Question:
Can I go to the psychologist before I even see the surgeon?

My PCP has never handled WLS before. She has put me on 12 week diet (I asked her too so I could get it out of the way) and set up a sleep test. I have not yet met the surgeon (I will go to a siminar on 12/1/02) I wanted to get everything together so that I can move through the system as quickly as possible. What do I need. Can I just ask my PCP for a referral to the psychologist and nutritionist? Do I have to wait till after I see the Surgeon? What other Dr. will I have to go to, and do those have to be at my Surgeons request? Is there anything else that my PCP needs to do? I have Cigna HMO of Arizona. I am 5'0", 212# w/ BMI of 41.4. My surgeon is Dr. Blackstone of Scottsdale, Az. Please help, I want to make sure I have everything covered!!    — Brandyraj (posted on November 14, 2002)

November 13, 2002
Many surgeons require your psychological assessment to be handled by a specific person that they refer you to. Contrary to what some folks may think - this isn't because they've set up some special deal with them, it's because they want to be sure you're being evaluated by someone who's either been formally educated about WLS or someone who taken the intiative to educate themselved about the special needs of the bariatric patient. If you contacted my program I'd be perfectly happy for you to go ahead and have the assesment prior to seeing our surgeon - you'd just have to see the psychologist we use. Why don't you call the surgeon's office and if they use a particular person just get the name and schedule your appointment. Be sure you tell the psychologist's office that you're need the assessment for WLS purposes. Good luck to you!!!
   — ronascott

November 13, 2002
Hi, This was a requirement of my insurance co. Humana HMO, not the surgeon's office. My surgeon may have required an assessment if they questioned someone's ability to adjust to life post-op. I contacted my former therapist and told her about the surgery. She wrote a letter to my Dr/Humana and I gave it to my Dr at my first meeting with him. They said that was adequate to cover the psych eval. requirement. Here is an excerpt from the letter she wrote: "I am writing at the request of my client Tana Richardson regarding her readiness and appropriateness for weight loss surgery. I have known Tana since October, 2001 as a psychotherapy client...Tana is an intelligent individual who educates herself well about any issue she is confronting....When she gets clear on a course of action she is very dedicated and determined in following through. She has been concerned about her weight, self image and diabetic health issues for a long time...She is aware that this surgery is not a magical panacea but sees it as a tool to get to a much more desirable body size and to develop a healthful/practical eating and exercise regimen for maintaining her health and weight for the duration of her life. In my opinion she is aware of the challenge of sustaining good eating practices...Her husband and mother are very supportive of her with regard to this surgery. It appears that they have reflected on the psychological aspects of what the weight loss will mean. I hope these reflections are beneficial to you in considering Tana for these surgical procedures. P.K. LMSW-ACP, LMFT Just FYI...you may want to contact the Dr's office and ask or find out from your insurance company if that is part of their requirement for approval. That is my two cents worth...(grin)
   — TanaMom2JAM

November 14, 2002
Be sure to call your ins. co and see exactly what THEY require for WLS approval - hopefully the CSR you speak with will be educated enough on the subject...no need to start a bunch of tests and hoop jumping before you know exactly what they want. Good luck.
   — rebeccamayhew

November 14, 2002
I agree with RONA--the group I am going through to schedule my surgery requires you to see a specific psychologist for a "Bariatric Surgery Evaluation"--I would call your surgeon and ask about this--then you could have your PCP refer you to the proper person.
   — Jeanine E.

November 14, 2002
what a pro-active patient you are and this will make your journey much easier!! i did the same thing you are doing and it made things much smoother for me. i was already seeing the shrink, so she tested me and it took awhile to take and evaluate the tests. i did the sleep apnea test and got set up on the machine cause of course it was positive:) i had a history of ulcers and had an upper gi test which showed a current active one. had an endoscopy and was put on meds for two weeks due to h-pylori which was never caught before. got copies of all my previous heart tests and got an updated ekg just to be sure. i was on a three month wait list to see the surgeon and while i was doing this i sent all the above info to another surgeon who gets insurance approval before the consult instead of after, which is what the other surgeon does. well, the insurance got approved, i saw the "wait list" doc on thursday, would have had to wait another three months to schedule surgery, went to the other doctor who was much better anyway on the following tues, had surgery on wed and the rest is wls history. my pcp was very supportive, my insurance bluecross blueshield never questioned a thing because i was symptomatic for everything and they didnt require strict pre-auths. email me if you want any other info. it helps that i am a nurse and know how this system works. patsy in las vegas
   — PATSY N.

November 14, 2002
Hi Brandy, Here is the information that Dr.Blackstones office sent to me on what is needed. Insurnace card PCP address and fax # PCP authorization Copay (cash or check only) wt loss records for the last (1) year Psychological evaluation by a Ph.D. psychologist who performs MMPI-2 testing (this is the test required prior to scheduling any surgery). Contact our office with name, address and fax number so she may provide theat psycholosist with Scottsdale Bariatric Center's protocol. It goes on to say that if you have Cigna HMO insurance - all management of mental health is provided through Cigna Behavioral Health (CBH), for those members with CBH benefit. If you do not have CBH benefits, you should call Member services at 1-800-832-3211. If you do have CBH call 1-800-343-2183 state-wide. Identify yourself as a Cigna Participant Schedule an appointment Contact Noreen with psychologist name, address and fax number you can also go to Dr. Blackstone's website for more info. you can also print your paperwork off of the website and mail it in as soon as possilbe. they won't schedule your consultation with Dr.Blackstone until you have completed your paper work and mailed it in. The appointments are given in order of receipt of the paper work. Since you have a seminar coming up, you could probably be proactive and file the paper work out now and mail it in to get a jump on things. I filled my paper work in September and my consult date is not until Feb 13th, 2003! :) the website you can go to is as follow's: www.bariatricsolution.com p.s. You will need to gather all of your medical records on your own. They do not do that for you. Hope this info helps. :)
   — Tammy O.

November 14, 2002
One test that I didnt know I would have to have was a gyne exam. It took me the longest time to get in for an appointment. This is one I could have had done before I even saw the surgeon. Other tests I had done were EKG, chest x-ray, upper endoscopy, psych test, and a lot of bloodwork, but they all had to be ordered by the surgeon.
   — Amanda H.

November 14, 2002
Yes you can. That's what I did, because it took a while to find a dr that would do a psych eval for gastric bypass surgery. A lot of the dr refused to do an eval for that purpose. good luck!!!!!
   — Farrah M.