How can I get psych eval covered?

[AtlantaRed 651]

I will most likely be self pay, hubby's new insurance starts in November but I asked already and was told WLS wasn't covered. I need a few things done. I know my PCP can order the EKG just based on weight itself, for insurance to cover. I'm also pretty sure she can get the upper GI ordered because I have been on a PPI for over a year since my gallbladder was removed.

Just wondering how to get the psych eval covered, if possible? I did go to a therapist on my previous insurance and that was covered fine. However, I need to go to a licensed psychologist and am guessing an "evaluation" is different than just a therapy session, isn't it?

Thanks for any insight!

[Steam 0]

You can always check a college affiliated hospital to see if they have a student that need the experience. Usually the cost is inexpensive and the doc they are training under is close by. Also, bring the topic up to your doctor and ask if they could recommend some one that you can afford. If your ins kicks in later try to push back the surgery. I am still trying to find a psy that takes my ins.

Good luck

[AtlantaRed 651]

Thank you for your response.

I will start pricing evals tomorrow. I was just wondering if there was a way to present it to my new insurance that wasn't weight loss surgery related. Like the EKG and upper GI evaluations can be coded in a way that are not related to weight loss surgery. I am wondering under what circumstances I would need a psych eval (not related to upcoming weight loss surgery) that the insurance would cover.

Maybe there isn't a way, and that is fine. I understand I might have to pay this one out of pocket. Just wondering.

[MissErika 65]

I was self pay and my insurance covered most of my psych evaluation. I think I only had to pay about $25. Actually, they paid for almost all of my testing including blood work, hida scan, endoscopy, etc. My insurance is with an employer that excludes bariatric surgery so I wasn't denied "personally" either. The staff at the psych office should give you an estimate and check with your insurance before you go that day so you will know exactly. I'm sure it varies on the plan and the insurance company but if you are covered for normal psychiatric care this should be included.

[sherri scheffler 10]

I will most likely be self pay' date=' hubby's new insurance starts in November but I asked already and was told WLS wasn't covered. I need a few things done. I know my PCP can order the EKG just based on weight itself, for insurance to cover. I'm also pretty sure she can get the upper GI ordered because I have been on a PPI for over a year since my gallbladder was removed.

Just wondering how to get the psych eval covered, if possible? I did go to a therapist on my previous insurance and that was covered fine. However, I need to go to a licensed psychologist and am guessing an "evaluation" is different than just a therapy session, isn't it?

Thanks for any insight![/quote']

Mine was all in one session but insurance paid it but in Nashville a psych evaluation was only $75 if paying cash.I hope it helps

[AtlantaRed 651]

I was self pay and my insurance covered most of my psych evaluation. I think I only had to pay about $25. Actually, they paid for almost all of my testing including blood work, hida scan, endoscopy, etc. My insurance is with an employer that excludes bariatric surgery so I wasn't denied "personally" either. The staff at the psych office should give you an estimate and check with your insurance before you go that day so you will know exactly. I'm sure it varies on the plan and the insurance company but if you are covered for normal psychiatric care this should be included.

Thank you so much, Erika! This was what I was hoping to hear!

I know who the new insurance will be so maybe I can go ahead and schedule an appt for right after Nov 1, so as soon as we have coverage, I can get it done.

They didn't ask why you needed a psych eval? If it is a PPO and generally you don't need a referral, the insurance wouldn't question why you wanted yourself evaluated?

Thanks for your help!

[AtlantaRed 651]

Mine was all in one session but insurance paid it but in Nashville a psych evaluation was only $75 if paying cash.I hope it helps

Thanks, Sherri!

I was trying to look online and found one that said their "Full Brief Psychological Evaluation" was $675 and it was freaking me out!

Did you have one of those extensive, hours long assessments or more like a regular session?

Thanks for your help!

[MissErika 65]

Thank you so much, Erika! This was what I was hoping to hear!

I know who the new insurance will be so maybe I can go ahead and schedule an appt for right after Nov 1, so as soon as we have coverage, I can get it done.

They didn't ask why you needed a psych eval? If it is a PPO and generally you don't need a referral, the insurance wouldn't question why you wanted yourself evaluated?

Thanks for your help!

Well I have a history of seeing a psychiatrist and counselor. I just called the office that my surgeon recommended and asked them to check with my insurance and when they called back they said it was covered and the price would be $25 that day. Of course make sure the office you go to accepts your insurance.

Also, to your other message, my appointment was really short. I filled out a two page survey basically asking my history and the last time I felt certain ways, etc. Then we went over it in a meeting and I was out in 20 minutes. I considered mine REALLY lucky because my mom took a really big "test" and I have seen others do it too. If you have to then it would most likely cost you more.

[AtlantaRed 651]

Well I have a history of seeing a psychiatrist and counselor. I just called the office that my surgeon recommended and asked them to check with my insurance and when they called back they said it was covered and the price would be $25 that day. Of course make sure the office you go to accepts your insurance.

Also, to your other message, my appointment was really short. I filled out a two page survey basically asking my history and the last time I felt certain ways, etc. Then we went over it in a meeting and I was out in 20 minutes. I considered mine REALLY lucky because my mom took a really big "test" and I have seen others do it too. If you have to then it would most likely cost you more.

Thanks so much!

I saw a counselor twice this summer but she told me she didn't think I needed to go back unless something "happened". However, she was not a licensed psychologist. The surgeon's office did give me some names but as they are an hour from me, so are the psychologists.

Maybe I should bite the bullet and call one of them even though they will be quite a drive!

Thanks for your help!

[sherri scheffler 10]

Thanks' date=' Sherri!

I was trying to look online and found one that said their "Full Brief Psychological Evaluation" was 675 and it was freaking me out!

Did you have one of those extensive, hours long assessments or more like a regular session?

Thanks for your help![/quote']

Regular session