Nt1330 Week 1 Case Clinic Weight Solutions Clinic

KEL030

SUNIL CHOPRA AND CANAN SAVASKAN

Weight Solutions Clinic:
Bariatric Surgery Center
“Tell me Mike, how do you expect me to face Mr. Spitzer, who has already waited ten weeks for an answer from his insurance company, and tell him that the earliest we can operate on him is in three months’ time? You know that he is struggling to make this drastic commitment, and we are just making life more difficult for him,” Dr. Crawler said to his head surgeon. “We urgently need to do something about this. This is not the first time that I have had to deal with such an unpleasant situation, and I am sure this will not be the last.” Dr. George Crawler, one of the leading bariatric surgeons in the country, founded the Bariatric Surgery Center at
After the initial consultation, about 40 percent of the patients decided to avoid surgery and try other methods for weight loss. The patients who opted for surgery spent another 10 minutes with the surgeon as he requested a set of tests (e.g., blood, psychological, endocrine, cardiology, and radiology). Next, the patient returned to the receptionist and arranged for an appointment for the tests. Setting up the second appointment took about five minutes. When the patient returned for the second appointment, he went to one of the two outpatient rooms where the care nurse performed the tests. The entire battery of tests required about 60 minutes per patient. Test results were typically available within two days. During this time, the patient also decided whether he would pay in cash and immediately schedule an operation date, or apply to his insurance company for reimbursement and schedule an appointment after the company gave its approval. Those patients who opted to pay by cash called the receptionist and scheduled a pre-surgery visit with a surgeon. Arranging these appointments took five minutes. If the patient wanted insurance reimbursement, the process took much longer. A surgeon had to spend about 20 minutes preparing a letter explaining why the gastric surgery was a medical necessity and then send it to the insurance company to get approval. About half the cases were approved within three weeks. For the remaining 50 percent, the insurance company asked for additional tests and records. This response also took about three weeks. Those patients then had to schedule another visit with a surgeon and undertake the additional tests. The call for the appointment (to the receptionist) took about five minutes; the visit with the surgeon took about 15 minutes; and the additional tests, handled by a care nurse, took about 30 minutes. The results of the additional tests were available within two days and were sent to the