ATTENTION KMART SHOPPERS???

Try it, it can't hurt. They probably will cover it but I'm not sure with your insurance. I was only sure with BC/BS. Anne

THANKS Anne, I never would of thought to use my EAP. Do I need to call them and let them know, or do I schedule the psych eval with them or what??? Some ppl that have gone to Centennial have told me that the drs. office took care of all of it, and others have said that they had to have a psych eval first before the surgeon would talk to them, so I'm lost! Taking ALL advice ! Thanks for your reply, Carol

Carol, You call them and then they give you the name of someone to call. Or you can call your surgeon's office see who they would like you to go to and you can see if that person is in network. They will tell you it has to be a psychiatrist not a psychologist. I called them and gave them the name of the psychiatrist that I wanted to see and they told me he was in network and then gave me not only the evaluation appointment but also 4-6 more appointments for the next year in case I don't handle the changes well. That was a plus in my book. It only cost me $25.00 for the evaluation. My husband is a state employee also, so I know we have the same insurance. Anne

Anne, You up too? LOL, I was up reading the responses to my earlier posts, and POOF, there you are! Thanks for the info. I am guessing that I have to wait until I hear from the insurance with either yea or nay, and then begin to schedule my appts. When you say in network, you don't mean like HMO or POS in network do you??? I have PPO, does that matter? Gosh, I feel like such a ditz...Thanks Anne, I'm gonna go try this sleep thing again.......

Nope it's PPO....but you still have to stay within the network. However, almost everyone is in the network for Bc/BS ppo. I'm kinda in the same boat you are, my PCP sent in all the information but the weight history for the last 5 years. Thank god when I moved here I used the same PCP every year. He told me he'll make it look really good so I have no problems with the insurance company. The dietician I saw says that sometimes BC/BS says yes right away and sometimes the Surgeon has to fight with them. She said it all depends on *****views your case. She said it's like they don't go by any guidelines..."if this is here say yes" So we will see. I have to call the PCP office on Monday to see what the hold up is. Anne

Anne...careful how you post things. Just a word of advice. I have read post from people who said their insurance companies read post on here and used it against them. I am speaking about the part where you say your PCP said he will make it look really good....while your history probably would qualify you, you don't want the insurance company having any reason to think that your PCP would embellish his recommendation. Good Luck!

Carol....things must be different for each hospital. I am going through the Center for Human Nutrition at Vanderbilt and they require you to have the consult with the surgeon & pysch eval before they submit to the insurance. (By the way I also have BCBS of TN PPO and I got approved on the first try.) Once the insurance approves then the surgeon's office will set the surgery date and before surgery you have 2 dietician visits, lab work and pre-op tests. I have my surgery on July 14. Good luck with your journey to a healthier life. Cindy

hello all im new here but wanted to add my 2cents lol.Im also going though Vanderbilt and im now waiting to hear back from my insurance co.im having my sleep study may14 after that they only thing i need is my utrasound. im not sure how the other hosptails do it but i didnt set anything 1st they had me come in for the 1st evaluation and then started to set dates for all the test i need done.

Hi kym. I'm new here also.I'm also going to Vandy. I saw Dr. Richards on the 11th and the pshc. , now waiting to hear back from ins. also.I have to see my pcp to set up my sleep study, have the scope run because of my gerd history, and also need thyroid blood work run. Dr. R said we were maybe looking at July I can't wait. Best of luck to all.

Carol, I just had surgery there on April 12th. I have the "end of the alphabet" insurance lady--no problems, but she wasn't super-friendly either. I'd guess they have tons of people to deal with trying to get this done. Good news is that the rest of the office has been WONDERFUL ever since! They knew me by face on my third appointment! To answer your question, once you get your approval, they're going to ask you to go to the psych eval and any other testing you need. I only had the psych eval--a couple long written tests and 30 minutes with the psychologist. I actually appreciated the way that office does it--I didn't have to get off work for an initial consult until I KNEW I was having surgery, and I didn't waste a bunch of money (it's now $295 for the psych eval) before I even knew I was approved. I have BC/BS, too. I hope you're going to Dr Dyer--he's in-network for them and I've had to pay a GRAND TOTAL of $650 out of $45,000 worth of hospital and surgeon's charges. If you have any questions, please ask and I'll do my best! Erin in Antioch