We were staring at a rejection letter from our insurance company. "Vitamin D tests are not a necessary medical procedure" it read. Julie was recovering from two surgeries and radiation therapy, and her naturopathic doctor was monitoring her vitamin D levels because it is known that cancer patients often have suboptimal levels of vitamin D. We had also read in non-technical sources that optimal vitamin D levels significantly reduce the odds of recurrence. Shaking our heads, we initiated a google scholar search, soon finding ample evidence for the importance of optimal vitamin D levels during treatment and in preventing recurrence of a variety of cancers including breast cancer. We quickly drafted a technical memo to our insurance company and eventually the decision was reversed.

Our story about vitamin D pales when compared to Joe's father's experience. Diagnosed with high grade recurrent retroperitoneal liposarcoma, his oncologist recommended ribociclib, a CDK4/6 inhibitor with demonstrated efficacy in treating liposarcomas, but not yet FDA approved for that application. Covered by his insurance? No. Out-of-pocket costs? $15,000/month, an impossible amount of money. Supported in the technical literature? Yes, without question. What we all face in the current system is the fact that insurance companies hire highly educated Ph.D. scientists to review claims and comb the scientific literature looking for reasons to deny coverage. Often times, the scientific basis for denial is biased and not well-founded, and technical appeals can lead to reversal of decisions.

Be it cancer, autoimmune disease, or any other metabolic disorder, we conduct a review of the scientific literature and provide you with a personalized letter for submission to your insurance company. The outcome of such an appeal is not predictable or guaranteed, but our technical background allows us to give you the best possible chance for reversal by empowering you from the scientific literature in the technical language that they understand.