*****QUIRES THE PCHYE EVAL?

Hi, I am in the "waiting for approval" stage of my journey....I have a question.....*****quires the pchye eval? the dr or the insurance? Does every one have to have one? and how is it? any comments would be appreciated......thanks.......Julie

Here is a list of surgeons that I copied off of Debby G's profile. Hope this helps!! I was asked to add the current list of IL PA surgeons with some info about my approval. My surgeon required all my tests done before he would see me, so how long you get yours done is up to you, each surgeon has his own routine so how long this can take vary. I had everything done within 2 weeks!!! It took 3 weeks for my surgery consult. They submitted my pre auth. the next day. Public Aid came back 4 days later and said I was approved... ( dancing in the streets eating everything I knew I couldnt ever have again!!!) 4 weeks before my surgery date I was notified that my Psych eval was rejected because "I was not released for surgery"... So we re-wrote it and re-submitted it. Once PA actually got the psych eval I was approved ok. That was on Dec.10 (whew talk about cutting it close) Ok before I go on and on here is a list of known surgeons that take IL PA. If you find anyone else please let me know so I can update this list!!! ***New surgeon in Iowa Dr. Matt Glass**** Cedar Falls, IA 319-268-3994 getting IPA approval. If you call him and he has not received his IPA providership yet or they tell you NO they are not getting it please let me know so I can get him off this list. He's Tim's surgeon and Tim started out at 600lbs and was able to have it done Laproscopically.. HOW FANTASTIC IS THAT!!!! Dr. Shayani In maywood.... he only does the Lap Band and he requires you to go to one support group meeting then will schedule a consult he moves pretty fast. 708-327-2899 Dr. Maillefer Dekalb Clinic 217 Franklin Street Dekalb, Illinois 60115 815-758-8671 Dr. Oliphant in Urbana he moves slower you have to call his office for a packet fill it out send it back in and you'll hear from them for an appointment in a few months I think he's currently scheduling for January/February. 217-383-3240 RNY only The surgeons at the COMP clinic at SIU they require a $260 up front to cover things that medicaid wont ??? and then 10-20 for nutritionist appointments and support group costs too. (217) 545-COMP Open RNY only Dr. Frederick Tiesenga in River Forest. (708) 386-1078 He just started accepting public aid. To get into the consult with him you will have to go to an informational meeting and get a packet. In the packet will be papers for you to fill out. You will need an upper GI, Gallbladder U/S(If you still have it), Psych Eval, Sleep Study (IF NEEDED), nutritionist consult ($75 OOP) You also have to write an essay explaining how YOU think the surgery is and how it is going to go. You have to explain WHY you need the surgery. (This all gets sent to the insurance company) He is now doing only 2 IPA surgeries a month. There's a surgeon in Bloomington Indiana that just got Illinois Public Aid providership. His name is Dr. Bradley Ray 812-330-9962 LAP Band Only Psyc Eval _ you have to apply for a grant to pay for it, grant is based on income. Georgeann Russell 708 763 2120 Hinsdale Hospital Dr. Dillon (the surgeon currently doing wls does not) but he takes Medicare

whoops... totally disregard the other post from me. The insurance are the ones who usually require it. I have public aid and they required me to have one before my paperwork was submitted to thim. It seems like most insurance companies require it anymore. My psych eval wasnt too bad at all. I had like 20 questions to answer and went in and talked to the psychologist for about 30 minutes. Just be sure to answer truthfully. It was really easy. But I was soo nervous as I was afraid they'd think I wasnt "sane" enough..lol Best of Luck!!

Both my doctor and my insurance required it. Nancy

Julie, Both situations can be the case. My insurance required it as a pre-requisite along with an indication of medical necessity.. but the surgeon I chose also required it. So whether my insurance wanted it or not, my doc was going to have me do it. Not every doctor or insurance company requires it, however. It's not scary or anything.. it was actually pretty easy and my psych doctor was way cool. Depending on the psychologist you go to, the appointment can go any number of different ways.. but the basic premise is they will ask you questions. Evaluate how much you know.. how much you understand.. what your support system is like.. what your expectations are.. they'll check for signs of untreated depression and make sure you are going to be okay for the difficult journey ahead. It's so easy to think this is "the answer." It's not. Most of us have issues that go beyond the number on the scale.. and some of this stuff is hard to deal with.. they want to make sure you understand the changes that are coming and are prepared to deal with them. Being told you have depression won't necessarily exempt you from surgery.. but it will require a post-op care plan that includes treatment for your depression. It's just to make sure you're going to be okay. Stef Lap RNY 11/12/04 390 -> 313 -> 175

Julie, My surgeon required it, but when I went for insurance approval they sent a letter stating approval was pending for Psych and nutritionist. My surgeons office gave me a list of psychs they use and sent me to the nutritionist they require you to see and I was approved in days after they received the info. Then I also had two things the surgeon required out of the way. Good Luck on your journey, D