Psych appointments at Duke

There has been some discussion about the pre and post op group meetings at Duke weight loss center not being covered by insurance, but I just found out today that most insurance companies are not covering the mandatory psych visit that all patients must go through to qualify for surgery.

I have BCBSNC and got a denial letter a couple of weeks ago for the pre-op group I attended at the end of March.  I called Duke and they told me those meetings are currently not being covered by a lot of insurance companies because they are considered out of network psych consults.  Since I attended the pre-op meeting, assuming it was covered by insurance, I now have to pay $130 out of pocket for that meeting.

Yesterday I got another denial letter from BCBSNC for services on Jan 12th.  That was the day I had my psych meeting.  I called Duke this morning and was told that the psych meetings are not being covered either, so that is another $216 I will have to pay.

I still think Duke has a great program, and I am very happy with my surgery, but it would have been nice to know I was going to be expected to pay almost $350 for services that were required to have surgery there.

Patients are not being told upfront that these services are not covered, so if you are considering surgery at Duke, you may want to ask whether or not your insurnace covers these services before you get the bills in the mail.

WORD sister

Hrm.

May be worth asking Duke if they will permit out-of-clinic psych visits with psych people who are inside the insurance network.  My guess is no, that Duke wants you to use their people, but we'll see.

Thanks for the information. BCBSNC did pay for my psych visit, but I haven't had a pre-op. Will be interesting to see how it turns out. T

Terri,

You may want to check on the psych visit, I assumed mine was paid for because I had the visit on January 12th, but I just got the denial letter yesterday.  I have no idea why it took them over 3 months to deny it, but they did.

Good luck on your surgery!

I had an appointment on Tuesday of this week to attend my three week group and appointment. I was told, after I asked, that the groups are not covered unless you have medicare. I am not planning on attending the 3 month group. The three week group had 3 weekers, 3 monthers, 6 monthers, and years all in the same meeting. I think you hear the same thing everytime, except for complaints and maybe different people.

I also waited 2 hours to see Dr. Pryor and then didn't get to (we were told she was running an hour behind, but it was two hours before I was placed in a room). I think I saw her med student?  I didn't get all my questions answered. It was a disappointing visit.

Sarah,

Please consider contacting Dr. Applegate and let her know of your concerns about the visits. Let her know what your experience was and would you expected and/or would like to see. I think that your constructive critique might help them help and others. I know that they want it to help. The used to do the meetings so that they only had people in each group that had their surgery within the same time frame. I imagine that there are pros and cons to doing it each way. I am not privy to why they do it the way the do or why they made changes, but if people let them know what is working for them and what isn't I think that they will listen and may make some adjustments. 

I would also contact them and let them know what your questions were that weren't answered and let them know that you were disappointed. I had a similar thing happen to me at one point and when I spoke up, they made the time to see me and make sure that my questions were answered, so please consider contacting them. 

I look forward to seeing you at the next meeting. 

Warmly,

I haven't even been to the seminar at Duke yet, however, I must say that I get a little discouraged when I sign into the forum and hear stuff like this. I feel like I'm headed to an up hill battle and haven't gotten out of the gate yet.

But in saying that I can't thank you all enough for the heads up all the information. I'm supposed to attend the seminar on May 14th to start my journey.

Don't get discouraged, in my opinion the surgery was totally worth it, just a few little surprises along the way!

Thank you.
I can't wait for the day that I can say it was totally worth it.