Question:
Are psych eval and dietician meeting required by BCBS of IL PPO

Has anyone with BCBS of IL PPO been required to have a psych eval or meet with dietician prior to approval? They sent me a letter with the basic info they needed me to submit with my request for surgery and it did not include either of these. But I have noticed that people with BCBS PPO's from other states have been required to have them and were not told until after request was initially submitted. All the customer service reps have told me is that my request was sent for review and they may require more info from me....nice and vague, huh.    — Maureen C. (posted on April 7, 2002)

April 7, 2002
I would encourage you to make your insurance company be as specific as possible when it comes to these issues. It is going to be very difficult- I know. My BCBS (based out of Ohio, Anthem, PPO) requested a psych eval and a "nutritional eval" well, the psych eval was easy, as my doctor requires that, but the nutritional eval was not required by my doctor. So I went crazy trying to find a dietician to talk to on such short notice, when come to find out what the insurance company really wanted was a more consice document of what diets I had been on, and a doctor's letter stating that they were or were not suppervised. I hope you don't have the same problems with your BCBS that I have, but if you do, please be consistant with them, and if you have any questions at all, don't hesitate to e-mail me and ask questions, [email protected] I think if I would have started out more persistant, I wouldn't have had some of the problems I do. My best!
   — Sarah P.

April 7, 2002
I don't know if BCBS of Illinois PPO requires it, but I did it and was approved in 2 days. I had the psych and the nutritionist (licensed dietitician) at the local hospital was free. To me, it's better to be over ready than to be under and have to wait longer for an approval. I also sent pictures of my front, back and side. One of the customer reps suggested that. she said it would give them a visual. Good luck.
   — Joy B.

April 9, 2002
I wanted to post an answer to my own question. I was approved this morning!! Woohoo!! I did not have to go see a psych or dietician. My surgeon did briefly ask questions about depression and what I expected from surgery, etc. And I did send in my diet history (ie type of diet, starting weight, weight lost, kept off X # of months, etc). But I was not required to submit more info. And a side note, it is the DS that they approved.
   — Maureen C.