IMR DENIED
Apparently, the DMHC (or more accurately, their external medical review organization, which I believe is CHDR/Maximus) now has a DS-hating, fatty-hating MD (who knows what this person's qualifications are?) reviewing DS IMRs, and in particular, requests for revision. See this recent one:
Case Details
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Lori -
I am so, so sorry. I know you must be devastated.
Next step - become a total PITA for your insurance demanding seeing a dietitian and therapist weekly, so you can document the hell out of your efforts that you have been compliant.
Then try again in 6 months, or earlier if you have more complications, with additional letters from the therapist, dietitian & your PCP that you HAVE done what is required and that the band failed you.
Kim
I am so, so sorry. I know you must be devastated.
Next step - become a total PITA for your insurance demanding seeing a dietitian and therapist weekly, so you can document the hell out of your efforts that you have been compliant.
Then try again in 6 months, or earlier if you have more complications, with additional letters from the therapist, dietitian & your PCP that you HAVE done what is required and that the band failed you.
Kim
Lori,
Keep your chin up!!!!!
-Jamie
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**