Psych Eval Insurance Issue?

mistyjean10
on 7/20/12 5:12 am - AZ
RNY on 10/29/12
This is my first post but I have been lurking for a little bit.

I had my initial consultation for RNY last week. I just need to get my psych eval and meet with a nutritionist and then they can submit all of my other paperwork to my insurance (Empire Blue Cross).

I have called two different psychology offices and tried to schedule an appointment. Both took my information and said they will get back to me after they call the insurance company. It has been over 2 days and I have not heard anything. Is that normal? Did it take a while to get authorization for the psych eval or did you insurance deny the authorization?

I guess I am being a little anxious but does anyone have any advice?
Vicki D.
on 7/20/12 7:08 am - TX
RNY on 06/12/12
 Going through the hoops required by insurance is probably one of the hardest things I experienced! It can be long and frustrating but as long as you keep plugging, it all gets done eventually. My surgeon's office referred me to a psych. for my eval. If yours didn't and you haven't heard anything by Monday or Tuesday, I would call the surgeons office and ask them what to do. 
            
manda2108
on 7/20/12 7:10 am
 My insurance would not cover the psych that my surgeon pumps all of her patients into so I found someone local..I called my PCP to get the referral and then called the insurance company and saw the psych within a week. When I went in to see her she said that she has a hard time getting insurance companies to pay for the eval..so she was going to enter it in as a normal session? In the end it didn't make sense to me because if my insurance required it...a normal session wouldn't have cut it..at any rate my insurance paid for my surgery! I have blue shield of california
            
CarolinaKelly
on 7/20/12 9:00 am - NC
RNY on 08/29/12
My surgeon had two docs he refers out to. I called to make an appointment and got in within a week. I have Anthem BCBS and they paid.
Cicerogirl, The PhD
Version

on 7/20/12 11:20 am - OH
Some insurance companies will pay for the evaluation and some will not.  I have been doing the evaluations very part time for a couple of months, and sometimes it depends on whether or not the insurance company requires the psych eval or whether the surgeon requires it (which is far more common).

Part of the delay in getting back to you is because many psychologists and counselors do not have administrative help to take care of such things. They have clients scheduled through most of the business day with only 10 minutes between clients (and they need those few minutes to use the bathroom, return phone calls to clients, etc.) it usually takes far more than 10 minutes to verify coverage and get approval from an insurance company.  That means that the therapist has to do it during their lunch or dinner break (otherwise it is too late in the day to get in touch with anyone).... and there may be clients in distress or personal matters that require more urgent attention than getting insurance authorization for someone who may come in only for that one session.  So it does not surprise me at all that you have not heard anything back in just 2 or 3 days.  Give it another couple of days and then you can call the office(s) and inquire.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

mistyjean10
on 7/20/12 1:02 pm - AZ
RNY on 10/29/12
 Thanks everyone for the responses. I am totally green about the administrative or insurance part of health care. It's good to know that what I am experiencing is typical. I hope my insurance covers the eval. I believe that my insurance requires it and when I called about getting approval for weight loss surgery, they said that I have mental health benefits. 
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