Question:
In-network psychiatrist vs. surgeon-referred, in-demand psychiatrist.

My insurance company has requested my psych evaluation before they will approve or deny my request for surgery. The earliest appointment I can get with the surgeon-referred doctor is at the end of August. I'm now trying to decide whether or not to have an in-network doctor evaluate me and send his/her results to the insurance company on the off chance that I might be approved sooner. But, I am fearful that I may be denied on that particular evaluation if he/she does not perform this evaluation and/or test on a regular basis. From what I understand, this evaluation will determine whether or not I can handle the surgery. Is it safe to assume that all the psychiatrists/psychologists will know EXACTLY what the insurance company is looking for? This is the main reason my surgeon referres to this particular doctor. During our orientation, we were told that past patients had elected to use other psychiatrists and were denied the surgery as a result. Does anyone know if an insurance company will easily change its mind with a second physician's evaluation? I'm open for any and all suggestions. Thanks.    — gracie30269 (posted on July 9, 2001)

July 9, 2001
My surgeon refused to let me go to any other psychologist but his own even though I live out of town, so I had to drive 5 hours to get there. The reasoning is that not every psychologist is wls-friendly and may want to qualify you for surgery or may know how to write a report that would increase your chances for ins approval. Find out from your doctor if you can go ahead with your choice. Although the psychologist was out of network, if I had chosen one in network my surgeon wouldn't do my surgery, even if I'd got approved with that other psychologist. I have my opinions on why a doctor would insist on using a particular psychologist, but I need this wls so I follow instructions. Best wishes.
   — [Anonymous]