Psyc Eval - How might it affect insurance

TraciLJ · January 15, 2004

I had my psyc eval today. It was exhausting, but I'm glad I did it. Anyway, the psychologist said my tests indicate that have a high tendency towards problematic compliance. Which basically means that consciously I have every intention of following the after-care regimen, but my sub-conscious kind of takes over and knocks me off the wagon. An additional component of this is that I let the "world" think I'm doing ok.

She said that wasn't a problem as long as I would agree to see a therapist for the first six months to help me through the rough spots and as another source of support. Of course I agreed to do so...whatever it takes to be successful at this! She is going to write her evaluation "approving" me for the band provided I get the proper after care.

What, if any, problems can I expect with my insurance company?

Thanks!

Mahoney · January 15, 2004

Hi,

I don't know for sure, but my guess is that it won't matter at all. The surgeon may mention in their summary letter to your insurance that you've seen a psychiatrist and that you have his or her blessing (which you do), but I seriously doubt that they will provide any additional information about your session beyond that to your insurer. My hunch is that requirement for the psych eval is more to provide a defense against any potential legal issues against the surgeon more than anything else. That being said, I think they are a good idea to make sure that someone is ready for the surgery. Like you, I wasn't looking forward to the psych eval, but I ended up finding it interesting.

Best wishes on your insurance approval - I'm awaiting the good word myself,

Bob

alicia · January 15, 2004

My insurance wouldn't approve me until I HAD the psych eval. My surgeon did not require one, the insurance company did . As long as your psych eval says you are a good candidate, then the insurance should cover it, regardless of post-op care.

Wishing you the best of luck!

Alexandra · January 15, 2004

My psych eval was done by someone my surgeon referred me to, and at the end I was handed a paper saying I was "cleared" for surgery. She did a longer report which was sent to the doctor, but it was just the clearance note that went to my insurer.

I agree with Bob, I don't think this level of detail will be important to the insurer. Your surgeon might care, but of course you can always *talk* to him. It's not so easy to talk with the insurance carrier.