Well, I got my insurance approval for surgery and I was all excited. Then, the Dr's office called me today and let me know that I am not approved because my psych consult result was that I have Major Depressive Disorder. They are requiring 3 months of counseling before the surgery now. That means that surgery will be next year and will cost twice as much since I'll have to pay my deductible twice. How lovely! Makes me so much less depressed to hear that great news...

On the other hand....you'll be good and ready for the challenges ahead...and you still paid less than the self pay folks.

Hope all goes well.

Anyalee,

I too am worried my insurance may stall me until next year, as I have already paid my $2,000 deductible for this year. I still have a $2,000 "coinsurance" left for the year and I"m sure I'll end up paying that as well, but I really don't want to pay another $4,000 next year too.

Yes...it's less than a self-pay, but I could really use that money for other stuff.

Can you appeal the denial? It's worth a shot.....

Best of luck to you,

Margie

Sorry to hear that...I was a self pay , so I didn't have to have the psych study...when you give them $15,000.00 they don't care what frame of mind you are in...

Hi Anyalee,

What was the pysch appointment like? What questions did they ask? This is the last step I have to complete, then I go back to my doctor and with any luck with get my surgery date. I take it there is no right or wrong answers, therefore, I will speak from my heart and the truth. I have asked so many people on this site about the pysch appointment and have not received one response. I am looking forward to your response about this appointment.

Dlew i lied my ass off at my psch appointment seriously i guess i shouldnt say i totally lied but i did answer the questions the way i thought they would want me to does that make sense? of course we are depressed being 100 lbs overweight what do they expect ? WHEN THEY asked me i just said i had mild depression all evaluations are different but they usually have you take a meyers briggs test personality test i guess then they you take a test its like 585 questions try to be honest but dont give out to much info either i guess good luck to you oh by the way i did pass mine! with flying colors lol!

At my psych appt. the doctor said that she didn't think I answered the tests honestly as they conflicted. She tried to make me very depressed, honestly I don't see myself that way. I do admittedly have some issues in that department but am already on an antidepressant and feel great most of the time. I'm not sure what she wanted besides me to come back a couple more times at $150 a shot. Not a huge problem but office is 150 miles away and requires me to take time off from work. My doctor agreed that if I did not need to go back unless insurance required or psych dr. recommended denial until appts completed. Neither are an issue now but dieting for 6 more months for approval. I suppose psych will be next issure for delay. Oh well I will do whatever it takes, I am determined!

I am self-pay and I still had to have the psych eval. I think it depends on the surgeon as well and what he or she requires.

I am self pay and had to have psych exam also.

I was a self pay too and had to have an eval too. She just asked me what changes I thought I would have to make after I had the surgery. It wasn't a big long involved appointment. She asked me if I was willing to exercise and I said I was. She asked me why I thought all my diets in the past had failed, and I said I usually give up because I am not losing, so I decide to have something I have been craving, and that's the end of the diet. I told her I was sure I would see results from banding because my portions would have to be smaller, and that would motivate me. She told me I had a good attitude, and that was the end of that!

You could talk to the psychologist and ask them if they see you as depressed and the depression interfering with you getting the surgery. the surgeon or the insurance company maybe the source requiring the therapy automatically because of the diagnosis. If the psychologist doesn't see it as interfering with you getting the surgery ask them to write a letter stating that. Wouldn't hurt to check.

I agree with shellqueen. call the psych and ask questions. Sure can't hurt!

As far as trying to fake it don't. The 500 pus questions are designed to determine if you ARE lieing becasue there are repeates done in different ways and you will not get it right if you are not honest. That being said, I had MAJOR depression 10 years ago. I mean MAJOR. I have seen a psychologist for many years. At this point I mainly go just to BS. (once a month). I asked my surgeon if he could do teh eval and he said yes as he has my history. Even if he had said no, I would have had him do a letter with my history to bolster my chances. I simply cannot see how a psychologist who runs you through a few hour test can trump a ten year relationship with someone who worked you through the worst time of your life all the way through getting my life together, completing undergraduate school, going on to law school and passing one of the countries most difficult bar exams. Now, I think HE can demonstrate I ahve the tools to deal with stressful situations. :clap2:

I never tried to fake answering any of the questions on the psych evals, they just seemed stupid to me. I am a registered nurse and have been to counselors before and have a couple of very close friends that are counselors. I will go if my doctor or the psych eval says I need to. I just felt she was reading alot into these tests and didn't spend much time getting to know me or anything about the way I deal with things. I have worked critical care and emergency rooms all my career. I have learned not to sweat the small stuff in my life. As long as there is a pulse and breath you have a great start! I have never felt more ready to take on something more than I do about taking control of my health and eating. I feel very confident in my support system and in myself to make this a success.

I passed my phyc test too. she asked me if i had ever tried to lose weight with exlax or making myself t.u. she also asked me a bunch of questions that weren't hard to answer like how sad are you now, what do you expect the l.b. to accomplish, how discouraged are you. things like that. I too, was worried about passing and thought i would only answer what she asked not get into it too much. thats too bad that you are stalled for another 3 mos. I have bcbs and have made it half way thru all the requirements and lost the 5% weight so far. they told me I was looking at Nov surgery if all went well. I guess it's the all going well that gets us in the end. I now have been diagnosed with hiatel hernia and might not be able to get the surgery unless they determine it is small so I feel your pain. Having to wait after going thru years of being unhealthy is terrible.

newbeginnings

Get this: I had surgery in Mexico, and the psych evaluation was done on the second post-op day--AFTER surgrey! It was a joke, this woman came in my room, didn't even introduce herself, and started asking a lot of personal questions. She seemed offended when I asked her who she was! After talking to me for maybe 15 minutes, she told me that I need counseling. Then she left--just like that. Now, what was the point of that? I never even got to tell her that I had years of psychoanalysis with a nationally known psychiatrist.