non-Americans, if you want to see what insurance is like here... the partial transcript of the phone call alone is a year's worth of wtf
(CW: descriptions of suicide attempts)

After Highmark BCBS Repeatedly Denied Their Claims, One Psychiatrist Was Their Last Hope — ProPublica

Most people haven’t heard of external reviews, and most denials are not eligible for one. Those that are eligible typically involve medical judgment, surprise medical bills, or an insurer deciding to retroactively cancel or discontinue coverage or determining that a treatment was experimental. Even then, insurers can argue that a denial is ineligible for an external review.

Only after the internal appeals with the insurer are exhausted is an external review an option for some denials. Requests have to be filed within a certain time frame, depending on whether they’re filed under state or federal laws. That distinction can also determine if insurance plans get to pick the company that does the external review.

propublica.org/article/mental-…

After Highmark BCBS Repeatedly Denied Their Claims, One Psychiatrist Was Their Last Hope

After a North Carolina man attempted suicide twice, his wife tried to get him help at an inpatient clinic. But their insurance provider refused to cover the treatment, deeming it “not medically necessary.”

^ProPublica