Question:
Does anyone get turned down because of psyc. eval.?
— angela D. (posted on April 23, 2002)
April 23, 2002
Yes, a psychologist can certainly recommend to your insurance co. that you
are not a good candidate. They are primarily looking for three things: (1)
do you have reasonable expectations, (2) are you fully committed to the
necessary lifestyle changes and (3) are you mentally stable enough to
withstand this major change. I don't imagine many people get "turned
down" because of a psych. eval.
— Terissa R.
April 23, 2002
I got turned down because my psych. evaluation was not submitted with the
doctor's paperwork to the insurance company. I had to have the doctor's
office fax the psych. evaluation letter and after 3 faxes to the insurance
company, they 'finally' acknowledged getting it. I am now approved but it
took me about 2 months to get approval. Hang in there. It will happen,
even if it takes you some time and perservance.
— Judy W.
April 23, 2002
Heres a lengthy discussion of this subject. <P>
http://www.obesityhelp.com/morbidobesity/question.phtml?N=n1009689926&Search_Word=
— bob-haller
April 23, 2002
This is a sore subject with me. My first psych eval. went badly - the
psych insulted me, was very judgemental, etc. etc. and then waited forever
to write a letter that would have blown my surgery - because six months
before I had asked my PCP for prozac! Needless to say, I got a second
opinion. (And I did not allow that original letter to go to ins. co in
any way, shape or form!) In the second evaluation I was careful with what
I said...basically that I am a happy person on the inside and I was ready
for my ouside to reflect that. (Which is the truth! Good Lord, if they
denied everyone whose ever taken prozac, who would get the blasted
surgery!) Anyway, this doc. had no problems with recommending me. My
advice...get the psych letter read to you before they send it off!
— rebeccamayhew
April 23, 2002
Sore subject for me also. I am in the middle of it right now. The psych I
went to was very judgemental and against the surgery in general. I just
got a call on Friday from my surgeon that they didnt like what he said in
the letter. He said "discussed unrealistic expectations" but he
meant, he thought the surgery WORKING was unrealistic! I was not
unrealistic with my expectations at all!! My surgeon is going to talk to
the psych and tell him that the ONLY thing he was to evaluate was my mental
competency and try and get him to change the wording. If not, I am going
to fork out the money to go to THEIR psych who doesnt take my insurance.
Hopefully, your surgeon is good like that.
— emilyfink
April 23, 2002
Ok, I have to add my two cents to this one...here goes. I believe that if
surgeons (whether it be their requirements or the insurance company's) are
going to make us have these psych evaluations, nutrition consults, etc,
then these doctors need to begin to find them for their patients. I am so
blessed to have a surgeon who sends us to people who are not only WLS
educated, they are WLS supportive!! I am so upset when I read about people
having panic attacks/ bad experiences, etc, with people who are supposed to
be helping them!!! This shouldn't be!! When my original PCP called WLS
foolishness and told me he would have no part in my death, I called my
surgeon and they recommended a wonderful doctor who I really like and has
helped me get to this stage...surgery tomorrow morning!!!
— Linda D.
April 23, 2002
Yes its BEST to use your surgeons suggested support doctors espically
psych. These docs will be familiar and suppportive of surgery.
— bob-haller
April 23, 2002
Geez, I must have had a different experience with the pshyc eval than most.
My doc had one on staff and she came to the surgeons' office, went into a
room with me after I filled out the lengthy questionaire, and talked to me
for 45 minutes. That was it and I had my psych approval the next day. I
don't know if this is a good thing or not because I doubt that she turns
many down but it was so easy compared to what I am reading here. Good luck
— Barbara H.
June 8, 2002
I just got denied by my insurance company due to my psych eval. I went to
my employee sponsered psychologist
instead of the psychiatry group that works with my surgeon. Because I
thought the psych eval was just a formality
I thought I would go where I did because it was a free benefit where
I work. Now I have to go back and talk to the
first psychologist who was not very familiar with WLS. He said he
thought I was depressed and needed to be
reevaluated in 6 months. The funny thing is he never told me this or
contacted me regarding further counseling or
treatment.I only found out about it from my insurance company. My
only depression is related to being overweight
and that is not going to go away after continuing to live with this
problem for 6 more months. If he won't change his
mind I will go to the psyphiatrist I should have gone to in the first
place. My advice is: if you really want this surgery
and you want to make it as easy as possible to get approved go where
your surgeon recommends. They will be
more familiar with the whole process and it will be worth it in the
long run. Gale
— Gale H.
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