for Weight Loss Surgery and Osteoporosis ProgramsValleyCare Health System925-416-6712 >>> "AndiB" <andibukowski@...> 3/5/2012 8:37 AM >>> Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi

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[Guest guest]

Our program recently started a requirement that all patients must complete 3 consecutive monthly visits in addition to a pre-op class (2 weeks prior to surgery). We have only been doing this for a few months, however thus far I have found it helps to better prepare the patients for surgery and aid determination of whether patients are candidates. The time period gives us an opportunity to evaluate if patients are serious about the process.

, MS, RD, CDN

Secretary, Greater New York Dietetic Association

Bariatric Surgery Dietitian, Montefiore Medical Center

Pre-op nutrition sessions survey

Hi All-

Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.

Andi

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[Guest guest]

Our program requires 6 pre-op visits. We have a multidisciplinary team (MD, Psychologist, Exercise Physiologist, and Dietitian). We do education and goal setting at each visit, using Motivational Interviewing. The last visit is a pre-op visit where we discuss pre/post op progression diet. We have been doing this for over 1 year and have much better success. It takes a long time for patients to get comfortable with changes.

Da: <krisper@...>A: Inviato: Lunedì 5 Marzo 2012 13:28Oggetto: Re: Pre-op nutrition sessions survey

Our program recently started a requirement that all patients must complete 3 consecutive monthly visits in addition to a pre-op class (2 weeks prior to surgery). We have only been doing this for a few months, however thus far I have found it helps to better prepare the patients for surgery and aid determination of whether patients are candidates. The time period gives us an opportunity to evaluate if patients are serious about the process.

, MS, RD, CDN

Secretary, Greater New York Dietetic Association

Bariatric Surgery Dietitian, Montefiore Medical Center

RE: Pre-op nutrition sessions survey

We only do the 3-6 month pre-op education if insurance dictates it is needed. Everyone else just gets 2 mandatory pre-op visits. From experience, the individuals with the pre-op education seem better prepared for surgery as they can gradually learn and prepare for surgery.

From: [mailto: ] On Behalf Of AndiBSent: Monday, March 05, 2012 11:37 AM Subject: Pre-op nutrition sessions survey

Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[Guest guest]

Our program requires a one-on-one assessment for every patient and then 3-6 months of nutrition education prior to surgery. We also have a referral process for patients who may require more individual instruction in order to be successful. Since we have implemented this process (approximately 7 months ago), we have seen better outcomes, fewer complications due to inappropriate eating behaviors following WLS, and better patient compliance with dietary recommendations. We have monthly group classes for those who don't require more intensive education and we are seeing a great response in terms of outcomes. Good luck with your endeavor to assist patients in being more successful. Teague, RD, LDNBayhealth Food & Nutrition ServicesBayhealth BariatricsMilford Memorial HospitalKent General Hospital(302) 430-5528 (office)(302) 735-2793 (pager)----- wrote: ----- From: "AndiB" Sent by: Date: 03/05/2012 11:37AMSubject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi

[Guest guest]

Currently we offer a 3-6 month nutrition education program for patients with insurance requirements. For non-criteria patients, they are required to complete at least three visit with the dietitian (1:1 and 2 group classes) prior to scheduling surgery. Everyone will attend 2 week pre-op nutrition and nursing class. We also require a psych eval for everyone. We find the more practice and repetition they have with the behavior changes prior to surgery the fewer complications they have post-op and they are much more successful. Kadlubar, MS, RD, LDBaylor Weight Loss Surgery CentersGrapevine: 2020 W Hwy 114, Ste 180, Grapevine, TX 76051Irving: 1901 N Mac Arthur Blvd., Irving, TX 76051Phone: 817-305-5063 Fax: 817-305-5069www.baylorhealth.com/grapevineweightloss

This e-mail may contain confidential and/or privileged information. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient (or have received this e-mail in error) please notify the sender immediately and destroy this e-mail. Any unauthorized copying, disclosure or distribution of the material in this e-mail is strictly forbidden and possibly a violation of federal or state law and regulations. Baylor Health Care System, its subsidiaries, and affiliates hereby claim all applicable privileges related to this information.

[Guest guest]

Can anyone provide me with information on what they are charging for the monthly visits prior to a dietary consults or pre-op class. Are you charging a onetimefee that needs to be paid in full or are you rolling it into the cost of the surgery? Also, if you are currently charging and you except Medicare, have you had difficulty with these patients being able to pay for this and how did you make it affordable forthem? Also, what was the education breakdown (did the RD do the nutrition part, a personal trainer talk on exercise, and a psychologist work with them as well)? Thanks for your all your help! We just have to make sure that it won’t shy patients away from our program because of the cost or the additional time they willhave to commit prior to surgery. Abby Herrick, RD, LD, cPTMyNewSelf BariatricsProgram Dietitian and Wellness Coordinator(314) 966-9645abby.herrick@...www.mynewselfbariatrics.com True intelligence operates silently. Stillness is wherecreativity and solutions to problems are found.Eckhart Tolle, Stillness Speaks From: [mailto: ]On Behalf Of Sent: Monday, March 05, 2012 12:28 PM Subject: Re: Pre-op nutrition sessions survey Ourprogram recently started a requirement that all patients must complete 3 consecutive monthly visits in addition to a pre-op class (2 weeks prior to surgery). We haveonly been doing this for a few months, however thus far I have found it helps to better prepare the patients for surgery and aid determination of whether patients are candidates. The time period gives us an opportunity to evaluate if patients are seriousabout the process. , MS, RD, CDNSecretary, Greater New York Dietetic AssociationBariatric Surgery Dietitian, Montefiore Medical Center RE: Pre-op nutrition sessions survey We only do the 3-6 month pre-op education if insurance dictates it is needed. Everyone else just gets 2 mandatory pre-op visits. From experience, the individualswith the pre-op education seem better prepared for surgery as they can gradually learn and prepare for surgery. From: [mailto: ]On Behalf Of AndiBSent: Monday, March 05, 2012 11:37 AM Subject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respondto this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[Guest guest]

Hi Asheley,

I would presume that the 1:1 session is the dietary consult where you talk about the surgery itself, the patient’s current lifestyle, and the behavior changes

needed after surgery? How are the 2 group classes structured? Are they just with the dietitian and what do you cover? Also, do you limit how many people can be in a class?

Thank you for your help,

Abby

Abby Herrick, RD, LD, cPT

MyNewSelf Bariatrics

Program Dietitian and Wellness Coordinator

(314) 966-9645

abby.herrick@...

www.mynewselfbariatrics.com

Be the change you wish to see in the world

~Gandhi

From: [mailto: ]

On Behalf Of Kadlubar,

Sent: Tuesday, March 06, 2012 8:38 AM

Subject: Re: Pre-op nutrition sessions survey

Currently we offer a 3-6 month nutrition education program for patients with insurance requirements. For non-criteria

patients, they are required to complete at least three visit with the dietitian (1:1 and 2 group classes) prior to scheduling surgery. Everyone will attend 2 week pre-op nutrition and nursing class. We also require a psych eval for everyone. We find the

more practice and repetition they have with the behavior changes prior to surgery the fewer complications they have post-op and they are much more successful.

Kadlubar, MS, RD, LD

Baylor Weight Loss Surgery Centers

Grapevine: 2020 W Hwy 114, Ste 180, Grapevine, TX 76051

Irving: 1901 N Mac Arthur Blvd., Irving, TX 76051

Phone: 817-305-5063 Fax: 817-305-5069

www.baylorhealth.com/grapevineweightloss

This e-mail may contain confidential and/or privileged information. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited

without proper authorization. If you are not the intended recipient (or have received this e-mail in error) please notify the sender immediately and destroy this e-mail. Any unauthorized copying, disclosure or distribution of the material in this e-mail is

strictly forbidden and possibly a violation of federal or state law and regulations. Baylor Health Care System, its subsidiaries, and affiliates hereby claim all applicable privileges related to this information.

[Guest guest]

Hi ,

For the patients who are not required to be on a supervised diet, are you providing them with the educational classes as well? Is there a charge to the classes,

who teaches them, and what is the structure of the class (content of each class and are they in consecutive order), how many classes do you have and how many times a month? Also, is this a requirement of the program prior to having surgery or do you leave

it optional?

Any information would be very helpful, I’m trying to structure the program but would like input from someone who is already doing this not just for supervised

diet patients, but every patient.

Thank you so much!

Abby

Abby Herrick, RD, LD, cPT

MyNewSelf Bariatrics

Program Dietitian and Wellness Coordinator

(314) 966-9645

abby.herrick@...

www.mynewselfbariatrics.com

Be the change you wish to see in the world

~Gandhi

From: [mailto: ]

On Behalf Of angela_teague@...

Sent: Tuesday, March 06, 2012 7:00 AM

Subject: Re: Pre-op nutrition sessions survey

Our program requires a one-on-one assessment for every patient and then 3-6 months of nutrition education prior to surgery. We also have a referral process for patients

who may require more individual instruction in order to be successful. Since we have implemented this process (approximately 7 months ago), we have seen better outcomes, fewer complications due to inappropriate eating behaviors following WLS, and better patient

compliance with dietary recommendations. We have monthly group classes for those who don't require more intensive education and we are seeing a great response in terms of outcomes. Good luck with your endeavor to assist patients in being more successful.

Teague, RD, LDN

Bayhealth Food & Nutrition Services

Bayhealth Bariatrics

Milford Memorial Hospital

Kent General Hospital

(302) 430-5528 (office)

(302) 735-2793 (pager)

----- wrote: -----

From: " AndiB "

Sent by:

Date: 03/05/2012 11:37AM

Subject: Pre-op nutrition sessions survey

Hi All-

Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond

to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.

Andi

[Guest guest]

Abby, It is rare that we see a patient who has already met the insurance requirement for "supervised weight loss", not because they haven't done other diets/programs, but because they do not have the documentation that insurance companies require. Therefore, most insurance companies mandate that they have 3-6 months (some are thinking about going to 12 months) of nutrition education prior to surgery. We count the one on one assessment with the patients as their first month and then we send most of them (there are exceptions as some patients require more intensive 1:1 counseling) to our nutrition education program. I teach the classes 4 times per month (2 evening and 2 morning classes; 2 at each campus that I cover), but it is the same class all month long. We have the classes on a rolling schedule so that no matter when a patient starts, they can immediately start going to classes. We rotate 6 different classes ranging from "Nutrition Basics" (macro nutrients and daily needs for men and women) to "Cooking made quick and easy" (ways to improve quality and nutrition of meals without spending all day/night in the kitchen, healthy eating on the run and recipe exchanges), to "Intuitive Eating" and "Emotional Eating" to help arm these patients with the tools that they will need in order to be successful after surgery. Although, it is tempting to focus these classes on post-op information, insurance companies mandate that they be focused on Pre-Surgery Nutrition in order to count for the 3-6 month requirement. We are in the process of developing a specific Post-Op class that would be held for patients approximately 1 month prior to their surgery (in addition to the other classes that they must attend), but we haven't started implementing that yet. Currently we bill for the 1:1 assessment; however, there is no charge for the classes. Another program that I worked for charged $10 per class to get a financial investment from patients so they were more likely to attend and were invested in the program. I teach the classes at this point (typically an RD would be the one teaching most of these classes; although, exercise physiologists have been invited to participate in every other class to incorporate the importance of exercise in weight loss). Please let me know if there is anything else I can help with or if you have more questions. I am happy to help. Teague, RD, LDNBayhealth Food & Nutrition ServicesBayhealth BariatricsMilford Memorial HospitalKent General Hospital(302) 430-5528 (office)(302) 735-2793 (pager)----- wrote: ----- " " < >From: "Herrick, Abby" Sent by: Date: 04/10/2012 12:14PMSubject: RE: Pre-op nutrition sessions survey Hi , For the patients who are not required to be on a supervised diet, are you providing them with the educational classes as well? Is there a charge to the classes, who teaches them, and what is the structure of the class (content of each class and are they in consecutive order), how many classes do you have and how many times a month? Also, is this a requirement of the program prior to having surgery or do you leave it optional? Any information would be very helpful, I’m trying to structure the program but would like input from someone who is already doing this not just for supervised diet patients, but every patient. Thank you so much!Abby Abby Herrick, RD, LD, cPTMyNewSelf BariatricsProgram Dietitian and Wellness Coordinator(314) 966-9645abby.herrick@...www.mynewselfbariatrics.com Be the change you wish to see in the world ~Gandhi From: [mailto: ] On Behalf Of angela_teague@...Sent: Tuesday, March 06, 2012 7:00 AM Subject: Re: Pre-op nutrition sessions survey Our program requires a one-on-one assessment for every patient and then 3-6 months of nutrition education prior to surgery. We also have a referral process for patients who may require more individual instruction in order to be successful. Since we have implemented this process (approximately 7 months ago), we have seen better outcomes, fewer complications due to inappropriate eating behaviors following WLS, and better patient compliance with dietary recommendations. We have monthly group classes for those who don't require more intensive education and we are seeing a great response in terms of outcomes. Good luck with your endeavor to assist patients in being more successful. Teague, RD, LDNBayhealth Food & Nutrition ServicesBayhealth BariatricsMilford Memorial HospitalKent General Hospital(302) 430-5528 (office)(302) 735-2793 (pager)----- wrote: ----- From: "AndiB" Sent by: Date: 03/05/2012 11:37AMSubject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi

[Guest guest]

Very helpful, . I think many of us are finding that we need to do something within our bariatric program to help patients meet this requirement. Simler, MS, RD, Manager for Weight Loss Surgery and Osteoporosis ProgramsValleyCare Health System925-416-6712 >>> <angela_teague@...> 4/10/2012 9:32 AM >>> Abby, It is rare that we see a patient who has already met the insurance requirement for "supervised weight loss", not because they haven't done other diets/programs, but because they do not have the documentation that insurance companies require. Therefore, most insurance companies mandate that they have 3-6 months (some are thinking about going to 12 months) of nutrition education prior to surgery. We count the one on one assessment with the patients as their first month and then we send most of them (there are exceptions as some patients require more intensive 1:1 counseling) to our nutrition education program. I teach the classes 4 times per month (2 evening and 2 morning classes; 2 at each campus that I cover), but it is the same class all month long. We have the classes on a rolling schedule so that no matter when a patient starts, they can immediately start going to classes. We rotate 6 different classes ranging from "Nutrition Basics" (macro nutrients and daily needs for men and women) to "Cooking made quick and easy" (ways to improve quality and nutrition of meals without spending all day/night in the kitchen, healthy eating on the run and recipe exchanges), to "Intuitive Eating" and "Emotional Eating" to help arm these patients with the tools that they will need in order to be successful after surgery. Although, it is tempting to focus these classes on post-op information, insurance companies mandate that they be focused on Pre-Surgery Nutrition in order to count for the 3-6 month requirement. We are in the process of developing a specific Post-Op class that would be held for patients approximately 1 month prior to their surgery (in addition to the other classes that they must attend), but we haven't started implementing that yet. Currently we bill for the 1:1 assessment; however, there is no charge for the classes. Another program that I worked for charged $10 per class to get a financial investment from patients so they were more likely to attend and were invested in the program. I teach the classes at this point (typically an RD would be the one teaching most of these classes; although, exercise physiologists have been invited to participate in every other class to incorporate the importance of exercise in weight loss). Please let me know if there is anything else I can help with or if you have more questions. I am happy to help. Teague, RD, LDNBayhealth Food & Nutrition ServicesBayhealth BariatricsMilford Memorial HospitalKent General Hospital(302) 430-5528 (office)(302) 735-2793 (pager)----- wrote: ----- " " < >From: "Herrick, Abby" Sent by: Date: 04/10/2012 12:14PMSubject: RE: Pre-op nutrition sessions survey Hi ,For the patients who are not required to be on a supervised diet, are you providing them with the educational classes as well? Is there a charge to the classes, who teaches them, and what is the structure of the class (content of each class and are they in consecutive order), how many classes do you have and how many times a month? Also, is this a requirement of the program prior to having surgery or do you leave it optional?Any information would be very helpful, I’m trying to structure the program but would like input from someone who is already doing this not just for supervised diet patients, but every patient.Thank you so much!AbbyAbby Herrick, RD, LD, cPTMyNewSelf BariatricsProgram Dietitian and Wellness Coordinator(314) 966-9645abby.herrick@...www.mynewselfbariatrics.comBe the change you wish to see in the world ~GandhiFrom: [mailto: ] On Behalf Of angela_teague@...Sent: Tuesday, March 06, 2012 7:00 AM Subject: Re: Pre-op nutrition sessions survey Our program requires a one-on-one assessment for every patient and then 3-6 months of nutrition education prior to surgery. We also have a referral process for patients who may require more individual instruction in order to be successful. Since we have implemented this process (approximately 7 months ago), we have seen better outcomes, fewer complications due to inappropriate eating behaviors following WLS, and better patient compliance with dietary recommendations. We have monthly group classes for those who don't require more intensive education and we are seeing a great response in terms of outcomes. Good luck with your endeavor to assist patients in being more successful. Teague, RD, LDNBayhealth Food & Nutrition ServicesBayhealth BariatricsMilford Memorial HospitalKent General Hospital(302) 430-5528 (office)(302) 735-2793 (pager)----- wrote: ----- From: "AndiB" Sent by: Date: 03/05/2012 11:37AMSubject: Pre-op nutrition sessions survey Hi All-Our center is trying to implement a 3-6 month pre-op education program, mainly to help some patients meet insurance requirements. Our office manager is not convinced that this would be a good idea. I am wondering if I can as many people as possible to respond to this message telling me if you are or are not doing something similar. I would like to take this info to our manager as a good representation of what other clinics are doing. Thanks in advance.Andi