RD supervised weight loss program 1-3-2012 hn

Nancy Lum RD, LDN DIETICIAN SUPERVISED WEIGHT LOSS PROGRAM In order to meet the requirements of your insurance company, you must follow a “Physician, Dietitian or other qualifying supervised weight loss program.”

IMPORTANT NOTE: Nancy Lum RD LDN is our program Dietitian. The nutrition program details as discussed below are for all incoming patients to the practice.

We want to encourage you to choose to do the weight loss documentation with the Dietitian here, as this will be an extension of your Bariatric nutrition education and help you to make these lifestyle changes prior to surgery. This will help to ensure success with your procedure as the food and exercise lifestyle changes are enormous keys to your success with the procedure chosen. The early education will help minimize anxiety with diet and lifestyle change prior to surgery as the education will be Bariatric focused.

To make your initial consultation/assessment appointment with the Dietitian to be scheduled for the small group 30-40 minute weight loss documentation monthly meetings and bariatric nutrition classes please contact: Nancy Lum RD, LDN at 443-490-1240 or by e-mail at nutritiontruth@gmail.com Please contact us as soon as you have an initial appointment with the surgeon to schedule your initial appointment with us so that we will be able to schedule you for the appointments necessary prior to surgery and to ensure documentation for insurance and the pre-op education process is completed quickly for us to clear your for surgery.

To do the weight loss documentation with the Dietitian, the process involves an initial fee of $215. This initial consultation/assessment fee includes:

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A 1-hour initial consultation/assessment which includes the first month note for the weight loss documentation as well as the 3-hour Bariatric nutrition education class, a 2 hour pre-op vitamin education class with the Dietitian, and a 2-hour post-surgery nutrition Transition class, and a nutrition clearance letter provided to the Surgeon letting the Surgeon know you are ready for your procedure.

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After the first initial consultation/assessment appointment with the Dietitian, there will be a $15 fee per one hour class fee. The initial assessment will count toward your first month of supervised weight loss documentation for insurance if you choose to use us for your notes.

The total fee for the number of weight loss documentation hour classes you need for your insurance company will be due on your second month of weight loss documentation. One weight loss documentation class is needed per month to full-fill the supervised weight loss documentation process necessary for insurance to approve surgery. These notes will meet the insurance companies’ weight loss documentation requirement.

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We accept exact cash, checks, or money orders due at the time of the appointment or you may pre-pay the classes needed via Master card/Visa money order, or cash for the remaining months at the initial consultation with the Dietitian, but not at the time of class as

we are unable to utilize the credit card machine at that time. . There is a $5.00 processing fee per transaction for credit card payments.

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Each weight loss documentation small group class will last 30-40 minutes. This class will reinforce what is learned in the 3-hour Bariatric nutrition education class and help patients adopt new lifestyle habits prior to surgery to ensure surgical success and provide access to other patients who are going through the same journey.

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These appointments are VERY IMPORTANT to get the approval from the insurance company for the surgery. If you miss a month of documentation the insurance company will require that you start all over again.

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If you are ill, in a car accident, or have a death in the family or any other emergency please contact your Dietitian at the above phone/e-mails provided and we will need to have you reschedule this appointment as soon as possible to avoid losing a month of documentation.

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At any time during the three to six month period, you must communicate with Nancy and/or Devorah if you have any questions or concerns about the process or your progress.

PATIENTS WITH MEDICARE INSURANCE PLEASE READ BELOW

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You will need 6 consecutive months with the Dietitian and documentation by your physician.

Our monthly group documentation meetings should be sufficient documentation for your primary care doctor. You will also need to be in a program with your surgeon for at least 3 months prior to surgery. Your primary care Physician (PCP) will need to document these sessions and sign off forms will be provided by the dietician. Please discuss this with your primary care physician before beginning the program to be certain they agree with this plan.

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Your primary care Doctor (PCP) will need to document what weight you have lost and what you are currently doing to try to lose the weight including attending these group appointments, and following with Dietitian for lifestyle habit change.

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The forms to take to your primary care Doctor (PCP) will be provided to you by the Dietitian at the initial consultation/assessment appointment and must have the physician Stamp and signature on them to be accepted by the insurance company.

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You must return the copies of the PCP letters provided to you to the Dietitian to provide to the surgeon’s office. Due to the volume of patients we see, we cannot do this for you.

WEIGHT LOSS DOCUMENTATION NOTES DONE THROUGH PRIMARY CARE DOCTORS If you chose to do the diet documentation at your physician’s office, please see page 2 of this form. You are still required to see the dietician for teaching.

*** ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE ***