Question:
I am curious if anyone out there has Selectcare of MI HMO

and if anyone has ever been approved without having to have a big battle over the surgery. I would like to know what kind of fight I should be anticipating with them.    — Claudette G. (posted on May 21, 2001)

May 21, 2001
A woman in my support group had them and had to take her case all the way to the state insurance board to have it paid for (reimbursed). The physician who dealt with them has an excellent assistant named Julie who might be of some help. Look up Marek Lutrzykowski, MD, in Bloomfield Hills at www.duodenalswitch.com Good Luck!
   — merri B.

May 23, 2001
Hi Claudette...Merri is correct about Selectcare of MI. Also, Selectcare has been bought out by Health Alliance Plan and I know for certain that you will be denied until you exhaust all your appeals. You will have the option of going to the state level, Center for Health Dispute Resolutions (CHDR). If it is medically necessary for you to have this surgery the decision will be overturned, but the insurance company still has the right to appeal. Ofttimes they don't because it is cheaper to pay for the surgery.
   — Margaret M.