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Pre-op Gastric Bypass Gastric bypass surgery dates, insurance issues, emotional preparation, etc.

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Old 09-12-2004, 10:56 PM   #1 (permalink)
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Default need psyc eval, ins wont cover

I called my ins for a referal to get my psyc eval, and was told they won;t cover pre op psyc evals. I don't know what to do. I can't afford to pay out of pocket. I have an appt to have my gallbladder us on tues. Thats the last thing on my list 'sides the eval. Does anyone have any ideas? I have Health Net
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Old 09-13-2004, 07:40 AM   #2 (permalink)
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Yes! I was told specifically by Leslie in Dr. Callery's office to state that "I have food issues" to discuss with a psyc. and not to say that it's pre op because they won't cover it if you say pre op.

Worse case, you pay for it yourself. It will all be worth it in the long run.

Good luck to you! Keep us posted.
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Old 09-13-2004, 08:00 AM   #3 (permalink)
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Smile Jenna

Jenna,

I went round and round with my insurance company about this subject. It took a bit longer for me, but finally they approved it. Fist I was told to call on the back of my card and get a consult. So I called the 800 # on the back of my insurance card, then they told me no way we don't do pre-op evals. So then I called my Insurance company back and explained to them what was going on and they denied it, then they finally approved it but I would have to go for something like 3 months or something it was rediculous.. I kept fighting and finally had my Doctor send over a new referral after calling Dr. Paintel (the Dr. I saw) and they got the ICD.9 (Diagnosis) code and faxed over a new referral and it was approved. You may want to try it that way.. if you have any questions please private message me as I remember this stage way too well. It sucks but you'll get through it I promise.
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Old 09-13-2004, 10:48 AM   #4 (permalink)
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Well that sure was easy, I have an appt tommorrow. I did what ya'll suggested and it worked. Thanks so much. Woo hoo!! We're getting there.
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Old 09-14-2004, 12:41 PM   #5 (permalink)
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Good advice from this group, huh??? Glad it worked out for you, Jenna.
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Old 09-14-2004, 04:11 PM   #6 (permalink)
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Wow taht was painless. I had my eval today with Dr John Ward in San Marcos, he was cool. Said he would get the letter out by the end of the week. Tommorrow is my Gallbladder US, last thing on my to do list woohoo
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Old 09-14-2004, 08:27 PM   #7 (permalink)
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Smile Congrats Jenna

Jenna,

Congrats on getting through this process.. it's a pain in the butt but it is so worth it in the end.. Also all the crap we go through.. makes us appreciate it even that much more and make us want to stay on track.. well at least that is my experience anyway I guess I can't speak for everyone..
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Old 09-21-2004, 02:28 PM   #8 (permalink)
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Default psyc eval

How much did they charge you for the letter? I was told over the phone that they could charge up to $50.00 a page? Is that right?
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Old 09-21-2004, 02:32 PM   #9 (permalink)
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Default Psych eval charge...

All I had to pay was my $10.00 office visit co-pay, period!!
Good Luck
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Old 09-21-2004, 02:38 PM   #10 (permalink)
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Smile No Charge

There was no charge for the letter from Dr. Paintel. I paid my $10.00 office copay and the rest was history..
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