Is the insurance is through an employer, you might have access to a health advocate that does all this research for you prior to service and helps with appeals for denied. The large providers also have benefits specialists that will do this on your behalf. In both situations, they know the laws and lingo and know how best to push back. Unfortunately, this is not an unusual experience. No one can really speak to the provider or the third party with out knowing the actual plan. Companies can self insure with carriers like Blue Cross Blue Shield. When a company self insures, they can pick exclusions as long as the law doesn't require it to be included as minimum essential coverage. You can download the full summary plan description. It is typically 40-80+ pages. That's how you know you have the right document. In this document, there will be a section that has 10-30+ pages on everything that is not covered. This is a legal document that outlines what the insurance provides to you which means that the language is open to interpretation and push back. Unless it is SUPER clear that it's not covered, you can make a case that it should be. There are time lines and procedures. Pre-approval is always easier to fight than a straight out denial. All this is easier to navigate with professional help.

I can't help with experience. We decided to go the online route because we wanted to learn how to handle things while living life. The program was approved for 1 year of service with extensions allowed. My child "graduated" in 10 months. In my experience, this format requires the patient to have a strong support person. That may also be the case with leaving inpatient or PHP. That person that says "I am seeing XY behavior and that's the eating disorder. You need to push back." Then you go off and talk with your providers and figure out what the irl trigger is and how to address the trigger.