BCBS.....Grrrrrrrrrrrrrrr

I called them just to try and find out what nutritionist options and pshyc dr options I have and they won't tell me a damn thing other than your dr has to approve it 1st. I know that, but I was just trying to see who all I had to choose from, also they couldn't even tell me if the pshyc dr I go to now is a gastric bypassed approved dr. I mean lord I wasn't going to make an appt. before seeing Dr. Duncan, I just wanted to know kinda what direction I'd be heading in. Melissa

Hi Melissa, Sorry to hear BCBS is being such a pain. My suggestion would be to call your psychiatrists office and ask the front office staff if he could do that for you. Thats what I did... then I found out that he couldn't do my psych eval, and then had to find out what local psychiatrist/psychologist could do my psych eval for me. My insurance company finally gave me a list of all the providers on my plan, then I had to do the leg work to find one that could do the psych eval among them. The important part is that I finally found one who would accept my insurance, and knew how to file it. My surgeons office said it needed to be filed as medical, because it is pre-op for a surgical procedure, and insurance said, no, it goes under mental health... Just keep your spirits up, and don't let all the *crap* get you down. IT'll all be over with soon enough.... Susan Lap RNY 12-1-04 285-189-155 (-96)

Thank you Susan, although all the *crap* is mentally draining for sure, I will see what I can find out. Melissa

Hey Melissa, I used the people that Dr. Duncan's office referred me to. They were great! I emailed you the info. Caren

Thanks Caren as of this point I haven\'t received the e-mail yet. Melissa

Melissa sent you an email if that doesn't help let me know and i will do some more looking ok sandy

Thanks, Sandy,I\\\'m sure I will get it soon. Melissa

BCBS had a little trouble with the psych eval. approval for me as well. Even after I had the PCP's referral, there were no psychologists in my network...so...they had to approve out of network. I had to pay upfront, but they re-imbursed me for all but the co-pay. A lot of behavioral care groups do not provide these evaluations, so I think you were very smart to check ahead. The person you spoke with probably had no clue, and put it back on you! If you do go out of network, there's a form online through BCBS that you will need to use along with the referral. The good thing about using the psychologist who Dr. Duncan recommends is that he/she will already be an expert with this process. They'll know the answers. I kind of wish I had gone that route. I didn't want to drive to Atlanta. I had to make MANY phone calls to get this part done. I think you are smart for being pro-active and wanting to be informed! Hugs, Becky

Becky I actually have psych. dr. that I go to now, and I would love for him to do the eval, but they couldn't/wouldn't even tell me if he was gastric bypass approved. As far as the nutritionist they did tell me that I would have to go to a hospital on my list for that, but other than that NO names or choices of Dr's at all. Thanks, Melissa

I ended up calling and asking behavioral health provider offices whether or not they had docs who did psych evals for WLS. Call your psych doc, and if he does it, then you can call BCBS for approval (after you get the PCP pre-approval). When I called BCBS with a name, they finally were able to help me. I think it's because Magellan handles their Behavioral Health Care and the psych stuff normally falls under them...but not for this surgery. Weird!