Woohoo more delays
Well I am jumping through so many hoops like many of you have to get surgery covered. Sometimes it feels like a mental olympics or something lol.
Anyways, I sumbitted an external appeal to get a consultation with a DS surgeon with the DMHC since I live in California and have an HMO. I also appealed because I was denied for any and all other referrals, such as a sleep study, endocrinologist, wheelchair, painmanagement specialist, etc. Now they told me they all qualified for an IMR (independent medical review). I also had a case worker that suddenly called me shortly after submitting for the IMR through my insurance company. I was supposed to have a sleep study back in February when I was waking up with chest pains but there was some drama that made it so I couldn't (someone had the wrong code down so insurance denied). The case worker fixed it and I had an appointment for the sleep test. Anyways, before this got fixed, the DMHC informed me if I submitted the IMR for the DS before the sleep test was done, I could get denied. So I just had the sleep test last night and informed the DMHC but they want the results which is going to take 4-6 weeks to get them. Then I can fax them to the DMHC and wait until they do the IMR.
So yet again more waiting for me. I've waited 4 years just to get this far, what's another 2-3 months for a consultation, right? It's just frustrating. Who knew a consultation could be such hard work? But in the end I'm hoping I get that gold metal for achieving the impossible: fighting for myself to win my life back, the greatest and hardest race of all.
Anyways, I sumbitted an external appeal to get a consultation with a DS surgeon with the DMHC since I live in California and have an HMO. I also appealed because I was denied for any and all other referrals, such as a sleep study, endocrinologist, wheelchair, painmanagement specialist, etc. Now they told me they all qualified for an IMR (independent medical review). I also had a case worker that suddenly called me shortly after submitting for the IMR through my insurance company. I was supposed to have a sleep study back in February when I was waking up with chest pains but there was some drama that made it so I couldn't (someone had the wrong code down so insurance denied). The case worker fixed it and I had an appointment for the sleep test. Anyways, before this got fixed, the DMHC informed me if I submitted the IMR for the DS before the sleep test was done, I could get denied. So I just had the sleep test last night and informed the DMHC but they want the results which is going to take 4-6 weeks to get them. Then I can fax them to the DMHC and wait until they do the IMR.
So yet again more waiting for me. I've waited 4 years just to get this far, what's another 2-3 months for a consultation, right? It's just frustrating. Who knew a consultation could be such hard work? But in the end I'm hoping I get that gold metal for achieving the impossible: fighting for myself to win my life back, the greatest and hardest race of all.
Hey there! So sorry to hear about more hurdles they want you to jump! LOL I too, received more hurdles. I finalyl found a pcp that referred me for wls, got my referrals and all...called the hospital (my hmo required it at a certain hosp) for my dietary sessions and of course that hospital did not have a dietician! HAHAHA They told me it was a 3 to 6 month wait for their dietician. LOLOLOL If it isnt one thing it is another. But much like you I figure I have waited this long what's another couple months. *sigh*
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