Blue Cross denied residential treatment for my 16-year-old daughter's anorexia as "not medically necessary" five days after a cardiologist documented her overnight heart rate at 38 beats per minute, the denial letter says she "has not failed treatment at a lower level of care" as if failing outpatient first were a prerequisite for keeping her heart beating, the peer-to-peer reviewer was an adult psychiatrist with no eating disorder background, the facility is holding a bed they cannot hold for long, and i learned the phrases "medical necessity criteria," "parity act," and "expedited external review" four days ago. how do i fight a level-of-care denial fast enough for it to matter?
my daughter is 16 and has been restricting since at least last fall, though we can now see the runway went back further than that. the pediatrician caught the weight curve in april, we were in with a...