Help with ins.question

Hello family, ok here it is i am suppose to see Dr. Hruska in Clarksville tenn. for my surgery and go to the psych dr.they have but i called her and she does not take my tenncare ins. so what to do? can anyone help with this please and thank you. Do we have to pay out of pocket for this. thanks Eva

I have bcbs and I still had to pay out of pocket for my psych eval. mainly because most psych evals have a hard time getting ins to pay them so they are now requiring pay up front and letting individuals fight for reimbursement from their ins co. wish I had better information for you. can you use a different psy eval? if so youmight contact Tenn care for a list of providers.

Hi Joe, thank you for the info. i was afraid it was that way,well you do what you have to do i guess.thanks again. Eva

Hey Eva, I have Cigna ins.and planning to go to Centennial to have my surgery.They work with one group for their Psych evals.Their cost has recentally went up from $250 to $295 and it is all out of pocket because they say there are "no billing codes".I'm not sure what that means or why but I feel that with the increase in the people having this done,something should be done to get some "billing codes"so that Ins.companies can cover this also.I would call the surgeons office and try to get a list of Psych Drs that take your Ins.If I didn't get anywhere with that route I would call TennCare and ask them which Dr's take your Ins.I'm fixin' to start my battle with Ins.co. and I'm getting fired up already because I feel I will have problems with my Ins co also. See Ya! April

Hi April, I hear u April i think so to the dr. should have to take the ins. and yes that is what i am hearing from a lot of people here on this board that it is out of pocket pay.thank you for the post and good luck to you. Eva

Hi again,just had another ??? does anyone know if tenncare pays for the fills after i have the lap band? thanks Eva

Eva - Call the 1-800 number on the back of your TennCare card. Explain to the lady what is going on, then she'll send your information to the correct department, and THEN the lady in the correct department will call you back with information on where you can go - using your insurance card! After that - You can call where every they send you and make the appointment on your own. I, personally, did ALOT of my own work when it came to getting this surgery - Personally, thats the only way to go in my opinion. Good luck, Katie

HI Katie and Anne, thank you for the reply and the info. i do have a case manager at tenncare that is helping me a lot.i did call her on Friday and i am waiting on her to call me back.It seams we are having to do a lot of the work our selfs for these appts. but that is ok b/c we are getting closer to the wls.ha!!!!!!!!!!!!!! thanks guys Eva

I have bc/bs but my surgeon wasn't so stringent on making me go to anyone in particular. My husbands EAP paid all but $25.00 for the evaluation. According to most everyone on this board though that is not the norm. Most everone here had to pay out of pocket. Sorry, Anne

Ok are you saying that the psych doesn't take your TNcare? If not here is the deal. With TNcare you have two insurances. One for regular medical.Another for behavioral health ( shrinks, substance abuse etc...) Your case manager might or might not know who your BHO is because it will be different from your main TNcare. What you will need to do is call TNCARE. Not the MCO that you have. The tncare office will be able to tell you the name of your BHO and give you their number. You don't have to see the shrink that Dr.Hruska uses. I went to one locally and had them fax the info to Dr.Hruska.