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:think I am having major problems with getting BC/BS HeleathSelect of Texas to pay for the lapband and after this last appeal I have decide to get an attorney, does any know of a Good Attorney that can help with an appeal,either in TX. or Can practice law in Tx. I have 2 names Gary Viscio of Viscio & Associates,PC and Walter Lindstrom Jr. the only problem I'm having is obtaining some credentials and ratings from the ABA.in my area. If anyone has retain either one of these attorneys and won their appeal Please put up a posting .:pray: :pray: :pray:

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I've contacted Gary Viscio's office two days ago and again today. I am still waiting for his call back. Walter and Kelly Lindstrom have won a case for someone on this insurance forum. It's titlted "We fought HA and WON!!!" Look it up.

I am now in the appeals process as of today with Health Net. My surgeon's office appealed today and I wrote an excellent appeals letter that I got from ObesityLaw.com. They show a sample of an appeals letter. I used that letter and added my personal touch. It was a strong and direct letter. In the letter I did mention that I would take this to another level if I was not approved. We need to show insurance companies that we will not back down. I'm in the fight for a little while. Like I said in another thread, if worse comes to worse, I'll have to self-pay, but I won't give up without a fight.

Good luck. Don't give up!

Emily

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I had a terrible experience with Walter Lindstrom of http://www.obesitylaw.com/.

Initially he wrote a good letter to the insurance company, but that was all I got for my money. He never appealed to the state board as promised. He and his wife Kelly failed to return MANY attempts at communication. In one instance Kelly didn't even know which case I was.

Eventually I had the surgery after waiting for Walter and wife to do something. It had been six months since I paid them and they'd done nothing but sent one letter to my insurance company. Even after I had the surgery and self-paid (and threatened to report Walter Lindstrom and obesitylaw.com to the CA bar) they promised to appeal my case to the State Insurance board. I sent them all the documentation and once again I got NOTHING from them. They never filed a thing with my insurance company, never filed a thing with the State appeal board. NOT A THING! SAVE YOUR MONEY or get a real attorney.

I believe the insurance companies know that Walter Lindstrom or ObesityLaw.com have no leverage, and no jurisdiction outside of maybe California. They are ignored, have no influence, and have no impact.

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Everyone's experiences are valuable--but crossposting multiple times is not acceptable.

Anyway, with regard to finding an attorney in your area, try calling the Bar Association of your city or state. Look for doctors with experience in battling HMO decisions. It's a huge area of attorney practice, and they don't have to be particularly schooled in bariatric issues. You are being denied medically necessary treatment, and if the carrier doesn't have an ironclad reason (such as an exclusion on your contract) any attorney with experience in this area should be able to help you mount a good appeal.

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I too have just hired Walter Lindstrom after his being recommended by someone who he helped. I am so upset at the post concerning his help, and do not want to loose more money. I paid $22,200 to be banded last August, after being turned down by GHI and United HealthCare in NYC. The attorney seemed so good and his website is impressive, but I am not sure now. Anyone with positive experience with him and / or his wife, please let me know. I cannot stop thinking about this. Bless all of you for your continued support and inspiration. We are a lucky group of people. I have been a devoted reader but clouded due to a son's severe drug problem, and my using my life savings to help him. I am sorry to vent, but need your support. Be well. Fran

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Fran, I know of many people who had good experiences with the Lindstroms, so don't base your expectation on this one person's story.

Why were you denied coverage?

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I was denied coverage because I used a doctor at first in New Jersey-Dr. Davis and his secretary did not know what she was doing. She just batch fed papers to GHI without waiting for the full set, and they used it as a segway to deny me. Then she did the same thing with United Health Care. I then went to a wonderful surgeon upstate where I live and self paid. The Lindstroms seemed genuine and said I have a good case, or they would not have taken it. You just have to have faith in people. Thanks for your concern.Fran

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

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