Question:
Who requires the Psych evaluation Dr or Insurance?

In my packet I was told Insurance would not approve without Psych evaluation, however I am already approved without one, I am seeing a psych for 2 years but he will not give me a clearance letter as he claims because of liability. My question is How did I get approved without the evaluation?? any ideas? my guess is psych is Dr's requirement ????? Thanks    — catherine J. (posted on August 17, 2001)

August 17, 2001
Hi. It can either be the insurance company and/or your insurance company. In my case my primary care physician(PCP) did mine in her office. SHe asked a few question then filled out a form. So I would discuss this with your PCP or your surgeon. If he is the one who wants it then maybe he can refer you to someone. Hope this helps.
   — Karon C.

August 17, 2001
this is a weird thing i am self pay and the surgeon never mentioned it to me while my mother going to the same sergeon was told her insurance requires one...she called them and they said they don't. Booklet about surgery says they recommend one but, it's not a requirement...so i guess you'll just have to ask both the surgeon and the insurance what they want...hope this helped
   — deborah D.

August 18, 2001
My insurance company (BC/BS of WI) required it, my physician did not, felt it was pointless. It's suppose to identify individuals with substance abuse problems, bulemia, etc. Mine was a total waste of time.
   — Aloha D.

August 18, 2001
The surgeon I'm using requires a psych eval, no exceptions. He has a very high success rate and very low complication rates, and he believes (as do I) that his extensive pre-op testing is partly the reason. He is able to use the psych eval to weed out people who have unrealistic expectations of surgery, who have little or no social support, or who will not comply with post-operative care protocols. Sometimes he will accept someone "iffy" but will spend extra time with that person making sure that things go right for them. I found the psychologist I saw insightful and helpful. He had me thinking about things, particularly in my family background, that I'd never considered before, and helped me see my weight problems in the context of bigger family issues. The MMPI-2 was a bit annoying but I answered it honestly. HTH and good luck with your surgery. As your surgeon point-blank why they require the psych eval, you might get good info that way.
   — Julia M.

August 19, 2001
The program that I'm in requires a consultation with their own therapist, despite the fact that I see one on my own, and had a written recommendation to the program from her. I guess it depends from program to program....
   — [Anonymous]

August 20, 2001
A lot of you folks aren't going to be very happy about this but, in most cases it's not the doctors or the patients insurance company that requires a mental health exam. While most doctors would most likely consider a psych exam for some people as part of a complete lifestyle program because of the nature of eating disorders in general. But, the primary reason the exam is required is the Doctors malpractice insurance company requires it because of the very nature of the problem having both physical and emotional consequences. And some people have brought litigation because after the surgery, damn it all to hell they still weren't happy with themselves! They were just slimmer and had better physical health . As this is already becoming a trend across the US expect to have to have a psych exam before other types of surgery as well. Many cosmetic surgeons are finding themselves also required to obtain psych exams on their patients . One odd side effect of this is it also keeps many people from surgery because psychological exams, testing and treatment violates their churches teachings.
   — [Anonymous]

August 21, 2001
My psych signed the refferal without seeing me as he already had a through knowledge of me and my issues. The surgeon still required another psych eval (everyone must do one)
   — Michele W.