Anthem Blue Cross Cuts Off Benefits in the Midst of Eating Disorder Treatment Program – Court Orders Benefits Paid

We recently obtained a Judgment against Anthem Blue Cross regarding its refusal to pay for 2 weeks of inpatient treatment for our client who struggled with an eating disorder. The client, a middle-aged woman, sought treatment for her anorexia nervosa at Pacific Shores Hospital, in Oxnard, California. Her health insurer, Anthem Blue Cross, agreed to pay for the first part of the doctor prescribed treatment, but then cut off benefits before the treatment program was complete. Anthem informed her of its denial on March 19, with a retroactive denial date of March 11. Since her doctors advised her to complete the program they had set for her, our client paid out of pocket for her last 2 weeks of treatment.

Our client successfully completed her stay at Pacific Shores Hospital and went home, equipped with strategies learned during her five-week-long treatment, to maintain a healthy body weight and image. She continues to be conscientious in her recovery and has returned to her active life and hobbies, including horse-back riding. Her case is an example of how focused treatment for eating disorders, uninterrupted by insurance claims denials, can be highly effective.

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