Insurance Appeals?

[RKidder 0]

I recall at one time, some information on submitting appeals to insurance companies, when denied. I also recall seeing somewhere an email address for an attorney who could assist with appeals. I believe he, himself, had had lap band surgery.

I found out today that my insurance company denied the surgery, as the surgeon's office was "out of network". This surgeon has a great reputation, and is in a well-established bariatric program which has been in place for the past 4 years. All 3 surgeons learned their "craft" from Australian surgeons who have been performing this procedure for a very long time.

The local surgeon (within the network) has just opened up his practive to lap band surgery since Feb. 06. I am not comfortable in going to someone who is relatively new to the procedure.

In advance, thanks to all who can help me with my dilemma.

Rachel

[Wheetsin 714]

My best guess (I work for an insurance company, but am not personally in the insurance business) is that going out of network is always seen as optional. And I can't think of any insurance company that is going to see "I want someone with more experience" as a reason to accomodate coverage for an out of network provider.

I believe the site is obesitylaw.com, or something similar.