Question:
Does anyone have advice for my denial through Care Choices?

Received my first denial on Saturday. I have met all criteria, so me and my doctor thought. Until the denial came. Care Choices did not accept the way my doctor dictated my visits. He touched on my diet and my comorbidities but did not document my weight and inches gained or lost at each visit. I already have done this for over one year. Now they tell me this. How frustrating. I want to write an appeal letter. Any advice for me? I have a few comorbidities including a stroke due to being overweight.    — Sandy R. (posted on March 27, 2006)

March 27, 2006
I can't believe your Dr didn't chart your weight at every visit...that was one of THE MOST important things!!! Insurance companies want to see if you can loose it on your own before WLS. Looks like you will have to start over unless your Dr can come up with something..I don't know??? ~Melissa
   — WannaBSlim

March 27, 2006
I know how you are feeling right now. I also was denied by my insurance and had to visit my doctor for a year. After about six months I decided to write an appeal letter which they accepted and in about three weeks I had my surgery. If you would like a copy just email me. Good luck and don't give up. Laural HW-313 SW-292 CW-195 GW-135
   — Laural D.

March 29, 2006
Hi Sandy- I don't want to sound too harsh here, but have you thought about switching doctors? I am going through Beaumont in Royal Oak and they have this stuff down to a science. I have Preferred Choices (which is baisically the PPO equivalent to Care Choices) and they are in-network. I am just really surprised that your MD didn't document your weight and your weight loss attempts? I am going through Dr. Rifai and he works with Dr. Doyle at Beaumont. My husband went through them after a botched experience at Barix and they were wonderful. In the meantime, it seems that an appeal letter wouldn't hurt. If anything, you can see whichever doctor and at the same time begin the appeal process. Good luck to you, I wish you all the best!
   — amysocko