Insurance Question

Joanne D.
on 10/24/08 2:44 am - South Easton, MA
Hi Everyone,
Does anyone know what it means if you get a letter from the insurance company telling you that
youve been approved for 12 counseling visits?  Does that sound like its a requirement pre-surgery?  Just wondering if this has happened to anyone else?  Any input would be very much
appreciated.
Thank you,
Joanne
NeedhamGal
on 10/24/08 2:49 am - MA

I don't think it means you 've been approved for surgery...it would come right out and say that. Sometimes on the back of the health card it says...for psych services call this number. they kind of oursource the psych stuff and you need different referalls than from regular medical stuff. Maybee because you needed a psych pre op visit..they authorized it and gave you a standard of 12.    When I get medical referalls they give me a standard of 3.
I think that is what is going on.

You could always call the medical part of the insurance to see if you are approved.
also many insurance carriers have on line self help. you should register for this and you can see what is approved, what referalls are approved, etc.

good luck.

Joan

SandieMc49
on 10/24/08 3:49 am
The type of insurance you have allows for 12 behavioral health visits (per calendar year).  I work in health insurance on the behavioral health side.  That's standard for them to send you out the letter.  Apparently, a therapist called the insurance company to inquire about your eligibility (most likely a psych screening is required) and the letter was auto-generated.  Some psych evaluations take 1-3 visits - so that means you're covered.  The letter should have specified who the counselor is, however.  Check to see.
Joanne D.
on 10/24/08 5:57 am - South Easton, MA
Thanks Sandy and Joan that makes sense.  Before deciding on gastric bypass I had an
appointment at tufts to investigate the lap band.  Unfortunately the lap band wasnt right
for me because of my hietal hernia.  But at least my insurance company is responsive
which is great.
Joanne
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