Mandatory Psych Exam?

[Drasan 23]

Who determines that pysch evaluations are mandatory prior to band surgery? Is it the insurance company, the surgeons, the band manufacturers, malpractice insurance?

My insurance company will not cover this and I want to know what the options are, if any.

[kiz 1]

I was self-pay, but my doctor required it. His office is a "Bariatric Center of Excellence", and it's part of the protocol for having that designation. It seems that most doctors require it for WLS though. Believe me, I asked too, because it was an additional charge to be paid to the psychologist, and I didn't want to have a psych visit on my insurance history, so it had to be out of pocket too. They gave me a list of names to call, and the prices varied a lot, from around $500 to $100. I went with the cheapest, and she turned out to be very nice.

[Drasan 23]

Kiz, Thanks for the information.

Does anyone know who assigns the 'Bariatric Center of Excellence' standards? I would guess this is who is creating the mandate. Again, I'd like to know if this is insurance companies, the band manufacturers, the surgeons, or ?

In the meantime I'll make some calls to see if I can get a better price. $350 for a one hour consultation seems high to me.

Edited November 17, 2009 by Drasan

[kiz 1]

Just be sure the psychologist you chose is okay with your doctor. I was given a list of doctors to call. At the seminar, several people were already under the care of psychologists, and it didn't seem to be an issue for them to use their own doctor, but they just had to let the surgeon's office know.

Edited November 17, 2009 by kiz

[pipedoc 0]

Both my Dr. and the Ins. co required it. I asked my Dr. why he required it and he said he had a patient who once committed suicied after not loosing weight as fast as her thought he should and the Dr. almost stopped preforming Lap band surgeries after that so that is why he requires it. I assume the ins. does for simmillar reasons.

[Melinco 1]

I'm self pay and my doctor required it. I met with the psych for about 20 minutes, did about 90 minutes of testing (answering questions on paper) then talked with him for over an hour. In fact, we would have continued talking even more if I didn't have to leave for my dietician consult. He charged $275 for the consult.

I think the reason behind it is to see if we have really given due consideration to what we're doing, how we think it will effect us, etc.

The tests I took included a medical history (about 10 pages long), alcohol use, drug use, and three or four others. What the psych said to me was that he was really trying to determine if I had the cognitive ability to realize what I'm doing.

My consult was like an added bonus as my psych had gotten the band in May of this year, so he was able to give me his own personal experience plus answer questions about the band. Only downside was that he was doing things that my dietician told me I shouldn't (like drinking soda, and eating McDonalds, etc.).

Just shop around, find a good price, but also find out how long it will take to get the report to the surgeon. You don't want to be waiting around for weeks on the report.

[Drasan 23]

Great feedback thanks!

I'm trying to findout if the requirement is insurance driven because if it is, they better darn well be paying for it.

I'm stalled in my process over this and I'm finding it very frustrating. My surgeon and I are shooting for a mid December surgery date. I sure hope this snag doesn't change it.

Thanks again! This is my last hoop to jump through! Almost there!

[vonhelzing 3]

My insurance required it. I just had to use someone who was familiar with the surgery. I used the local hospitals psych dr. I answered one page of questions and talked to the dr for about 15 min. and done.

[lalida 0]

I have tri care and they require the Psych exam. They only cover 2 hours for psych exam and ooccording to the psychologist with the test & all it equal to 3 hours. I had to pay $200 for the extra hour. I choose someone from the list that my surgeon gave me. They really didn't even do anything. Just gave me a multiple choice test and talked for about 15 min. Total rip off. Also it's a good idea to get a list from your surgeon because I did a nutritionist consult. It was $140 and found out that I have to do it with a different once which will cost me another $250.