Question:
When are you usually required to get the psych eval?

My insurance requested that i get my psych eval done. i thought that you only got the psych eval after you were approved. is this correct or am i confused(probably the latter). thanks for any comments.Since the insurance requested this eval, surely they will pay for it, right?    — wendyfinn29 (posted on February 21, 2004)

February 20, 2004
My insurance company requires me to get the psych eval done first before the information is submitted in for approval. I also had to visit a dietician/ nutritionist before sending my information over to BCBS.
   — Katrina B.

February 20, 2004
I had to see the shrink & diection b-4 I was approved they want you to do that b-4 they approve you so they know you are mental able to make the changes Take Care Huggs Beth
   — wildbrat

February 21, 2004
My psyc evaluation had to be done prior to approval. It was one of the best things I've ever done for myself. I continue now to see her to help me understand and change my emotional eating habits and will see her after my surgery for awhile. I have Medicare & AARP, and so far they have paid for everything. I'm sure there is a limit to what they will do, but for the time being, no $'s out of pocket.One thing I have experienced for probably the first time in years is the feeling of fullness. It seems writing down everything makes you very aware, as well as trying to make constructive changes. Good Luck & God Bless.
   — CarolynT.

February 21, 2004
Psych was required before they approved me, too. As for whether the insurance will pay for it, the only way you can know is to ask them. Just because they require it, doesn't necessarily mean they will pay for it.
   — lharbison

February 21, 2004
Why would you need it IF wls has been approved??? Most seem to require it for approval. Just be careful and don't VOLUNTEER any extra info. Anything you say CAN and WILL be used against you. For example as a child I went through alot of sexual abuse. There is NO WAY I'd ever volunteer that info! I don't like lying but I certainly would have on that question. I know it is important to weed out those who won't comply with the correct eating ect after surgery, and perhaps those who have various eating issues. So I'm not saying an evaluation is'nt important. But sometimes, the littlest thing they will grab on and then it's a money grab for lots of therapy. $$$ So I've learned to answer their questions but NOT volunteer any extra info! The ether will want to "save you" or clean out your pocket book for lots of therapy. $$$ Just be careful. There are both good and bad therapists out there. Most I have seen are the bad ones. Thankfully I have a good one now that I see every few weeks. But most of them... ouch.
   — Danmark

February 21, 2004
I had to get a psyc eval, dietician eval & an exercise consult before my surgeon's office would submit my packet to the insurance. Be careful about some sugreons office staff. The first group I went to was not helpful at all. They never told me what was needed or what my insurance co wanted so I was denied twice. My PERSONAL belief is that if his staff sucks he might not be the best in the world either. I switched surgeons and my new doc's office staff was great and I was approved within days of my packet being submitted. My insurance paid for all my evals but I had a private psyc eval that I paid for out of pocket because I couldnt find someone who specialized in eating disorders in my area. Good luck to you. ~Sidney~ Open RNY 10-23-02 down 130+ and below goal
   — Siddy I.

February 21, 2004
I didnot have to have a psych evaluation before my surgery. But I have known allot of people who have also had the surgery that were required to have the psych eval. The main difference was that they didnot have a very long medical history.
   — jcooper

February 21, 2004
Wendy I had to get my psych evaluation, turn in my packet to Liv-Lite and have a consultation with the dietician all prior to getting an approval for WLS. I think this is standard policy with most insurance companies. Deb
   — Deb S.