Dr. Kriston A. Segura - Licensed Clinical Psychologist
Bariatric Pre-Operative Psychological Evaluations

"Surgery is like heat on a stove, it doesn't put issues in your "pot," but whatever may be there will certainly boil up.  And without a proper container,
you'll end up with a big mess." --
Dr. Segura

Over the past 6 years, I have conducted literally thousands of pre-surgical psychological evaluations.  In my work, I've see patients in all phases of the surgical process -- before, during, and up to 10+ years post-op.  As such, I'm uniquely aware of the many pitfalls and roadblocks that may come up.

Q:  Why do I have to have a psych eval?
The purpose of the pre-surgical evaluation is to ensure that you are mentally and emotionally prepared for your lifestyle changes.  Also, most insurance companies require that a psychologist preform such an evaluation prior to authorizing coverage for your surgery.

Q:  What exactly is involved in the eval?
You will be scheduled for a 2-hour session.  The first hour will consist of a paper-and-pencil test (MBMD).  The MBMD  helps to quickly identify any potential areas of concern regarding your readiness for surgery as well as your strengths and healthy coping skills. The test is normed against over 700 bariatric patients and is a well-used tool by most bariatric evaluators.   In the second hour, you will meet with the doctor and discuss any past or current hurdles that could complicate your success.  Additionally, you will be provided with psycho-education regarding the surgery including post-op nutritional and behavioral changes needed to reach your goal(s). 

Q:  What happens if I fail the eval? 
I like to say that everyone passes--eventually.  The majority of patients pass the first time.  However, as I and your surgeon are truly interested in your health and success, we want to ensure that you are as prepared as possible.  As such, pre-existing, un- or under-treated psychological or behavioral issues must be addressed prior to surgery.  A specific treatment plan will be recommended with a time frame (usually 6 months).  Typically, you will be referred for psychological therapy and/or medication evaluation by a psychiatrist.  I assure you that EVERY patient who has followed my recommendations has passed the second time.  Furthermore they typically thank me later for "failing" them! I know it may sound incredulous, but while the patient may be understandably disappointed at first, once he/she settles in and does the work, any underlying anxieties and fears regarding the surgery and life later seem to melt away.  They usually return with a renewed sense of purpose and confidence.

Q:  How long will I have to wait for the results?  And where does my report go? 
Typically, you will be informed within a week of the results of your evaluation.  A letter will be mailed to you clearly stating if you passed the evaluation or not.  Again, if you did not pass, a detailed, specific treatment plan will be tailored for you.   Your full evaluation with any follow-up  plan will also be forwarded to your surgeon's office.  Due to the sensitive and technical nature of the report, a copy may only be forwarded to another health care provider (i.e., therapist or PCP). 

Q:  Will my insurance cover the evaluation?
Typically, if you are covered by any of the following plans the evaluation will be covered by your insurance:

  • Medicare Part B
  • Medicaid 
  • Teacher's Health Trust
  • HBI
If you have Medicaid only and/or Medicare, Medicaid, or Teacher's Health as primary with any secondary, typically the entire costs of the evaluation will be covered (i.e., no out-of-pocket costs).  My office can bill your insurance(s) directly.  Any uncovered costs will be billed to you, directly. If you have any questions regarding billing or if you are covered by another type of insurance, feel free to contact my biller/office manager:

Elizabeth Wilkin
(702)434-8058 Phone and Direct Fax