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The candidate's treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling and.The individual has received a thorough explanation of the risks, benefits, and uncertainties of the procedure and.The individual has undergone a preoperative mental health assessment and is felt to be an acceptable candidate and.The individual has undergone a preoperative medical consultation and is felt to be an acceptable surgical candidate and.The candidate's post-operative expectations have been addressed and.The individual's psychiatric profile is such that the candidate is able to understand, tolerate and comply with all phases of care and is committed to long-term follow-up requirements and.The physician requesting authorization for the surgery must confirm the following:.The individual must have actively participated in non-surgical methods of weight reduction these efforts must be fully appraised by the physician requesting authorization for surgery AND.life threatening cardio-pulmonary problems, (e.g., severe sleep apnea, Pickwickian syndrome, obesity related cardiomyopathy) AND.BMI of 40 or greater, or BMI of 35 or greater with an obesity-related co-morbid condition including, but not limited to:.Gastric bypass and gastric restrictive procedures with a Roux-en-Y procedure up to 150 cm, laparoscopic adjustable gastric banding (for example, the Lap-Band ® System or the REALIZE ™ Adjustable Gastric Band), vertical banded gastroplasty, or biliopancreatic bypass with duodenal switch as a single surgery, is considered medically necessary for the treatment of clinically severe obesity for selected adults (18 years and older) who meet ALL the following criteria: This document addresses those procedures.
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There are a variety of surgical procedures intended for the treatment of clinically severe obesity. HIs specialty is the DS and the PPO covers it.unless the employer negotiates for less coverage.Ĭlinically severe obesity is a result of persistent and uncontrollable weight gain that constitutes a present or potential threat to life.
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Visit /bariatrics for more information on the Bariatric Weight Loss Center at NGMC.And you DO know that you are in the back yard of one of hte best bariatric surgeons on the planet, right? Keshishian. “This change in coverage will mean more people having access to our services so they can improve their health long-term.”įor more information on bariatric surgery at NGMC and your coverage, call 67. Robert Richard, medical director for the Bariatric Weight Loss Center at NGMC and surgeon at Longstreet Clinic. “We know that obesity affects nearly every aspect of our health, and losing weight not only improves quality of life now but can lead to less health problems down the road,” said Dr.
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The Bariatric Weight Loss Center at NGMC offers a variety of aftercare support options for patients – including behavioral and nutritional counseling, yoga and weight-lifting classes, a free clothing closet and more. “Weight-loss surgery helps our patients feel better, get conditions like diabetes and high blood pressure under control, and live a fuller, healthier life.” “Our comprehensive program helps patients achieve their weight loss goals with support every step of the way,” said Amy Smith, Bariatric Program Manager at NGMC. Northeast Georgia Medical Center (NGMC) offers a variety of surgical and nonsurgical weight-loss options and is an Anthem Blue Cross Blue Shield Blue Distinction Center for Bariatric Surgery.
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Patients in Georgia who are insured through the State Health Benefit Plan will now have coverage for weight-loss surgery beginning in 2022.