Okay folks, this is what I've been expecting. They've (HMO) has taken so long, I figured this is what's going to happen.
So, why was I denied? Because I don't have a dietician/nutritionist evaluation, and a "six month medically supervised diet" with my doctor. (They don't like the idea I did weight watchers).
Yes boys and girls, this means they wanted me to come in every month for six months to say hi to my doc, get weighed and talk about dieting.
My surgeon's office had me call the Department of Managed Healthcare (California)
www.hmohelp.ca.gov / 888-466-2219 to help me. They said I need to go through my HMO's grievance process first. If, the deny me again, then the DMHC will get involved. Oh, apparently, there is no state requirement for a supervised diet (again, this is in California), but need to follow the HMO's rules first. Fair enough.
Oh yeah, the topic of exercising came up. Interestingly, since I started the WLS process, my back has been getting worse, and have been diagnosed with degenerative disease (have to go in for xrays). In fact, I'm going to the DMV today to pick up my temporary disability placard (second one this year), and have had to start using a cane when I'm out having to stand/walk for long periods. I have that documented, plus the type II diabetes so I have that on my side.
For now, I need to be sure my HMO has "everything" they want so I'll make the appointment and play their game.
The funny thing is, they don't know who they's messin' with!
anyway, that's where I'm at in this fiasco!
Gotta laugh about it, it's is so absurd.
So, what am I going to do next? I'm going to Disneyland!
Might as well enjoy a smoked turkey leg, go on the Haunted Mansion (it's been redone with the Nightmare Before Christmas theme) with our son a half dozen times, have some roasted chestnuts, and just let loose!
Thank You - You've Been Denied!
DYANN
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