Bariatric Care Management
Reducing the complications of bariatric surgery through nurse support
With obesity prevalence in many U.S. states over 30%, the epidemic is resulting in high costs for health
plans and health complications for members. For members who have chosen bariatric surgery to manage their
obesity, American Health’s Bariatric Care Management program assists in avoiding complications from the
procedure and provides support for improving their health.
Our program consists of medical necessity review, network verification and comprehensive reporting. We also recommend the following requirements that members must satisfy prior to and following bariatric surgery as part of the preauthorization process:
Disease Management
Upon enrollment, the member participates in Disease Management for six months. Our nurse health coaches provide education on nutrition and physical activity and support for managing nine chronic conditions.
Case Management
After surgery, members are supported in Case Management for 12 months. Case managers review treatment plans and medications and can assist in identifying potential complications.
Product Highlights
- Precertification of medical necessity and verification of network provided for bariatric surgery
- Six months of Disease Management nurse health coaching prior to surgery
- After surgery, members are supported in recovery by a case manager for one year
- Option of behavioral health assessment through our partner CuraLinc Healthcare