Psych Eval not Necessary with AETNA

[Ladiec2 74]

Trying to stay on top of things that my insurance required and trying to get information on the approval process, I decided to contact AETNA. I asked them several questions and I told her that my surgeon gave me a list of AETNA's requirements. She asked me what they were and when I got to the psych eval, she told me that was not required. I start smiling ear to ear...yah!!!! don't have to go through that process. She also sent me the clinical note for the psych eval which states: For members who have a history of severe psychiatric disturbance (schizophrenia, borderline personality disorder, suicidal ideation, severe depression) or who are currently under the care of a psychologist/psychiatrist or who are on psychotropic medications, pre-operative psychological clearance is necessary in order to exclude members who are unable to provide informed consent or who are unable to comply with the pre- and post-operative regimen. Note: The presence of depression due to obesity is not normally considered a contraindication to obesity surgery. I don't have a history of mental illness. So I contacted my benefits coordinator at the surgeons office and her response was that I was right, it is not required, BUT she has never submitted anyone's paperwork without a psych eval. She mentioned that I may need a letter from my doctor stating that I am not being treated for mental conditions.

Should I go through with the psych eval (I really don't want to!) or just get the letter from my PCP? Does anyone have AETNA and didn't have to do the psych eval?

[della street 213]

The surgeon's office might require it even if your insurance doesn't -- the benefits coordinator might be able to clear that up -- hope that's helpful, good luck!

[Ladiec2 74]

The surgeon's office might require it even if your insurance doesn't -- the benefits coordinator might be able to clear that up -- hope that's helpful, good luck!

[Ladiec2 74]

Nope that is not a requirement for the surgeon.

[NavyMom2006 119]

I have Aetna and didn't have to have a psych eval. My surgeon's office did all the back and forth with the insurance company, so I never even had to talk to them!

[Ladiec2 74]

I called my PCP today and asked for a letter stating that I don't have any mental issues. I am just soooooo happy that's one thing I now don't have to do. As my nephew would say...O Happy Day!

[twittymilk 51]

Thanks for this you guys just saved me $200 some odd dollars.

[BLERDgirl 6,417]

I think everyone should go through with the psych evaluation. It's not just a matter of mental illness. A good psych eval should get you to thinking about how to begin to change your thinking about food and the relationship you currently have with it. It wasn't that complex. It was a 30 page questionnaire and then I had a chat with the psychologist for about an hour. I was glad I did it.

[CountryGirl5584 115]

Just be careful because I work with insurances on a daily basis and you can call 10 different times for the same issue on same patient and get 10 different answers