Guest guest Posted March 8, 2012 Report Share Posted March 8, 2012 You could consider waving or adjusting the fee in specific casesSent from my iPhoneOn Mar 8, 2012, at 11:18 AM, "Herrick, Abby" <abby.herrick@...> wrote: Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks, Abby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2012 Report Share Posted March 12, 2012 Hello all. I see very few bariatric patients as I am the hospital dietitian in a smaller town.  I have a new pt that the insurance is requiring her the 3month pre-op visits. What all do you guys cover in your education classes, and if anyone would be willing to share education materials I would appreciate the added information!! From: [mailto: ] On Behalf Of LeBrunSent: Thursday, March 08, 2012 5:37 PM Cc: Subject: Re: pre-op classes You could consider waving or adjusting the fee in specific casesSent from my iPhoneOn Mar 8, 2012, at 11:18 AM, " Herrick, Abby " <abby.herrick@...> wrote: Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks,Abby **CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@... by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2012 Report Share Posted March 13, 2012 I cover basic nutrition, an overview of each macronutrient regarding guidelines post-surgical. Disucss good vs. bad fats, complex vs. simple CHO's, and good sources of protein. I also discuss why we need each food group and why protein is the main focus post-surgical. Also discuss hydration, goals - not with meals, carbonation, caffeine, etc. Pre-surgical diet, and the diets post-surgical (liquid, pureed, soft, regular). Lastly discuss exercise. I also have see patients 3 months pre-op, I usually have them sit in on my class which reviews the above. One-on-one, I have them start a reduced calorie meal plan, monitor their weight, discuss the diet stages, and by the last month, have them start the pre-surgical meal plan. It really depends on what the insurance requirements. Most of my clients insurance require that they be on a reduced calorie meal plan, nothing in terms of a certain amount of weight to lose before surgery. Hope that helps! Wichman, RD Benefis Bariatric Institute 406-455-8241 katiewichman@... Re: pre-op classes You could consider waving or adjusting the fee in specific cases Sent from my iPhone On Mar 8, 2012, at 11:18 AM, " Herrick, Abby " <abby.herrick@...<mailto:abby.herrick@...>> wrote: Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks, Abby ________________________________ **CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@... by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2012 Report Share Posted March 13, 2012 What all do you do for pre-surgical meal plans? All the information I have from the nutrition care manual is for post surgical not pre. From: [mailto: ] On Behalf Of Wichman,Sent: Tuesday, March 13, 2012 10:59 AM Subject: RE: pre-op classes I cover basic nutrition, an overview of each macronutrient regarding guidelines post-surgical. Disucss good vs. bad fats, complex vs. simple CHO's, and good sources of protein. I also discuss why we need each food group and why protein is the main focus post-surgical. Also discuss hydration, goals - not with meals, carbonation, caffeine, etc. Pre-surgical diet, and the diets post-surgical (liquid, pureed, soft, regular). Lastly discuss exercise. I also have see patients 3 months pre-op, I usually have them sit in on my class which reviews the above. One-on-one, I have them start a reduced calorie meal plan, monitor their weight, discuss the diet stages, and by the last month, have them start the pre-surgical meal plan. It really depends on what the insurance requirements. Most of my clients insurance require that they be on a reduced calorie meal plan, nothing in terms of a certain amount of weight to lose before surgery. Hope that helps! Wichman, RDBenefis Bariatric Institute406-455-8241katiewichman@... RE: pre-op classesHello all. I see very few bariatric patients as I am the hospital dietitian in a smaller town. I have a new pt that the insurance is requiring her the 3month pre-op visits. What all do you guys cover in your education classes, and if anyone would be willing to share education materials I would appreciate the added information!!From: [mailto: ] On Behalf Of LeBrunSent: Thursday, March 08, 2012 5:37 PM Cc: Subject: Re: pre-op classesYou could consider waving or adjusting the fee in specific casesSent from my iPhoneOn Mar 8, 2012, at 11:18 AM, " Herrick, Abby " <abby.herrick@...<mailto:abby.herrick@...>> wrote:Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it.Thanks,Abby________________________________**CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@... by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. **CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@... by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2012 Report Share Posted March 13, 2012 I think we are considering not charging at fee at all. I would be interested in hearing from our RD’s if you are currently charging for these classes and ifyou have run into any problems with patients not being able to pay the fee or choosing another program so that they can have surgery quicker. Thanks 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 LeBrunSent: Thursday, March 08, 2012 6:37 PM Cc: Subject: Re: pre-op classes You could consider waving or adjusting the fee in specific casesSent from my iPhoneOn Mar 8, 2012, at 11:18 AM, " Herrick, Abby " <abby.herrick@...> wrote: Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery,but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patientswill have no way of being able to afford it. Thanks,Abby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2012 Report Share Posted March 13, 2012 I attached the pre-surgical diet plus meal plan that we use. It is called Unjury ® , however, you do not have to use this product. Our surgeons recommend it since it is an isolate, more appropriate for bypass/sleeve patients. However, you can go with another product as long as it has 6gm or less of carbohydrate per seving and 15-20gm protein per serving. I also ENC pt's to monitor fat amounts, especially in pre-mixed shakes (i.e. Atkins, SlimFast). Smiles! Wichman, RD Benefis Bariatric Institute 406-455-8241 katiewichman@... Re: pre-op classes You could consider waving or adjusting the fee in specific cases Sent from my iPhone On Mar 8, 2012, at 11:18 AM, " Herrick, Abby " <abby.herrick@...<mailto:abby.herrick%40tenethealth.com><mailto:abby\ ..herrick@...<mailto:abby.herrick%40tenethealth.com>>> wrote: Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks, Abby ________________________________ **CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@...<mailto:SecurityOfficer%40gcrmc.org> by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. **CONFIDENTIALITY & PRIVACY NOTICE**: This message and any included attachments originate from Gerald Champion Regional Medical Center and are for the sole use of the intended recipient(s). This email and any attachments are confidential and may contain privileged or protected patient health information. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error with a copy to SecurityOfficer@... by e-mail or call Gerald Champion Regional Medical Center in Alamogordo, NM at 575-439-6100, attention Security Officer. 1 of 1 File(s) unjury pre-surgical diet.doc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 19, 2012 Report Share Posted March 19, 2012 The hospital runs the medicare program and I believe there is a $100.00 fee for their 3 month program. I would not consider doing the class for free. There is exceptional value in the nutrition/exercise component that these patients need to learn and need to realize there value. It also can be used to generate revenue for your practice. There is nothing wrong with having patients do a payment plan if they cant pay full amount upfront. Jerry Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks, Abby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2012 Report Share Posted March 20, 2012 We have a weekly class for 6 months and charge $300. If the individual has already completed weight loss classes (such as Weight Watchers, etc) somewhere else, then they can just complete the last three months (also weekly classes for 1 hour) for $150. We have been doing this for years our program has done nothing but grown, so the cost is not an aversion. For those that can't come up with the full amount, we do offer interest-free payment plans. > > >  > > > Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare †" we are concerned that these patients will have no way of being able to afford it. >  > Thanks, > Abby >  > > > >  > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Hi Jerry, We want to have a structured educational program where patients are learning about nutrition, behavior change, and exercise prior to having surgery. This couldbe something that we have for both a patient that insurance requires to be on a supervised diet, but we want to offer it to others as well to help them succeed after surgery. I’m trying to determine if we should make it a requirement of the program regardlessif insurance needs a supervised diet or let it be optional. Also, for those who do want to do it (not supervised diet patients), do we charge them or just make it be something we offer as a program. I don’t want to cause patients to go elsewhere to havesurgery because they are required to do the classes, however I feel that as a program our patient outcomes will be better. Are you doing something similar or are you referring to just a Medicare requirement below in your email? Thanks for your help,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 jeremiah elizondoSent: Monday, March 19, 2012 1:50 PM Subject: RE: pre-op classes The hospital runs the medicare program and I believe there is a $100.00 fee for their 3 month program. I would not consider doing the class for free. There is exceptional value in the nutrition/exercise component that these patients needto learn and need to realize there value. It also can be used to generate revenue for your practice. There is nothing wrong with having patients do a payment plan if they cant pay full amount upfront. Jerry Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes thatgo over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to affordit. Thanks,Abby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2012 Report Share Posted April 11, 2012 Hello Abby, About 20-30% of our patients are required to do a 3-6 month program. I would say 1/2 of those are medicare patients and go to the hospital programs. They other half we have been sending to dietitians in the community. We are starting a pilot 3 month program in house to see how it goes with a few of those patients. Plan is to bill them ~$290 for the full program - which is a competive rate for our area. If insurance does not require a program they only see me for 1 class and the exercise person for 1 class. The fee is about $175.00 for both. I will admit most patients don't want to do any classes and would prefer to go staight to surgery. However, after the classes almost all of them say they learned way more than they thought they would and are really glad they did them. Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks, Abby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2012 Report Share Posted April 11, 2012 We offer what is called a shared medical appointment. Each patient has a 10-15 minute appt with program medical provider and she checks on any labs, meds and other medical f/u as well as does a brief check-in around diet/activity. Then they join a 90 minute group that is facilitated by Psych, RD or PT each with a set topic pertaining to their discipline. We use the SMA as it is billed under medical provider and covered. This is not required by all patients, we use it for those that need 3-6 months.  If you are going to require something I would suggest this model so you don’t have out of pocket expenses for this type of education. If you google or search SMA you will find literature to support efficacy in chronic disease. I second Jerry in that most complain about it up front but after the fact tell us that they feel much better prepared. Good Luck From: [mailto: ] On Behalf Of jeremiah elizondoSent: Wednesday, April 11, 2012 11:21 AM Subject: RE: pre-op classes Hello Abby, About 20-30% of our patients are required to do a 3-6 month program. I would say 1/2 of those are medicare patients and go to the hospital programs. They other half we have been sending to dietitians in the community. We are starting a pilot 3 month program in house to see how it goes with a few of those patients. Plan is to bill them ~$290 for the full program - which is a competive rate for our area. If insurance does not require a program they only see me for 1 class and the exercise person for 1 class. The fee is about $175.00 for both. I will admit most patients don't want to do any classes and would prefer to go staight to surgery. However, after the classes almost all of them say they learned way more than they thought they would and are really glad they did them. Would anyone be willing to share what their program charges for pre-operative classes to help prepare the patient for surgery? Not the hour class that is a week or two before surgery, but the 3 month or 6 month classes that go over a variety of topics pertaining to lifestyle changes and success. I also wanted to see if you had any problems with patients being able to pay the fee if they have Medicare – we are concerned that these patients will have no way of being able to afford it. Thanks,Abby Quote Link to comment Share on other sites More sharing options...
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