insurance coverage and psych eval.

[Guest guest]

This info. may be of interest to pre-ops (post-ops may just laugh and

shake their heads at me):

I am scheduled for surgery June 19th. I had all of my medical work

completed in April within a week of my official consultation with my

surgeon. I knew I needed a psych. eval. and called to make an

appointment the same day I made all my medical appointments. I have

a comprehensive insurance plan and was thrilled to find one of the

two listed psychiatrists who do the bariatric evaluations in the

county listed on my mental health provider list. I had never taken

advantage of the mental health coverage with my insurance, so I

called and got an approval number from my provider. I then called

the therapist, and she obviously runs a one-person office, because I

could only reach her message machine even though I called repeatedly

during business hours. I left a message stating I had an

authorization number and would like to set up an appointment. I also

stated that I needed to speak with her before the appointment

regarding the nature of my visit. Since I work long hours, and I

have no intention of telling anyone at work about my surgery, I left

my home and cell phone numbers for the Dr. to call. She called and

left a message on my home phone listing possible meeting dates. We

then proceded to play phone tag three more times over the next week,

as we confirmed the exact date and time. Each time I called her

office and got her machine, I mentioned that I needed at least two

minutes on the phone with her, personally, so I could explain why I

wanted to meet with her. Her final message in April stated, " We do

not need to discuss the nature of your visit before your appointment,

that's what the original consultation is for, I will find out what I

need to know then. "

Well, I waited for the whole month of May, as the earliest

appointment I could get was June 1st. I had to take time off of

work, and drive to the large city where she is located. Once I got

to her office, she was of course running late and I sat through half

of my scheduled time just waiting for her. Once I finally completed

all the paperwork for the insurance and her business, and I had a

seat on the couch, I told her I was a bariatric pre-op and I needed

the psych. evaluation. She then proceeded to tell me, in a most

confusing manner that SHE DOES DO PSYCH. EVALS. AND FURTHERMORE

THINKS MY BARIATRIC SURGEON IS GREAT BECAUSE HE REQUIRES SUCH

THOROUGH REPORTS, BUT SHE IS ALSO UNDER CONTRACT WITH MY INSURANCE

COMPANY (and here's the really bizzare part) AND MY INSURANCE COMPANY

PAYS FOR BARIATRIC PSYCH. EVALS. BUT NOT AT A RATE SHE WILL ACCEPT,

SO SHE WON'T DO THE EVAL. FOR ME AS AN INSURANCE PATIENT, AND SHE

WON'T DO THE EVAL. ON ME AS A SELF-PAYING (ie-I'm ready to write the

check for the full amount as I'm sitting in her office) CLIENT

BECAUSE I'M COVERED BY INSURANCE AND IT WOULD BE A CONFLICT OF

INTEREST BETWEEN HER AND THE INSURANCE COMPANY. We went around and

around for a while as I tried to both understand what she was saying

and brainstorm possible solutions. Finally she said that I'd need to

find a psychiatrist who DID NOT accept insurance for anything and

then schedule a self-pay evaluation with that person. I mentioned

that I was under a bit of tight schedule, my surgery is only 18 days

away and I had already waited an entire month to meet with her (only

to be told something that could have been taken care of back in April

if she would have given me those two minutes on the phone like I had

asked). She then calmly remarked that I may need to reschedule my

surgery if I couldn't find anyone in time.

That was nearly my breaking point. There was no way she could know,

but the whole reason I'm having the DS with the surgeon I'm having it

with is because I have exactly a one week window in which I can have

the surgery. I had already gone through appointments with another

surgery center, but they couldn't schedule me until Aug. and I

absolutely need the surgery done the third week of June to allow

adequate recovery time during my scheduled vacation from work.

Short summary to a long story...I contacted the office of the only

other therapist who does the bariatric evals in the county, his

secretaries had to call him at home, and I'm pretty sure they did so

only because I was standing in their foyer with tears in my eyes

stating that it was an emergency and I needed to talk to him

immediately. The Dr. did schedule a psych. eval. for next Wed.

(yippee, another day I have to take off of work, when I only have 10

days left to get all my stuff wrapped up before surgery as it is) at

full self-pay price. Of course he sounded irritated to be contacted

at home late on a Friday afternoon and I'm pretty sure I'll be going

into this test with some black marks already against me. I can only

hope he'll see my decent, rational side during the evaluation.

Moral: pre-ops beware, especially if you have " good " insurance

coverage.

[Guest guest]

How ridiculous! She's supposed to be a shrink?! How about messing with

ones head...isn't that a conflict of interest??? At least you don't have

to subject yourself to a whole hour of her insensitivity. Good luck with

the new Dr. Let us know how you make out.

--- jant@... wrote:

> This info. may be of interest to pre-ops (post-ops may just laugh and

> shake their heads at me):

> I am scheduled for surgery June 19th. I had all of my medical work

> completed in April within a week of my official consultation with my

> surgeon. I knew I needed a psych. eval. and called to make an

> appointment the same day I made all my medical appointments. I have

> a comprehensive insurance plan and was thrilled to find one of the

> two listed psychiatrists who do the bariatric evaluations in the

> county listed on my mental health provider list. I had never taken

> advantage of the mental health coverage with my insurance, so I

> called and got an approval number from my provider. I then called

> the therapist, and she obviously runs a one-person office, because I

> could only reach her message machine even though I called repeatedly

> during business hours. I left a message stating I had an

> authorization number and would like to set up an appointment. I also

> stated that I needed to speak with her before the appointment

> regarding the nature of my visit. Since I work long hours, and I

> have no intention of telling anyone at work about my surgery, I left

> my home and cell phone numbers for the Dr. to call. She called and

> left a message on my home phone listing possible meeting dates. We

> then proceded to play phone tag three more times over the next week,

> as we confirmed the exact date and time. Each time I called her

> office and got her machine, I mentioned that I needed at least two

> minutes on the phone with her, personally, so I could explain why I

> wanted to meet with her. Her final message in April stated, " We do

> not need to discuss the nature of your visit before your appointment,

> that's what the original consultation is for, I will find out what I

> need to know then. "

>

>

> ----------------------------------------------------------------------

>