Can you "fail" psych eval and still get approved?

jenniferann6 · February 9, 2008

I'm very nervous about my psych evaluation letter. The 15th of Feb. is when I leave all of my paperwork to be submitted to Aetna. First of all it is very impersonal, and drug all of my past from 20 years ago into the letter, which I think was not necessary. Also, I noticed that her license # is not on the letter-will this affect approval.

Second, it was all "good" until the very last paragraph which states:

"Client would be a better candidate for bariatric surgery if she took time to prepare for sugery by addressing psychological issues. Major areas of concern to be addressed would be potential for symptom substitution once food is no longer an option and eating behavior that causes reflux. I recommend that client seek psychotherapy prior to and after surgery to address these concerns."

My sweet DH says that I can go to a different therapist, but that I should seek out the opinion of other bandsters first. Any insight would be great.

I would not reccommend the therapist I used either-she was $75 cheaper, IMHO not worth saving the money though. She's in Kingwood Texas, will give more info, just PM me. :thumbdown:

Thanks to all in advance for your help-I love the sight, yall have answered so many questions just by my reading things you've posted!

VegasGrace · February 9, 2008

Approved? That's what caught my attention to the thread.

So you are using insurance to cover this.... my first guess would have been to only submit a favorable report. But, if you gave her the goahead to submit it to your insurance without first knowing what she was going to say.... (happened to me in court once when I thought I knew what a witness would say...but...nope)

Right now, don't worry about it. Really. What's done is done and you have a 50/50 chance. Plus, even if ins. rejects you based on that report, you could always submit a 2nd opinion.

Plus, the report DETAILS what they feel you need to work on...why not start now AND DOCUMENT it. Go to a psychologist for a few sessions.

remember....LOOSE LIPS SINK SHIPS...so it's better to just keep quiet and tell them what you need to get approved.

February 10, 2008

Can you tell me exactly what they ask on a phyc evaluation? I went to my seminar last week and now have 2 support group meetings to go to. I go to the first one on Thurs. evening.

Also can anyone tell me when you start to loose weight. Do you start loosing immediately? Or is it slow. I was told lap band is a slower process. I know I will get this information later but would really like a heads up. Also how about what the nutrtional evaluation is all about and what information they need. I know they want a detailed list of diets we have tried before and how much weight I have lost.

Any advice for me is welcomed. I have blue cross and have picked a doctor in the network and also a hospital of expertise which blue cross wants. They said they will pay 100% after $100 deductible is made.

Thanks ahead of time everyone.........

SpecialK · February 10, 2008

Second, it was all "good" until the very last paragraph which states:

"Client would be a better candidate for bariatric surgery if she took time to prepare for sugery by addressing psychological issues. Major areas of concern to be addressed would be potential for symptom substitution once food is no longer an option and eating behavior that causes reflux. I recommend that client seek psychotherapy prior to and after surgery to address these concerns."

I actually don't think this sounds all that bad and I'd let it go. If you are obese, severely obese, or even morbidly obese, there is no doubt all of us have issues with using food as a substitute for dealing with other things in our lives. Yes, we will have to learn how to manage eating for eating sake and not abuse food. I would recommend, and I plan to continue, to see a psychologist/counselor to continue to talk through the feelings I know I will have with dealing with having to limit my food intake and not eating to Celebrate, eating when sad, etc. What the letter doesn't say, which is very good, is "I do not recomend this patient have bariatric surgery." they could have been that straight about it and since they didn't I'd just get busy going to a few appointments with a counselor like the others have suggested to document that you are getting prepared in advance of surgery, and that you are willing to work on what they said to do.

kbinaz · February 10, 2008

I was told that if you 'failed' the psych exam you would have to take care of whatever issues you were dealing with before surgery. It can delay your surgery date but might not make them cancel it. I'm sure it depends on the severity of the problem.