Psych eval today
Completed the mandated psych eval before surgery that my SURGEON requires. The psychologist said Aetna required two visits ( I am on the 3 month plan). I do not see that in any of their requirements.
My insurance plan pays 100% for the psych eval - so do you think he misunderstood or maybe wanted revenue?
Have I read Aetna wrong?
My insurance plan pays 100% for the psych eval - so do you think he misunderstood or maybe wanted revenue?
Have I read Aetna wrong?
I have Aetna, and was just recently approved after following their three month program. I went to the psychologist once a month for the three month period.....so three times. I also did this with the nut., and physical therapist (for the exercise part). Oh and don't forget your pcp.....all three months.
Maybe I over did it, but I doubt it as my surgons office printed the Aetna clinical bulletin out for me, gave me a list of providers, then put it all together in a nice package for Aetna. They insisted this is what it takes to be approved after you make sure your BMI is high enough and has been for two years (with proof).
I started with my PCP, making sure she was on board.....then went from there. The surgons office sent letters of referral to the other providers making sure that their notes included the stuff the insurance company was looking for. I was approved within two weeks of submittal.
I believe I am very lucky to have a surgon whos staff is very proficient at their jobs......
Get a copy of the clinical bulletin (google Aetna clinical bulletin for obesity surgery if no one post's it here), and go from there.
Good luck!
Maybe I over did it, but I doubt it as my surgons office printed the Aetna clinical bulletin out for me, gave me a list of providers, then put it all together in a nice package for Aetna. They insisted this is what it takes to be approved after you make sure your BMI is high enough and has been for two years (with proof).
I started with my PCP, making sure she was on board.....then went from there. The surgons office sent letters of referral to the other providers making sure that their notes included the stuff the insurance company was looking for. I was approved within two weeks of submittal.
I believe I am very lucky to have a surgon whos staff is very proficient at their jobs......
Get a copy of the clinical bulletin (google Aetna clinical bulletin for obesity surgery if no one post's it here), and go from there.
Good luck!