What options do I have if my insurance keeps on delaying my surgery?

You should pursue the appeal process with your HMO. Then, you may need to sue them.

I'm not totally clear about your medical situation from what you have described here, nor your procedural situation with the insurance company, but it sounds like no regular treating physician has recommended surgery in which case the insurance company would not be delaying anything. A treating physician or specialist has to recommend surgery. To recommend surgery, there is a strict protocol requiring a regimen of tests tailored to your particular medical condition that must be followed. I seriously doubt the ER Drs. have recommended surgery as they would not have had the opportunity to do all the necessary testing required by protocol. I'll bet if you ask them to prescribe surgery for you, they would decline and refer you to your regular treating physician. It sounds like you are up under a pain management Dr. That indicates to me that you have a non-surgical problem, which means there is nothing they can do for you other than to treat your condition with pain medication. Unfortunately, there are some medical conditions that science cannot cure, yet. You may just have to grin and bear it while waiting for a cure to be invented. Technology is rapidly changing the world of medical science every day. I suspect that that is your problem, which is not a legal problem, but a medical one. Good luck.

Sounds like you have several doctors who differ about you need for care/surgery. If you sue you will get that same split in court. How do you expect to win the day.

You might need to go "out of plan" and pay out of pocket for another opinion. Pain, in and of itself, is not a disease. It is evidence of a medical problem, because it indicates that there is something wrong. It can be a medical problem causing the pain (if you fix the problem the pain should go away,) or it could be a psychological problem that manifests itself as pain (if you find the psychological issue and address it, then theoretically the pain goes away.) In any event, you must deal with competent doctors who are capable of performing the proper diagnostic tests, who are capable of reviewing the results, and of understanding them, in order to come up with a correct diagnosis. Until you actually KNOW the problem, it is impossible to fix it except by blind luck. The problem with HMO's is that they control all avenues to experts, as well as the access to diagnostic tests, due to controlling whether or not they will pay. so, the only way to get around the road block is to pay out of pocket. You may want to check out one of the University hospitals, or possibly the Mayo Clinic or the Cleveland Clinic.

Ask your rheumatologist to refer you to a surgeon.

Based on the content of your question, it appears that you are not in the State of Louisiana or the State of Mississippi. As such, I am unable to give you legal advice as I am only licensed to practice law in those two (2) states.