BCBS Denial because of Psych Eval
I'm having a hard day today because of my denial last week. I was fine, or thought I was until today. I guess because my surgery was going to be in 3 days and now it isn't.
Has anyone else been denied because of a psych eval but appealed 6 months later and won?
Please help! I am needing some super words of encouragement.
Thanks!
Lisa
I spoke with one woman who was denied because of her psych evaluation. Actually, I think her doctor wouldn't submit her stuff to insurance because the psychologist said they felt she had some issues to work through before they could recommend her as a candidate for surgery. She was going through a very stressful period at the time. Anyway, she stayed in therapy with this psychologist and in about four months the psychologist cleared her. I only spoke with her briefly so I couldn't even tell you her name at this point.
Did the psych eval recommend continued therapy so you WOULD pass? I'm sure that there are other people who've had the same thing happen to them.
Christine
Lisa,
Did you have the psych exam with the psychologist that Dr. F uses? Did he indicate there was any kind of problem? The psychologist that did my exam told me what her findings were and what her letter to the surgeon would say. Is waiting six months the policy of the surgeon or the insurance?
If you were not told anything please remember, you have a right to see any and all of your own medical records. That is the law.
Please give us more information. Not sure we can help but we can try.
Pat
This happened to me, the first psych dr. caused me to be denied...so I found another psychologist, went to him for counseling over the summer-and he gave me the MMPI test-and the all clear and we won on appeal in October! I also submitted all current notes on my health from my PCP, and a personal letter about how miserable I am with all these comorbids..etc..took 2 days to get an approvalKeep trying-it WILL happen!
Hey Afro Cutey, thanks for responding to my message.I recently found out that on my new job I will be only offered Kaiser Permanente insurance. I did choose the plan with the most flexibility,and options-my hands were tied!!! Do you have any experience with Kaiser and WLS; do you know of anyone who has been successful with Kaiser?
Hi Lorraine,
Only 4 days to go. I can't wait. I am so happy for you and for all of the May WLS people. The Gerber - Stage 2 baby foods are great- or as great as they can be for pureed food. The Ham dinner has 8 grams of protein and the turkey w/ gravy has 7 grams. I also bought the Designer Whey Protein powders. I got choc. and natural. The Choc. I can mix with water or skim milk. Each serving is 18 grams of protein. That will be great for getting 50-60 grams per day. The natural I can mix with anything-egg beaters, baby food, shakes. I want to make sure that I get all the protein I need.
Right now I am just putting together the things I will need for the trip. I am having my WLS in Pittsburgh and I live in RI. I have to stay in PA for 2 weeks. My husband will be leaving me on the 8th, but I have a friend that will stay with me for the rest of the time.
I had my PCP surgery clearance today so I'm ready to go.
Good Luck to all and I'll be in touch when I get home.
Pam