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Physc... evaluation required by insurance?

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Old 10-17-2007, 07:08 AM   #1
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Physc... evaluation required by insurance?


I am in the stages of all of the pre-op clearances required by my surgeon's office. Even if my insurance company doesn't require these, they do.

The physiological evaluation is not covered by insurance and is $250! I don't really have that kind of money and will need to move some things around to pay it. I want to get it scheduled asap, this is 1 of 3 last things that I need to get done before the surgery can be scheduled. (physc. eval, nutrition class - which is also NOT covered by insurance and is $200 - and last support session)

All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done. I have a call into my surgeon's office to see if they can answer my questions as well. What was your experience with this? :help:

Thank you!

Brown Beauty in Philadelphia
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Old 10-17-2007, 07:26 AM   #2
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My insurance covered everything. I just had to pay my co-pays. You should call your insurance company and ask questions. Ask why they don't cover psych evaluations. I would think they would. Also ASK about weight loss surgery and if Lap Band is covered. You should ask all this before you go too far and find out later it is not covered. Some insurances won't cover it. Best to check before hand.
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Old 10-17-2007, 08:45 AM   #3
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Mine wasn't required or covered by insurance either.

It was required by my doctor's office, as was a visit to a nutritionist.

They were $250 EACH :speechles
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Old 10-17-2007, 09:08 AM   #4
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Same as Candle - Not covered or required by insurance, required by surgeon -$250.00 for psych eval - $325.00 for nutritional assessment. NYU Program - Dr. Fielding.


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Old 10-17-2007, 09:14 AM   #5
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My surgeon required an evaluation. But luckily his price included everything. I'm not insured and he gave me a great price of $7,000- best money I've ever spent.
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Old 10-17-2007, 09:52 AM   #6
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I agree with Barb, call your insurance company and ask them if the surgery is covered and why the eval. isn't covered. if you still have to pay, maybe you could set up a payment plan with the Doctor's office. They might be willing to work with you. I am self employed so I chose my insurance company. All of my visits were covered and with my plan I don't have co-pays but I pay almost $300 a month for health insurance. Good luck with everything!!!
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Old 10-17-2007, 10:05 AM   #7
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Quote:
Originally Posted by brownbeauty View Post
I am in the stages of all of the pre-op clearances required by my surgeon's office. Even if my insurance company doesn't require these, they do.

The physiological evaluation is not covered by insurance and is $250! I don't really have that kind of money and will need to move some things around to pay it. I want to get it scheduled asap, this is 1 of 3 last things that I need to get done before the surgery can be scheduled. (physc. eval, nutrition class - which is also NOT covered by insurance and is $200 - and last support session)

All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done. I have a call into my surgeon's office to see if they can answer my questions as well. What was your experience with this? :help:

Thank you!

Brown Beauty in Philadelphia
Is there anyone at your Surgeon's office that can help you work with your insurance? Most have a nurse or coordinator that will work with you one on one and help you in your path to surgery. Some will even try to convince insurance providers to go along with the surgery.

Ask around, I do and I find I usually get the results I want. Insurance is NO FUN that is for sure, but sometimes you just have to twist their arm.

Good luck! :)
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Old 10-17-2007, 02:18 PM   #8
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My psych eval was also a $250 out of pocket expense. My insurance did not cover it and did not require it. The surgeons office requires it and they told me it was more for my own benefit ..so that the psych could help me notice my shortcomings and how to properly overcome them to make this surgery a success. I found it all to be very helpful. Try not to view it as something you HAVE to do, view it as a learning experience about yourself, and if you have a good psych that is exactly what the experience will be.

-Libby :peace:
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Old 10-17-2007, 02:48 PM   #9
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Originally Posted by brownbeauty View Post
All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done.
You should call and verify your benefits and coverage before scheduling anything. When I had UHC Choice Plus (until March of this year) they wouldn't cover ANYTHING related to weight loss, although what exactly they do cover is determined by your employer. Good luck.
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Old 10-17-2007, 03:05 PM   #10
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Yeah, definitely call and ask.
I was much the opposite from you guys..
My insurance won't pay for obesity treatments (so surgery was out of pocket), but they DO pay for shrinks. So they did cover mine. If I didn't get it covered, it was going to be $100 for the psych eval.
Can you 'shop around' for a different psych, or do they require you use theirs at $250?
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