Question:
Psych eval question...is my doc a quack?

Seriously...I went to my first psych eval appointment last week where I was told that this particular therapist told me that she required three or more appointments before she would write the letter to my doc. Tonight, at a support group meeting, I learned from a few other patients who received evals from her that before she would write the letter, she demanded a $125 payment that was "not covered by insurance" before she would do it. IS THIS NORMAL??? Surely it isn't. I keep thinking that my records are MINE, and if my insurance company is paying her to see me the required number of times, then she is getting her money. Anyone else think this is strange, or is this par for the course???    — Suzanne S. (posted on May 22, 2002)


May 21, 2002
Why not call the Insurance Company and discuss this with them? It doesn't sound quite right to me, either. Why three meetings anyway? I think most pre-op screening exams are only for one meeting...at least that is what seems to be the "norm". Speak with your surgeon, too. Maybe there is someone he can recommend? Rule of thumb...if it doesn't feel right, it probably isn't. Best wishes...
   — Ann B.

May 21, 2002
Seems totally normal to me, and exactly like the psych eval I had. First session is a discussion and instructions for the MMPI evaluation and any other "tests" they want you to take; second session is further discussion to make sure that you understand that WLS is not a magic bullet and that it's going to take change on your part, and also to make sure that you have adequate social support; third session is a review of the evaluation results. All of the therapists around here charge a $150-250 report-writing fee since that's at least two hours that they have to spend working without a diagnosis code to report for insurance purposes.<p>But why are you asking us?? Your psychologist or psychiatrist would be happy to answer that question, if you ask it directly of her. Good luck.
   — Julia Z.

May 21, 2002
This is the exact same thing which happened to me. Good Luck
   — Robert L.

May 21, 2002
I only had to see the psych once, but she wanted 200 up front. I ended up getting 100 back from my ins.
   — Becky K.

May 21, 2002
Is this the person your surgeon sent you to or one you found on your own? I knew the one my Dr used wasn't on the insurance so I called up the referral service and told them that I was feeling a little depressed (who isn't at least every now and then when morbidly obese) and needed someone to talk to. They authorized six visits free of charge. When I went to the therapist I told her why I was there and delt with the depression as well. She wanted to see me two times and then wrote a letter stating that I seemed to have good understanding of the procedure and that I was of sound mind. No tests and that was all the insurance required to approve the procedure.
   — Virginia N.

May 21, 2002
Before I switched to my current Dr, I was going to go to another dr. His office recommended a psychologist who told me it would cost me $440.00 for the exam and write up. I asked about insurance, she said to me "Oh you have UHC? They would never cover this. Plus think of how much money you will save after surgery and you do not eat so much" I was appalled to say the least. Well I switched Dr's as my new one is the BEST and does DS. I called UHC mental health and asked them if they would cover a psych exam for WLS, they said yes. Then proceeded to refer me to a great psych who only took one visit, insurance paid him within 2 1/2 weeks after the appointment. I only was charged my co-pay! I would see if you could find someone else through your insurance.
   — Stephanie B.

May 21, 2002
Hi...This doesn't seem quite right to me either. Originally, I had scheduled an appointment for a pysch eval and at this place, it was to be 2 visits, one and one half hours the first day and an hour the second visit and the cost would be $220 which they wanted upfront and then I would have to get reimbursement because they were not with my insurance company. I then changed doctors, only had to go one time for an hour (although it lasted a bit shorter than that) and just had to pay my copay of $10, and that was it. She wrote a letter within a couple of days to my surgeon and I didn't have to go back or anything. You should really look into going someplace else because that sounds like a bit of a scam to me.
   — Giovanna G.

May 22, 2002
Beware, I went to a shrink that was who my doctor refered me to,cost me over $600 and they refused me. said I needed 3 months of therapy then another evaluation. needless to say I have not had the surgery yet and having therapy with a different therapist. Get a second opinion, good luck
   — meechi33823

May 22, 2002
I'd call the insurance company to find out. I wasn't required to have an evaluation.
   — [Deactivated Member]

May 22, 2002
WOW....SOUNDS LIKE YOUR PSYCHIATRIST IS TRYING TO MAKE A LITTLE MONEY ON THE SIDE. IF YOU HAVE INSURANCE INQUIRE ABOUT MENTAL HEALTH VISITS. ALTHOUGH MY SURGEON HAS A PSYCHIATRIST THAT IS AFFILIATED WITH HIS OFFICE I OBTAINED ONE THROUGH MY INSURANCE. NOT ONLY DID I GET AUTHORIZED FOR 6 VISITS, I ONLY HAD TO PAY A $20.00 CO-PAY.
   — donna R.

May 22, 2002
I only had a one day psych evaluation.. and I too was only charged the co-payment... but.. Later I kept getting billed... which is only now being cleared up.. call your insurance and verify coverage for this then.. asked them do I need to get approval through anyone else for the insurance to pay? I had blue cross blue shield.. and they sent me a approval so I went.. then I was (8 months later) told Magallen? actually pays for the mental health ect. work for blue cross and I was to get approval through them. I fought it and told them they approved me and that I was NEVER told about a second approval... then they finally paid the claim.
   — rinkadinktx

May 22, 2002
You should only need one visit. She should ask questions and give you a test that should not take more that a few hours. That just doesn't sound right and I wouldn't give her a dime.
   — Sarah K.

May 22, 2002
My Therapist had me come back three times including seeing my wife and me together for the third appointment. She endorsed the surgery and wrote the letter without asking for more $. I only paid a co-pay each time. I think your therapist is holding you up for money, which is dispicable. The letter is fairly simple and just states that you have been evaluated and are a good candidate for the procedure.
   — Michael N.

May 22, 2002
Does your particular insurance policy require you to pay a deductible or co-insurance (i.e. if your policy covers at 80%, then your co-insurance amount would be 20%)? It would certainly be worth a phonecall to your insurance company to check your benefits. If the information that your insurance company gives you is different than what the psychologist office has told you, perhaps their office was quoted the wrong benefits. My psychologist only required one visit. Good luck to you!
   — Andrea C.

May 23, 2002
OK...let me clarify just a bit. My surgeon gave me her name as well as the names of a few others. She was one of the few who accepted my insurance. He did say that the only reason why he gave me any of the names was that he had received evals from them all. This psychologist is a vegan, and she spent nearly ninety minutes during my first appointment telling me that I would not have this trouble if I were a vegetarian. She is about the same size as I am!!! Needless to say, I was a bit shocked. Because of time constraints and the fact that there are VERY few docs in my area that accept my insurance or who seem to know what kind of an eval to give for WLS patients, I feel stuck with her. I called my surgeon and complained to him about her, but he recommended that I stick it out and complain about her to my insurance company after I get the letter. He thought it was a bit odd that rather than ask me questions about myself and how much I knew about the surgery, all that she did was promote the vegan lifestyle. I thought it was strange, too. My insurance only requires one visit, but they commonly pay for up to eight visits.
   — Suzanne S.

May 29, 2002
I went for my first Pych appointment last week. She was refered by surgeon, and actually work out of his office. All I paid for out of pocket was co-payment. I have another pych appt. next month. And one after that. My docotor requires at least three pych appt. before sugery date. But he is VERY thorough, he wants to make sure his patients understand everything involved w/ WLS.
   — Marlene N.




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