Psych Evaluation Fiasco

[Imsojaz 8]

My doctor's office submitted my paperwork to the insurance company on 1/22.... I called today to check the status ( they told me that they should have the decision within 7 days) they said that they needed more information from my doctor. Specifically, the psych evaluation that was completed needed to be completed by a psychologist or psychiatrist. Well, my Doctor's office referred me to a person that has the certification to complete the evaluation but is actually a LMSW ( social worker). So now I'm out the $150 that I paid to have the eval done and I have to find an actual psychologist/ psychiatrist to do it. I would have probably been approved today if that was in order. Hopefully I can get in and get a new eval done this week and get an approval at the beginning of next week. Just super frustrated. I feel like the doctor's office should have caught this.

[animallover1247 249]

If I were you I would make sure to contact a psychiatrist to have the evaluation completed.

If you call a psychologist and ask for an evaluation for bariatiric surgery, you will have testing that needs to be completed in addition to an interview. With the testing they typically they use what's known as the MMPI. This can be very expensive and may not be covered by your insurance.

However, if you make an appointment with a psychiatrist, you will only have an interview. I only had to pay my standard co-pay for a specialist. The interview only took about 30 minutes whereas the testing and interview with a psychologist takes at least a couple of hours.

[Valentina 2,642]

Your surgeon's office definitely should have provided you with a list of providers complete insurance acceptance for each.

[Imsojaz 8]

That is extremely helpful information because I don't feel like my doctors office is taking this matter seriously. My insurance company faxed them the information on what I was missing and they never called to inform me of the snag. I emailed them and have not heard anything back. Thanks for your help.

[animallover1247 249]

That is extremely helpful information because I don't feel like my doctors office is taking this matter seriously. My insurance company faxed them the information on what I was missing and they never called to inform me of the snag. I emailed them and have not heard anything back. Thanks for your help.

You are welcome! I was trying to save you some money and time. Yes, your surgeons office should have told you where you needed to go. I was the one who called and asked if it had to be done by a psychiatrist or psychologist otherwise i would have never known becasue that specific detail was not in my insurance policy either.

Out of the people I've know to have the evaluation done by a psychiatrist, none had testing. I am sure this is the way you need to go, even if you have to travel to have it done. Good Luck

[WLSResources/ClothingExch 3,444]

@@Imsojaz, if you happen to see a psychologist, you can have your own person do it instead of running around.

@@animallover1247, are you saying that your own medical plan required the battery of written forms or that all plans require it? For my "psych eval" six and one-half years ago, my own therapist wrote a letter, all of seven sentences. No muss, no hocus-pocus, no nonsense, no rip-off.

[Valentina 2,642]

I

That is extremely helpful information because I don't feel like my doctors office is taking this matter seriously. My insurance company faxed them the information on what I was missing and they never called to inform me of the snag. I emailed them and have not heard anything back. Thanks for your help.

I just took a short note from my phycologist and that was the extent of it. Your surgeon, once he/she has decided that you are a candidate for the surgery does NOT want you to fail your mental evaluation. He/she just needs to know that you are "cleared" by "Mental Health".

Just one more box crossed off of the list from the first surgical office visit to surgery day!

[animallover1247 249]

I was not saying my plan required this or anyone else's plan requires it, all plans are different. I was just telling the person IF they have a choice between seeing a psychologist or a psychiatrist with their own particular plan, the psychiatrist visit is only an interview rather than testing and an interview if they see a psychologist. Yes, you are correct if they currently have a professional they are seeing then yes, they can write the letter. However, in my particular case my therapist is a LPC (Licensed Professional Counselor) and she was not allowed to write the letter becasue she is not a psychiatrist or psychologist, which is what my particular insurance required.

@@Imsojaz, if you happen to see a psychologist, you can have your own person do it instead of running around.

@@animallover1247, are you saying that your own medical plan required the battery of written forms or that all plans require it? For my "psych eval" six and one-half years ago, my own therapist wrote a letter, all of seven sentences. No muss, no hocus-pocus, no nonsense, no rip-off.

Edited February 3, 2016 by animallover1247

[myrizzy 41]

It is so true about the psychiatrist vs seeing psychologist. I originally psychologist and took 3 hours and 2 visits to get cleared. Was told it takes about 3 weeks for him to write evaluation so went to psychiatrist and they took 30 min and faxed it within 2 days. I just wish I would of known it before. Could of saved money, time and frustration.

[Imsojaz 8]

Thank you guys so much. I talked to the doctors office today and they said that it was my HR department that required it to be a psychiatrist or psychologist and suggested that I speak with HR to see if they would accept it (I work for the state, this would be impossible). So they basically has no one else to refer me to that met the qualifications, so I've spent the majority of my day (at work) trying to find a psychiatrist or psychologist that would do a bariatric evaluation( extremely hard). This is just turning into a big mess. But I appreciate yalls help.

[WLSResources/ClothingExch 3,444]

@@Imsojaz, you'll find someone who meets the criteria. Don't get discouraged.

[Imsojaz 8]

Update: I was able to find someone and have completed the evaluation. I just heard from my insurance that I have been APPROVED!!!!!!!! Thank you everyone for the help, I really appreciate it.

[myrizzy 41]

Yay!!!! Pray I'm approved too