Local lawyers

Hi everyone, I am looking for a lawyer in New Jersey who can help me with my fight with the insurance company. I have submitted my claim over 6 months ago and still they are denying it, even though I fit the criteria. I am thinking about trying to get loans and self pay. Any advice for or against this? Anyone in this website think that the insurance not approving me claim and have such a struggle is a sihn that maybe this is not for me?....I want to do a payment option, but I am thinking maybe the denials are a sign that this is not for me. How many people had a really tough time with the insurance and thought the adverse decision was meant to be?

hi post this on the baf message board..i remember someone posting about appeals and denials and giving specific to the "T" instructions on what to do......someone there maybe able to help you we post every single day...and a lot of people there have been denied then approved... http://www.obesityhelp.com/forums/black_american dre

Hi Ihav Thanks for your response to my post. I went over to the forum and tried searching for the post, but couldn't find it. If you remeber the title or even the person who post it let me know. I put a new post in asking for help but I will continue to search for that old one.

I had a little bit of a hard time with my insurance company, but went on to get things turned around. I had surgery July 2004. When you are denied, they MUST give you the reason for the denial(you might have to ask for the specific reason in writing). Why are they denying it? I'm sure that it's a technicality. But the way it often works is that you can only have a certain number of submissions (and denials). How many times has this been submitted (and denied) by your insurance? At this point, even if you qualify, you may need a lawyer just to help you with the appeals process. Irene

Hi Irene, I have exhausted all internal appeal. I went through three level of appeals and still I am denied. The reason for denial is lack of medical necessity. All the things that are listed in the denial I HAVE!! I meet the NIH criteria and also..meet all the requirements outlined in my plan for this surgery. I am 5'3 and weigh 297 pounds. I have 8 months supervised diet from my doctor, I have 6 months visits with the nutritionist and also 7 years medical history showing obesity. etc.. Now that I have exhausted my appeal process, what else can I do. Its injustice that they are denying my claim when I clearly meet the criteria. Do you know any lawyers that deals with health insurance law and will work with me for a affordable price? I have a self funded plan, so I dont know if I can get a arbitrator, mediator involved or write to the Department of Labor.

I just ran over this profile Her name is Doodlebug C she's from MN and she used the lawyers that i was refering to and if you read her profile she fought with the insurance company for like a year and then they got her approved maybe you could try emailing her and asking her about her eoerience and how they were when it comes totheir pricing. Gary J. Viscio, Esq. Viscio & Associates, PC 145 Willis Avenue Mineola, New York 11501 tel. (516) 742-5300 fax. (516) 742-8130 www.obesitylawyers.com Sorry about the repost Tyshea 315/189/150

Hi there: I'm a New Jersey attorney, and also a gastric bypass patient. I emailed you my information. Angela

Angela. From toms river and need help with health net...Could you email me! Thanks... Rich

check out obesitylawyer.com,Gary vacio, I have talked with him and may have him help me in my appeal if my union deems it necessary, if you are in a union, they have a legal obligation to obtain the benefits of your negotiated work benefits. I also have my congressman assisting me with my other insurance company, I cannot have a rny, it is incompatible with my previous bariatric surgery, I can only have a DS, which is excluded by both of my insurance companies. On the topic of self pay, the DS is often referred so much that some choose to travel to Mexico or brazil,spain for the DS instead of a free rny,it cost about 12k, it has a higher success rate,less chance of regain,no dumping, normal diet afterward, less post op revisions. visit the DS forum and check out the options for surgery and self pay, grew up in EO