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Eating Disorder: when insurers say no, reviewers often say yes

In 202 published external-review decisions involving eating disorder, independent physician reviewers overturned the insurer’s denial 53.5% of the time.

Published decisions
202
2001–2026
Overturned
53.5%
108 denials reversed

Most-fought treatments for eating disorder

What insurers denied — and how those fights ended.
TreatmentDecisionsOverturned
Partial Hospitalization Program20
50%
Residential Treatment18
61.1%
How to use this in your appeal

These outcomes come from California’s external review program — an independent physician panel whose decision binds the insurer. Every state has an equivalent, and internal appeals succeed even more often. If your care for eating disorder was denied, the published record says the denial is worth fighting.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Fighting a denial for eating disorder? 53.5% won.

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