Am I a Candidate?

Bariatric surgery isn't for everyone. Those who believe that this is merely a cosmetic weight-loss procedure are wrong. The surgical element of our program is a lifelong commitment demanding patience and discipline. The rewards? A new life - an open door to personal growth and opportunity. But failure to respect your body after surgery will result in little - if any - improvement.

St. Alexius NewStart is a weight-management program for the severely obese - those who are 100 pounds or more overweight - who have failed to sustain weight loss through diet and behavioral modification. This program is for people who want their life back; those who want to change, and are dedicated to their personal success.

Typically, patients wishing to undergo weight-management surgery must have a Body Mass Index (BMI) of at least 40 points. However, no two people are alike, and we all have unique bodies and conditions. If you're experiencing medical complications as a result of your obesity, we may still be able to help. Attend a St. Alexius NewStart seminar, and we can answer your questions.

View Available Seminars

Insurance and clinical administration have a few requirements that you will need to meet before you can enter the St. Alexius NewStart program. This guide lists those requirements, along with a few tips on achieving them. If you have any questions, please feel free to call the St. Alexius NewStart office at 1-800-245-1431, or visit us Monday through Thursday from 8a.m. to 6 p.m. and on Friday from 8.am to 4:30 p.m

Important:

1. Insurance Coverage
   We will be in contact with your insurance company to determine your benefits and coverage. However, you will be ultimately responsible for any updates, cancellations, deductibles or co-pays regarding your policy. Make sure you understand your policy, and be sure to verify all coverage with your provider. Please call us if you have any questions regarding insurance.
   
   
2. Diet and Medical History Forms
   You will need to complete a set of diet and medical history forms for you surgeon to review. We will mail these forms to your home, but they may also be picked up at a St. Alexius NewStart seminar or at our offices. You can download the forms from our website by clicking here.
   
   
3. Psychological Evaluation
   You will be required to have a routine evaluation performed by a licensed psychologist or psychiatrist . We can provide resources if you haven't already chosen one. Once you've chosen a doctor, we will provide guidelines for completion of this evaluation. This evaluation must be completed before your surgeon can review your medical information.
   
   
4. Primary Care Physician Letter
   You will be required to obtain a letter of medical clearance form your primary-care physician, as well as a recent TSH level (thyroid blood test). This letter should include your health history, any co-morbidities for which you are being treated, any previous attempts at weight loss, and your doctor's opinion as to your suitability for bariatric surgery. Your doctor can call the St. Alexius NewStart office if they have any questions regarding this letter.
   
   
5. Other Information
   Your surgeon or insurance provider may request other information or documents in order to review your case. We will review all of these extraneous requirements with you, and will help you in obtaining them, but you will be ultimately responsible to provide these items.
   
   
6. Educational Seminar
   You will be required to attend an educational seminar before your surgeon can review your records. Call the St. Alexius NewStart office at 1-800-245-1431 for seminar dates, locations and registration, or view our online calendar and then register online by clicking here.
   
   
7. Insurance Letter
   We will send a letter of medical necessity to your insurance company; however the approval can take from four to eight weeks, so please be patient! Your insurance company will review the information and determine if there is medical necessity for bariatric surgery, and whether this procedure is a covered benefit under your health plan. We will check the status of your review on a weekly basis, but you are welcome to contact your insurance company directly for an update.
   
   
8. Insurance Billing
   We will obtain insurance per-certification and benefit coverage for surgery, pre-operative testing and your hospital stay. Any deductibles or co-insurance fees that have not been met must be paid to the hospital prior to surgery. Your St. Alexius NewStart surgeon will bill your insurance company for the surgery fee and assistant surgeon's fees only. There may be additional charges billed by other providers, including services related to anesthesia, consultations, and/or interpretation of pre-or post operative tests.
   
   
9. Pre-surgery Consultation
   Before your surgery, you will need to attend an office consultation with your surgeon, pre-operative testing, dietary education and a hospital orientation session. You may also need to complete specialist consultations required by your surgeon or insurance company. Your St. Alexius NewStart representative will help you schedule the appointments, and will provide you with a pre-surgical itinerary, Not all of these appointments can be fit into one day, so plan for multiple trips to St. Alexius Hospital or to physicians' offices.
   
   
10. Post-op Follow-up
    The St. Alexius NewStart program includes all post-operative follow-up care at no extra charge. These appointments will be with your surgeon and/or dietitian, and are crucial to successful outcomes. You will need to come in one week, one month, three months, six months, one year and annually thereafter. After each appointment, you can schedule your next one, or call in to set it up later.