HARTCOLORADO

Anyone ever hire a Weight loss Surgery Lawyer?

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Hello! I am new here. My husband is asking me to hire a lawyer to fight my Anthem Blue Cross Blue Shield of Colorado insurance company for me.

They just denied me to have a Revisional surgery, remove old lap band and get a gastric bypass at the same time. Their reason for denial

is that my hospital in Grand Junction, CO is not a Center of Excellence and/or Blue Distinction facility. My hospital is already a COE for United Healthcare

but they are working towards becoming one under BCBS guidelines. I am told it could be another 6 months to 18 months before this happens. I've already been trying to

get this surgery since Sept 2015. I really don't want to wait another year. Besides, I've already paid for all the pre-surgery testing and paid up on my deductible. Should I wait any longer

I will have to start over from scratch. That means more money and a lot more time. I am wondering if it is possible to bypass the center of excellence rule with BCBS due to there not being

a center of excellence anywhere near me. BCBS customer service pretend to not know or just plain won't answer me. Anyone heard of this?

Also, my husband says he once saw that you can hire weight loss surgery lawyers to fight the good fight for you. Has anyone ever heard of this? If so, where do I go online to

find this? He can't find it now either.

Desperately seeking help,

Jamie

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I am not an expert by any means, but it's my experience that with things like this, insurance companies have the right to "make the rules".  Yes, the rules often don't favor the patient, but I would be concerned that bringing in a lawyer at this point would be very costly and wouldn't speed things up. 

I would try calling customer service again, and then if you don't get an answer ask to speak to the supervisor.  Keep going up the chain until you get someone who can answer your question about an exemption.

Good luck!

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I am an attorney and I have never heard of a weight loss surgery attorney.  The closest attorney specialty to this would be an attorney that does (as I do) "insurance coverage" work. Remember that an attorney without real experience in this area of the law will just take your money and almost certainly not help you much. 

I suggest that you ask your insurer how you can appeal their denial of surgery coverage at your chosen hospital. If that does not work your state attorney general office or state insurance agency may be able to help you. Be persistent but polite. Good luck!

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Thank you for great advice and info!!

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