Question:
Has anyone had their insurance pay for their psych evaluation?

I have Cigna PPO. My doctor, Dr. Michael Wood in Jackson, MI, requires that I have a psychiatric evaluation and h. pylori test before setting a date for surgury. I have already been approved by Cigna for the surgery. What are my chances of getting them to approve the psych eval?    — Amanda B. (posted on January 9, 2000)

January 9, 2000
Hi Amanda, I had B/C B/S PPO. The woman who did my psych eval. was out of network but, she was the only dr. I could find who was experienced. she charged 150 dollars up front. she did write me out a bill which I submitted to my ins. company with a note to them that they had requested the psych eval for a operation that they had approved. they reimbursed me 75 dollars. My understanding is if you go out of network with a PPO they pay 80/20. Especially if it was requested by them and they approved operation. Hope this helps.
   — Jodie R.

January 9, 2000
I had to take the MMPI(personality test) and meet with a psychologist for about an hour. All together the cost was $550. I had to pay a $50 co-pay, and another $11 was written off because the psychologist was an in-network provider for the ppo. Cigna paid the rest. I didn't have to get pre-approval for the psych visit, I just went, then had the psychologist's office submit the bill to Cigna. Of course you will have to look at your policy for your individual co-pay and yearly deductible. I hope this helps.
   — Lynn K.

January 9, 2000
I have Keystone Blue-Blue Cross Blue Shield HMO and because the psych testing was requested by my surgeon as part of my pre-op testing, it was approved, BUT I had to get a seperate authorization for it. It wasn't until after my surgery that I found out it was not approved. It took me 4 weeks of calls and numerous conversations, but my insurance made an adjustment and paid the claim for the doctor. Also, the doctor I went to was on the approved list from my HMO.
   — Kelly M.

January 9, 2000
I have bluecare network and they paid for 50% So I still had to pay 135.00. But it was worth it because I am having surgery on Jan.24. Good luck Dawn
   — Dawn T.

January 9, 2000
I have only had my insurance since the first of this month , I have cigna healthcare (hmo). However from what I undestand in the reading is that your Doctor needs to send in a referal for the pshychiatric evaluation, and they should approve it since they already have approved the surgery and the psych eval is a pre requisite. just a guess, good luck! cristy
   — cristy P.