Psych Eval
What does the Psych Evaluation include? The Dr. my surgeon suggests no longer takes my insurance. The customer service reps have told me that all I need is a Psychiatric Diagnostic Evaluation and it does not have to be Bariatric specific. I have been calling all the other psychiatrists on my insurance list in my area and so far no one does them. I'm worried that I will find someone else and then the Surgeon wont accept it. I'm worried Ill find someone who knows nothing about bariatrics (or is anti-surgery) and will fail me.
I'm in the home stretch in getting this submitted for approval. I'm more worried about not getting approved, or worse having them say I'm approved and then getting a huge bill afterward than I am about having surgery!
Have you called all the psychiatrists that take your insurance?
Does your insurance require the psych eval? If so, then I would call them and ask which providers do it.
Why do you think your surgeon won't accept it if you find someone else? Check with his office to make sure they don't require you to see a particular provider.
If you can't find someone that takes your insurance that does it, you always have the option of paying out of pocket.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
You should be calling Psychologists (or perhaps Counselors) rather than Psychiatrists. Most Psychiatrists focus on medication management rather than assessment. Psychologists are specifically trained to do psych evals in a variety of situations. Some Counselors might be able to do it (I did some while finishing my PhD) but trying to find one (unless your surgeon can direct you to one) is going to involve a lot of phone calling. Your insurance should have a list of Psychologists that are covered by our plan,
I am a little confused by the statement that the evaluation doesn't have to be "bariatric specific". If it isn't tailored to assessing your understanding of what you are about to have done to your body, your understanding of what has contributed to your weight (and what you might need to address after surgery), and the types of changes you will need to make after surgery (and your willingness/readiness to make those changes) what is the point of the evaluation?!?
As far as your concern about getting a huge bill afterward, even if you cannot find someone who is covered by your insurance, you can ask them what the cost will be beforehand. Your insurance might pay a portion of it if you have out of network benefits. Even if you are to pay for it out of pocket, it short be a "huge" bill. They generally range from $150-$300 (but some may charge more; probably none will charge less)
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
I have called almost everyone on the list my insurance gave me and so far no luck. I left a couple messages so hopefully someone will call back tomorrow. According to the insurance company it only says they need a Psych Eval, nothing says Bariatric specific. Didn't make much sense to me. I would much rather go to the Dr my surgeon suggests. Paying out of pocket is an option. I am just trying to get it all done through my insurance first. If I cant find someone to do it from the list I may be able to get a one time approval to go to the preferred Dr. BUT....if the insurance company thinks there is anyone else in my area that will do it they will deny it and ill get charged more. It would be cheaper to do it out of pocket but I need to at least try to have my insurance pay for it first.
It may seem petty that im stressing over less than $300 but we have been saving to pay for my Out of Pocket for the surgery ($6500 including Deductible!) supplies and my time off work.
It doesn't sound petty at all! No one wants to spend $300 if they don't have to!
Did your insurance company only give you names of Psychiatrists or have they given you Psychologists as well? Sometimes the insurance folks don't even realize there is a difference., so they may not be giving you everyone who is on the plan.
I hope you find someone.
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
I wonder if you've talked directly with any of the psychiatrists you've called....
The reason I wonder is that a receptionist may never had such a request... People usually just call asking for an appointment.
The first time an internist sees a patient, he takes a detailed medical history & family history, does a physical and notes any clinical condition and/or disease he finds or wants to rule out with tests. This is a physical diagnostic exam.
When a psychiatrist sees a patient for the first time he does a detailed family history, marital history, about your children, job, etc. He will inquire about your family psychiatric history and about yours. He will let you tell him about what's going on in your life and likely ask you questions.
The initial appointment interview may run to 90 minutes or more. Afterwards he will enter it all in a chart and it becomes part of your chart. From this assessment, he records his impressions of areas the patient might wish to address... He will consider tentative diagnoses or observations.
This is a psychiatric diagnostic evaluation. Just a sibling of the internist's medical diagnostic evaluation.
Just tell the receptionist that your Bariatric physician requires a Pre-Surgical Consult and a report sent to the sugeon. If she seems uncertain, have her write the sentence out for the doctor.
It took me. 2 months to get an initial appointment, so call as many as you like, make more than one appointment if you like (cancel laterl.
If you can have your surgeon send him a note telling what he needs to know, then it can help the doc to decide his fitness for the tadk
The PURPOSE of the report will to assure the surgeon that you have what it takes to have this kind of life-altering surgery. He/she may ask about your expectations and lots else.
You'll do fine... But since you doc refers to one particular psychiatrist, that means that person knows what to examine for and what to assess for. It's important that the doctor make that detailed referral once you've narrowed your search..
The problem of getting a report such as the one you describe from a psychiatrist (whose primary focus is medical, not psychological MOST of the time) is that the psychiatrist likely has no way of knowing whether the OP has a realistic view of what she is about to do, what it requires post-op, whether her expectations are realist is, etc. etc. etc.!
A report that basically just says that the client is obese, but has no apparent clinical mental health diagnosis doesn't tell the surgeon squat about whether she is a good candidate for surgery from a psychological standpoint.
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
Somehow I missed that you were calling psychiatrists. Psychiatrists don't often do psych evals. They are medical doctors. They prescribe drugs, mostly. Psychologists and counselors do psych evals. If you're calling psychiatrists, that would be like if you needed a dental exam but instead of calling dentists, called podiatrists (foot doctors). You'd have a hard time finding a podiatrist that would examine your teeth!
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
