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Pre-Operative Information

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Required Pre-Authorization Consultations

As part of your pre-operative clearance for surgery, I require you to have at least a psychological and pulmonary/critical care clearance, a PCP clearance letter, and a nutritional evaluation. This is another way in which I work towards the safest possible operative experience and the best outcome for you. As noted previously, this is how I have done it for the last 2500 – plus cases and it has been very successful. Currently, most insurances are requiring a 3or 6 month, documented, medically managed weight loss program to be completed prior to approval.

It would be ideal if when you come to seem me in consultation that you have completed these elements of your work-up. If they haven’t been done then I’ll order them when you come to see me. That is okay too, if you so desire. But, this may delay your approval because many insurers are asking for the “complete work-up including the psychological clearance and any other pre-operative evaluations that have been done.” Many will not review our request for pre-authorization until this is completed. So, it is ideal to have these two evaluations done prior to seeing me.

Take this request to your primary physician and ask for a referral to one of the practices noted below. If no referral is needed, then you can arrange this on your own. (We do allow you to use other practitioners, selectively—especially if you already have a relationship with a particular such provider OR the logistics of travel preclude you from using one of “our” doctors. But, you need to make sure that these alternate doctors contact us to guarantee that they are deriving the clearance information that we need.)

I. Psychological consultations:
1. Melinda McMahon, PhD 4500 E. 9th Avenue, Suite 720
Denver, CO 80220 5897
720.299.5897

2. Eating Disorder Center of Denver
Nancy Ziemke, PhD
950 S. Cherry Creek St, Suite 1010
Denver, CO 80246
303.771.0861

3. Hilary Silver, LCSW
1890 Gaylord St.
Denver, CO 80206
720-935-7393

If alternate Psychologic professionals are preferred by you or your primary physician, we will usually accept their clearance and analysis if they are board-certified and comfortable with this type of evaluation. If questions or concerns please feel free to just ask. If you are presently under the care of a licensed psychiatric professional or if you are going to see someone who is not routinely doing such pre-op evaluations, she/he CAN do your psych clearance. However, I like them to use my preferred framework that is available from our office. They have to call or e-mail us to get a copy of the template.

II. Cardiology consultations:

If you are 50 years of age or older, I also require cardiologist clearance with at least some type of evocative stress test. Once again, we liberally use this type of screening to further improve the margin of safety in all that we do.

The practice that does the vast majority of our cardiac clearance is:

1. Colorado Heart and Vascular
4545 E. 9th Avenue, Suite 540
Denver, CO 80220
303-331-9121

If alternate Cardiology professionals are preferred by you or your primary physician, or you are presently under the care of a cardiologist, we will usually accept their clearance and analysis if they are board-certified and comfortable with this type of evaluation. If questions or concerns please feel free to just ask. They can also contact me directly.

I appreciate your facilitation of these consults, as needed. From experience we have learned that having this done PRIOR TO your appointment with me significantly speeds up the approval process. But, completion of this step is not required prior to your appointment.

– Michael A. Snyder – MD, FACS

If you have recently been to one of my free Seminars, here is the information that you will need to read, review, complete and return to become one of my patients.

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Very Truly Yours,

Michael A. Snyder, MD, FACS