?: Pyschologist must refer me psychiatrist for ADD Evaluation? - ADD / ADHD Message Board

viball · 05-21-2009, 06:25 PM

I have a question, and hopefully some of you can help me out.

I have been recently Diagnosed with ADD and have been perscribed Vyvanse. I have had a great response to the medication and I am happy.

However,

When I first asked my doctor about this he recommended that I go have a Psychiatric evaluation done and to let the pys perscribe the medication and we will go from there.

The office schedule my appoint and for my first two visits I met with a psychologist and talked about everything. On my 2nd visit she asked me "ok, you feel you have symptoms of ADD, you need to see the psychiatrist, not me" The next day I returned to my Primary care doctor and told him I have been meeting with "Mrs. _____" he says "you were supposed to see the psychiatrist, not the pyschologist"

After that visit I went and talked to the Psychiatrist and we made progress...

THIS IS WHERE I GET CONFUSED: I get a bill that says I owe $150 for the "social services (psychologist)" and my insurance does not cover them. So I call my doctors office and tell them:
"Hey, I received a bill from the psychologist and my insurance does not help at all, you all scheduled my appointments and accidently sent me to the pyschologist, not the psychiatrist, this was not my wrong doing and the pyschologist should have been avoided all together, I feel I will need help with the $150 bill I am stuck with now because you sent me to the wrong person"

The Doctors office response: "We cannot refer you directley to the psychiatrist, you must speak to the pyschologist and they refer you psychiatrist"

This sounds odd as the pyschologist told me "You should be seeing the psychiatrist, not me" and my doctor also to me "You should be seeing the pyschiatrist, not the pyschologist" (They set up my initial appointments)

Is the proper method Pyschologist refers to the physchiatrist? or is this just a way hide their mistake and not be responsible for the bill?

Sorry it's soo long, but anyyy insight is GREATLY appreciated!!!

addprogrammer · 05-21-2009, 08:12 PM

Viball,

Your doctor handled your case well.

Your PCP suspected you have ADHD. He sent you to psychologist. Diagnostics is their speciality. Psychologist confirmed ADHD, not some other disorder mimicing ADHD symptoms. The psychologist sent you to the psychiatrist for medication management.

Your comment "I have had a great response to the medication and I am happy" says it all. You have an exceptionally good doctor.

Your insurance coverage is what sucks. If it is any comfort to you, I for one, haven't found insurance coverage that doesn't suck.

Pay the bill.

Bob

viball · 05-21-2009, 08:28 PM

Bob,

Thank you for the insights. The way the DR originally told me I was to see the Pyschiatrict and not the Pyschologist made me believe they accidently sent me to the wronge professional. Even the Pyschologist made a point to ask "Why are you seeing me and not the Pyschiatrictist?" I just said "I dont know, I am just going where my doctor tells me to go"

Orginally the Doctor made it sound like it was his mistake for scheduling me with the wrong person, then when I ask about the bills for the mistake, it seemed like they were tryin to cover themselves.

I have never had any of this stuff done before, so I am not educated as to the proper steps to treat. If this is the proper procedure, I am happy. But I don't want to be paying for DR mistakes (College student, 18+ credit hours and full-time with school sports = no work for extra expenses). I just became suspecious as to how one visit he apologizes for inconvienence, then when I ask about the bill its suddenly "the pyschologist refers you to pysch..."

I mean...I dont know? lol

Thank you for your help Bob!
Sincerly,
-Corey

marisuela · 05-22-2009, 01:24 PM

Unfortunately, something I have learned over the years, is that no matter who sets up any referred appointments, YOU have to be the one to make sure you're covered, because those lovely people working in reception usually don't give a rat!

So if you went and saw a doctor without checking if you're covered, whether your doctor set it up or not, and even if it was a mistake, you are still responsible for the bill.

Have you contacted your insurance company directly to find out why they wouldn't cover the visit? Are all psychologists not covered, or is it just that the particular one you saw doesn't take your insurance? Have you looked into your insurance's handbook of what's covered to see if psychologists are covered, and if so, to what extent?

My parents went through he** all the time with the insurance when my Dad was battling skin cancer for 10 months. It was like every single treatment he had to fight about. He passed away almost two years ago, and my Mom still gets harassing letters from the stupid insurance about it! And now my Mom is having some major health problems and to get a referral to the right specialist, she had to see three other specialists first.... AND even though one specialist would recommend the next, she still had to keep going back to her primary care doctor for a referral to the next specialist.... did that make sense??? It was a whole stupid ridiculous ordeal.... and she's not through yet!

Anyway, sorry.... I'm past my next dose of adderall now! My point is, don't take it for granted that you'll be covered next time. Make sure you find out for yourself, directly from the insurance company, before you go see anybody!

Oh.... one more thing.... pay the bill. If you want to fight it, fight it, and hope to get reimbursed for it. But if you don't pay it, you'll end up getting sent to a collections agency, and that goes against your credit and all that, and it's not worth it. Pay the bill and if you feel like you are right, make the right person reimburse you (and they usually will!). Good luck!

(now I'm off to take my afternoon adderall before I go rambling on another person's thread!!!)