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JourneyLite Physicians-Weight Loss, Plastics, and Spine Experts!

Your team for all your weight loss, body contouring, and spine surgery needs! Gastric sleeve, gastric bypass, gastric balloon, appetite suppressants and more!

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Offers

Plenity-A New, Non-Stimulant Weight Loss Treatment

23/09/2021 by DrCurry 2 Comments

Plenity is a new therapy that works like no other FDA-approved weight loss treatment, and is approved for use in patients with a body mass index of 25-40 kg/m 2.  It consists of 2 simple natural ingredients: cellulose fiber and citric acid contained and dehydrated in a gelatin capsule.  After swallowing 3 capsules (around 20 minutes prior to lunch and dinner) and drinking 16 ounces of water, Plenity re-hydrates itself, absorbing more than 100 times its own weight in water.  After this absorption occurs, Plenity expands in the stomach to take up space (see animation below).  The presence of expanded, re-hydrated cellulose in the stomach can reduce hunger and help patients get full earlier.  As it is not absorbed into the body at all, Plenity has actually been classified as as weight loss device, rather than a drug.  Plenity is the first weight loss treatment to be approved by the FDA for patients who are just mildly overweight, with a BMI of 25-27 kg/m2.

In a clinical study, nearly 6 out of 10 people who took Plenity lost at least 5% of their body weight. Their average weight loss was 10% of their total body weight (about 22 pounds).  Patients in our Plenity program must come in for monthly office visits and meet with one of our providers and a registered dietitian, as well as following a mindful eating plan and exercising regularly.

One major issue with many weight loss drugs is that they have a significant rate of adverse systemic side effects such as elevation in blood pressure or heart rate, nausea, overstimulation, etc.  A significant advantage of Plenity is that it does not have any major systemic side effects, since it is not absorbed at all into your body at all.

rehydrated plenity

Plenity must be prescribed by a physician, nurse practitioner, or physician’s assistant and can be obtained from their partner pharmacy, GoGoMeds.  In order to receive Plenity, your provider must send a prescription to GogoMeds, and the patient must log on to GoGoMeds.com and register as a patient.  After registering, you will have to add your prescriber in your account.  After payment, GoGoMeds will ship your medication to your home address.  The current 2021 pricing including shipping for a 30 day supply of Plenity from GoGoMeds is $98.

It remains to be seen if this medication can be used in patients who have had prior surgical weight loss procedures and at this point we would recommend against it, unless under the close supervision of a bariatric surgeon.

Appointment Request -Medical Weight Loss

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    Submitting this form does not constitute a doctor-patient relationship with Center for Metabolic & Bariatric Surgery, LLC/dba JourneyLite Physicians. Information submitted will not be shared with any third parties except for direct affiliates of Center for Metabolic & Bariatric Surgery, LLC.

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Filed Under: Anouncements, Offers Tagged With: plenity, weight loss drug, weight loss medications

Wegovy

28/06/2021 by DrCurry 2 Comments

semaglutide

Wegovy (generic: semaglutide) is a new injectable weight loss medication that is in the same family as Saxenda (GLP-1 receptor agonist).  Unlike Saxenda, howver, Wegovy only needs to be injected once a week!  Like Saxenda, this medication is approved by the FDA for patients with a BMI of 27-30 if they have weight-related medical problems, or any patient with a BMI over 30.

Wegovy works by interacting with GLP-1 receptors in your body.  GLP-1 (glucagon-like peptide) is an appetite hormone that is naturally produced in humans that helps to regulate hunger.  Saxenda works like GLP-1 by regulating your appetite, which leads to decrease calorie consumption and therefore weight loss.

Wegovy comes in a single-use pen that makes injections very simple.  The dosage is adjusted over 5 months, starting at 0.25 milligrams in the first month and going to 2.4 milligrams in month 5. Each dose comes in 1 pack of 4 pens and contains only the specific dosage for that month.

The manufacturer, Novo Nordisk, offers a savings program where eligible patients will pay $25 fo a 28-day supply of Wegovy with up to 6 refills.  Go to GetToKnowWegovy.com for more information! You will need a Wegovy savings card (or a Kit number) which we can provide at all JourneyLite Physicians offices.  You must know your financial responsibility for Wegovy before you come in for a consultation!

Wegovy is typically injected in the skin of the lower abdomen.  Make sure to clean the injection site with an alcohol swab or soap and water first.  Simply insert the tiny needle all the way into the skin and press the button on the end of the syringe.  You will hear 2 clicks – after the second click keep holding down the button until the yellow bar stops moving.  You can get further instructions and watch a video on how to inject at StartWegovy.com.

Pens must be disposed of in an FDA-cleared sharps disposal container, or a sturdy household container with a tight-fitting lid.

Filed Under: Anouncements, Education, Offers Tagged With: wegovy

Insurance Exclusions and Weight Loss Surgery

15/06/2020 by DrCurry Leave a Comment

Insurance

Many times patients who do not have coverage for weight loss surgery will ask us to file an appeal.  Will this work?  The short answer is no.  Read on for the long answer…

If your insurance does not cover weight loss surgery, this is called an “exclusion.”  This means that the employer who provides the insurance chose to exclude surgical weight loss from coverage in order to purchase a cheaper plan.  Once you understand this fact, it’s easier to understand why you can’t file an appeal and get them to cover it, no matter how severe your obesity might be.

If insurance companies were to allow this, then no employer would ever opt for the more expensive plans that do cover bariatric surgery. They would just buy the bare bones coverage and then tell their employees to all file appeals to get it covered anyway.

Unfortunately, when patients call their carriers, someone on the other end of the line (who actually works for the insurance company) will tell  you that you can file an appeal.  This is technically true, as you can file an appeal for anything your insurance denies.  However, in this case the appeal will never work because the issue is not one of medical necessity; in otherwords the insurance company is not saying that you don’t need the operation, they are denying it because you do not have the right type of coverage.  It would be somewhat like having a tree fall on your house and asking your car insurance to pay for it.  Or, perhaps more appropriately, asking your homeowners to pay for flood damage when it is specifically excluded from your homeowners policy.  It simply isn’t going to happen.

Also unfortunate (at least in Ohio, Kentucky and Indiana) is that marketplace policies purchased by individuals under the Affordable Care Act also exclude weight loss surgery.  Medicare, Medicaid, and most managed-care Medicaid plans such as CareSource, do cover weight loss surgery, however.

We wish that all Americans had access to life-saving surgical weight loss procedures, and maybe some day that will happen.  In the meantime, patients with exclusions essentially have two options:

  • consider self paying for surgery
  • look into a more affordable option such as one of our appetite suppression programs

Frequently Asked Questions (FAQ) about Bariatric Weight-Loss Benefit Exclusions:

  1.     Why do I have a bariatric weight-loss benefit exclusion? When employers decide on a policy to offer their employees, they determine if they want to include or exclude bariatric weight-loss benefits. It is an addition to a plan; it is not an automatic benefit for a medical health plan.
  2.     What happens if the practice submits a pre-authorization when my insurance policy has a bariatric weight-loss exclusion? If the practice submits a pre-authorization and gets approval for medical necessity, it may seem the patient is approved for surgery. But when the patient’s policy does not have bariatric weight-loss benefits, the insurance company will not pay the claim. This will make the patient responsible for the entire billed amount, possibly over $50,000.00. If the pre-authorization is denied, you would have to possibly complete extra insurance policy requirements, which you did not need when you have a bariatric weight-loss exclusion. Some insurance policy requirements are but not limited to, a body mass index (BMI) of over forty (40), 5-year weight history, and a twelve-month physician-supervised diet.
  3.     Why does the practice maintain a Self-Pay Financial policy not to submit a pre-authorization for a policy with an exclusion? When a practice submits a pre-authorization to an insurance company, they are checking to see if the patient is approved, medically, for surgery.  This is called medically necessity. The insurance company pre-authorization department does not always verify if a policy has bariatric weight-loss benefits. Therefore, we do not submit for medical necessity when a patient has a bariatric exclusion.
  4.     Why do I not have to meet my insurance bariatric weight-loss policy requirements when I have a bariatric exclusion? Each insurance company has a bariatric weight-loss policy with requirements to meet medical necessity; this is to qualify the patient medically. When you are not using your insurance for bariatric weight-loss benefits, you do not need to meet their guidelines.  You do have to meet the JourneyLite Physicians Self-Pay guidelines.  
  5.     Why am I waiving the right to file a claim? If you have a bariatric weight-loss exclusion, your claim will be denied, and you will be financially responsible up to $50,000.00.
  6.     Why should I continue as a Self-Pay patient? JourneyLite Physicians is a bariatric specialty group. Each and every day we work hand in hand with insurance companies to review their bariatric weight-loss policies and guidelines. We have created a partnership with them and would like to create this partnership with you also. If you have an insurance bariatric weight-loss exclusion, we want to help you through having surgery. It is very important for us to guide you or your loved one that is having surgery. We are here for you!

Filed Under: Anouncements, Education, Offers Tagged With: exclusion, insurance, insurance exclusions

Weight Loss Surgery In Lower BMI Patients

10/06/2020 by DrCurry 1 Comment

Unfortunately in the field of weight loss surgery we use the phrase “NIH criteria” frequently.  What does this mean?  If refers to a 1991 National Institute of Health consensus statement on which patients should qualify for weight loss surgery.  That’s right folks, in many cases we are basing our decisions today on a loose set of mandates from 30+ years ago, when all procedures were open surgeries with 12 inch incisions, were mostly all gastric bypasses, and had a mortality rate of 1-2%.

Nowadays the gastric sleeve is the most commonly performed procedure, and nearly all procedures are done with a laparoscopic, minimally invasive technique.  Therefore both the short-term and long-term risk of bariatric surgery is a least an order of magnitude lower than in 1991.  Yet most insurance companies still follow these outdated guidelines.

The truth is that lower BMI patients suffering from  class I or II obesity have an increased risk of weight-related medical issues and mortality.

Weight loss and metabolic surgery in lower BMI patients who continue to struggle with class 1 or II obesity, in the setting of failed attempts at lifestyle modification & weight loss programs is proven effective at leading to significant weight loss and an overall reduction in comordities and cardiovascular risk.

Also, it has been shown that diet, exercise, and weight loss drugs are largely ineffective for achieving durable weight loss, even in lower BMI patients. In this setting, weight loss surgery is reasonable and is supported by the recent American Society of Metabolic and Bariatric Surgery’s position statement in 2018 (Surgery for Obesity and Related Diseases 14 (2018) 1071-1087).

Obesity is probably the only disease where we make patients wait until they are sicker and a higher operative risk to offer them the most  successful treatment option, which is weight loss surgery. We need a change in thinking here as lower BMI patients often times have a higher success rate and are almost always a lower operative risk. Waiting until a patient is heavier and sicker is not the best strategy!

Filed Under: Anouncements, Education, Offers Tagged With: low BMI

JourneyLite Surgery Center: Now An Optum Center of Excellence!

20/08/2019 by DrCurry Leave a Comment

Optum complication rate

An Optum Center of Excellence

JourneyLite Surgery Center in Cincinnati, Ohio is proud to be one of the first ambulatory surgery centers in the country to be accepted into United Healthcare’s Optum Bariatric Resource Services Center of Excellence!  Data shows that Optum Centers of Excellence (COE) have a 19% lower mortality rate than non-COE providers, a 30% lower hospital re-admission rate, and a 20-30% lower cost than non-COE providers.  Since its founding in 2007, JourneyLite has been focused on providing the highest-quality, state-of-the-art care for weight loss patients, including surgical AND non-surgical options.  With procedure offerings from the powerful SIPS procedure to the non-surgical gastric balloon, JourneyLite has a weight loss option in Cincinnati to fit your needs.  In addition, JourneyLite Physicians offers satellite care in Columbus, Dayton, and Northern Kentucky.

Becoming a Center of Excellence can be a complex process.  Usually there is a high volume requirement as it has long been known that centers performing many of a few procedures have lower complication rates than those doing few of many different procedures.  Secondly, a multi-disciplinary team must be in place to ensure that all the needs of the patient can be met both before and after surgery.  Thirdly, there is a verification process in place where a third party reviews the information, and even sometimes travels to the facility for a site review.

JourneyLite of Cincinnati has achieved many Center of Excellence milestones!

  • first outpatient surgery center to be reviewed and accredited as an SRC Bariatric Surgery Center of Excellent in 2010
  • first outpatient surgery center to be reviewed and accredited as an MBSAQIP Comprehensive Center in 2016
  • One of the first outpatient surgery centers to be reviewed and accredited as an MBSAQIP Outpatient Center in 2017
  • One of the first outpatient surgery centers to receive Anthem Blue Distinction Plus certification in 2015
  • One of the first outpatient surgery centers to receive UHC Optum Center of Excellence accreditation

Whether its JourneyLite Physicians or JourneyLite Surgery Center, we will never cease our quest for continually improving patient outcomes while providing affordable access to care!

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  • Terms Of Service

    Submitting this form does not constitute a doctor-patient relationship with Center for Metabolic & Bariatric Surgery, LLC/dba JourneyLite Physicians. Information submitted will not be shared with any third parties except for direct affiliates of Center for Metabolic & Bariatric Surgery, LLC.

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Filed Under: Anouncements, Offers Tagged With: optum

Save $1000!

08/05/2019 by DrCurry Leave a Comment

For a limited time, take $1000 off select self pay procedures!

Excludes Orbera and all revisional procedures except band-to-sleeve, band-to-bypass and sleeve-to SIPS.

Choose your option!

Gastric Sleeve

vertical sleeve gastrectomy

SIPS

loop duodenal switch

Gastric Bypass

gastric bypass anatomy

Lap Band

lap band photo

Gastric Balloon

Orbera Intra-gastric Balloon

ESG

ESG

Appointment Request

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Step 1 of 4 - Contact Information

25%
  • MM slash DD slash YYYY
  • Please select the program(s) in which you are interested!
  • (for example for 5' 2", enter 5)
  • (for example for 5' 2", enter 2)
  • Please click here to watch the online infosession before requesting an appointment!
  • MM slash DD slash YYYY
  • Terms Of Service

    Submitting this form does not constitute a doctor-patient relationship with Center for Metabolic & Bariatric Surgery, LLC/dba JourneyLite Physicians. Information submitted will not be shared with any third parties except for direct affiliates of Center for Metabolic & Bariatric Surgery, LLC.

  • This field is for validation purposes and should be left unchanged.

Filed Under: Offers Tagged With: $1000

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