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Physc... evaluation required by insurance?



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I am in the stages of all of the pre-op clearances required by my surgeon's office. Even if my insurance company doesn't require these, they do.

The physiological evaluation is not covered by insurance and is $250! I don't really have that kind of money and will need to move some things around to pay it. I want to get it scheduled asap, this is 1 of 3 last things that I need to get done before the surgery can be scheduled. (physc. eval, nutrition class - which is also NOT covered by insurance and is $200 - and last support session)

All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done. I have a call into my surgeon's office to see if they can answer my questions as well. What was your experience with this? :help:

Thank you!

Brown Beauty in Philadelphia

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My insurance covered everything. I just had to pay my co-pays. You should call your insurance company and ask questions. Ask why they don't cover psych evaluations. I would think they would. Also ASK about weight loss surgery and if Lap-Band is covered. You should ask all this before you go too far and find out later it is not covered. Some insurances won't cover it. Best to check before hand.

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Mine wasn't required or covered by insurance either.

It was required by my doctor's office, as was a visit to a nutritionist.

They were $250 EACH :speechles

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Same as Candle - Not covered or required by insurance, required by surgeon -$250.00 for psych eval - $325.00 for nutritional assessment. NYU Program - Dr. Fielding.

Maria

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My surgeon required an evaluation. But luckily his price included everything. I'm not insured and he gave me a great price of $7,000- best money I've ever spent.

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I agree with Barb, call your insurance company and ask them if the surgery is covered and why the eval. isn't covered. if you still have to pay, maybe you could set up a payment plan with the Doctor's office. They might be willing to work with you. I am self employed so I chose my insurance company. All of my visits were covered and with my plan I don't have co-pays but I pay almost $300 a month for health insurance. Good luck with everything!!!

Jenn

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I am in the stages of all of the pre-op clearances required by my surgeon's office. Even if my insurance company doesn't require these, they do.

The physiological evaluation is not covered by insurance and is $250! I don't really have that kind of money and will need to move some things around to pay it. I want to get it scheduled asap, this is 1 of 3 last things that I need to get done before the surgery can be scheduled. (physc. eval, nutrition class - which is also NOT covered by insurance and is $200 - and last support session)

All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done. I have a call into my surgeon's office to see if they can answer my questions as well. What was your experience with this? :help:

Thank you!

Brown Beauty in Philadelphia

Is there anyone at your Surgeon's office that can help you work with your insurance? Most have a nurse or coordinator that will work with you one on one and help you in your path to surgery. Some will even try to convince insurance providers to go along with the surgery.

Ask around, I do and I find I usually get the results I want. Insurance is NO FUN that is for sure, but sometimes you just have to twist their arm.

Good luck! :)

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My psych eval was also a $250 out of pocket expense. My insurance did not cover it and did not require it. The surgeons office requires it and they told me it was more for my own benefit ..so that the psych could help me notice my shortcomings and how to properly overcome them to make this surgery a success. I found it all to be very helpful. Try not to view it as something you HAVE to do, view it as a learning experience about yourself, and if you have a good psych that is exactly what the experience will be.

-Libby :peace:

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All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done.

You should call and verify your benefits and coverage before scheduling anything. When I had UHC Choice Plus (until March of this year) they wouldn't cover ANYTHING related to weight loss, although what exactly they do cover is determined by your employer. Good luck.

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Yeah, definitely call and ask.

I was much the opposite from you guys..

My insurance won't pay for obesity treatments (so surgery was out of pocket), but they DO pay for shrinks. So they did cover mine. If I didn't get it covered, it was going to be $100 for the psych eval.

Can you 'shop around' for a different psych, or do they require you use theirs at $250?

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

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