Question:
Denied due to psych test saying I may be non compliant post op.

My insurance company just denied me because my psych eval indicated I may be non compliant after surgery. They want me to be reeavaluated and/or treated. Has anyone experienced this? Any advice? I really don't agree with this indication but don't know how to "prove" it. Thanks! Jill    — Jill E. (posted on April 7, 2003)

April 7, 2003
Jill, Wow! I'm sorry that happened to you. Do you have any idea why the psychiatrist thought you might be non-compliant? Your gut may be right, and should help you figure out what happened. Or, I would ask the psychiatrist what made him/her think that. It is however a good sign that your insurance company wants you to have it re done. This means they aren't willing to just take this Doc's opinion and not let you have the surgery. Talk with your surgeon about what happened and get his/her opinion and get a new referral from them. Good Luck!
   — Michele B.

April 7, 2003
I doubt the psych eval would have indicated possible non-compliance without some type of indicator from you. See if you can find out what led them to this decision. While you may not agree with this evaluation, perhaps there is something there. I know of a few who had to agree to counseling pre-op for a pre-determined period of time before the psych eval would pass them. Then again if the insurance company is considering re-evaluation, try a different doctor to see if you would get different results.
   — Cindy R.

April 7, 2003
I would suggest that you speak with psychiatrist and ascertain if counseling would help you to overcome this obstical or whatever the psych person thought was the problem. Do you have anything in your history to suggest you were non compliant? Start with the psychiatrist and see how you can get this reversed. Don't give up!
   — Marian B.