HELP PLEASE

CGervolstad2385
on 9/22/14 7:04 am

I need to find a psychiatrist to do my evaluation that specializes in bariatric surgery I am in Northern California

Also I have Anthem Blue Cross Medi-cal so if you know anyone please let me know

Oxford Comma Hag
on 9/22/14 7:52 am

Call the customer service number on the back of your card or go online to Anthem BCBS for a list.

I fight badgers with spoons.

National Suicide Prevention Lifeline: 800-273-8255

Suicidepreventionlifeline.org

poet_kelly
on 9/22/14 9:03 am - OH

It needs to be done by a psychiatrist?  Not a psychologist, counselor or social worker? 

And the provider must specialize in bariatric surgery?  I think you'll have a really hard time finding a psychiatrist that specializes in bariatric surgery.  Since bariatric surgery is not a psychiatric disorder, that's not something they typically specialize in.  If they specialize at all, it's usually in a particular psychiatric disorder.  For instance, you might find a psychiatrist that specializes in schizophrenia.  But probably not bariatric surgery.

But if that's what you need, I'd ask your surgeon's office or your insurance company, whoever is telling you that's what you need, to refer you to one.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

purplecow
on 9/22/14 11:17 am

Hi, I work for Anthem BCBS (not Cali) but most are similar.  Call and see what is exactly required. Here in GA we need psychologist.  Truly, I just called around and asked "hey, does your Doc give bariatric clearances?"  Does not have to be bariatric certified (not here). Good Luck!

purplecow
on 9/22/14 11:30 am

here are your requirements:

Gastric bypass and gastric restrictive procedures with a Roux-en-Y procedure up to 150 cm, laparoscopic adjustable gastric banding (for example, the Lap-Band® System or the REALIZE Adjustable Gastric Band), vertical banded gastroplasty, biliopancreatic bypass with duodenal switch, and sleeve gastrectomy (open or laparoscopic) are considered medically necessary for the treatment of clinically severe obesity for selected adults (18 years and older) who meet ALL the following criteria:

  1. BMI of 40 or greater, or BMI of 35 or greater with an obesity-related co-morbid condition including, but not limited to:
    • diabetes mellitus; or
    • cardiovascular disease; or
    • hypertension; or
    • life threatening cardio-pulmonary problems, (for example, severe obstructive sleep apnea, Pickwickian syndrome, obesity related cardiomyopathy); AND
  2. The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery; AND
  3. The physician requesting authorization for the surgery must confirm the following:
    • The individual's psychiatric profile is such that the candidate is able to understand, tolerate and comply with all phases of care and is committed to long-term follow-up requirements; and
    • The candidate's post-operative expectations have been addressed; and
    • The individual has undergone a preoperative medical consultation and is felt to be an acceptable surgical candidate; and
    • The individual has undergone a preoperative mental health assessment and is felt to be an acceptable candidate; and
    • The individual has received a thorough explanation of the risks, benefits, and uncertainties of the procedure; and
    • The candidate's treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling; and
    • The candidate's treatment plan includes counseling regarding exercise, psychological issues and the availability of supportive resources when needed.

 

I just printed this out for my state and took it to my Dr and he just did a check list.  Most docs do  that.

eringudge
on 9/26/14 8:05 am
RNY on 07/28/14

Your surgeon's office should have a list for you. Then you just need insurance authorization and you should be good to go. My surgeon's office has a psychologist on staff who specializes in bariatric patients. He was pretty amazing with me. 

Most Active
×