NBC News contacted Quantum Health with a list of questions about Johnathan’s case. In response, a Quantum Health spokesperson said in a statement: “Quantum Health is not an insurance company, insurance company or provider. We provide healthcare navigation and care coordination services to our members on behalf of our employer’s health and welfare benefits programs.”
“The decision is based solely on current policy parameters regarding member compensation under a particular plan and does not reflect the value of the care or treatment decision requested,” the spokesperson wrote in an email.
In a denial letter from Quantum Health, the company wrote that details of Johnathan’s case were “reviewed against the planning documents and usage standards adopted in the plan.”
“Usage Standards” refer to internal guidelines used by insurers, which assesses how well a patient is doing and determines whether to cover care.
“So many people are self-generated by each company and are essentially black boxes because they don’t know what we are outside,” Trestman said. “The dealer plays with a stacked deck of cards, the insurance company. Even the internal appeal process is within the company, so I’m literally controlling everything.”
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According to insurance documents reviewed by NBC News, Benz-Bushlings’ insurance plans use a set of guidelines called Interqual, created by Optum, a division of UnitedHealthCare. In a short issue of the 2025 issue, the American Medical Association classified spacing guidelines as “standards of their own financial lead.”
“These standards often resulted in delays in care through prior permission and rejected care through other financially driven, profit-based motivations,” says AMA Brief.
In a statement to NBC News, Quantum is obligated to comply with the terms of a particular plan, including the “health needs” rules and “appropriate level of care” when considering a request for behavioral health services.
“Standard standards are objective and concrete and help to guide consistent, defensible decisions to ensure proper and quality care,” Optum’s website describes the guidelines as a “strict, evidence-based development process.”
Benz-Bushlings appealed three times for Quantum’s decision. Every time they were denied.
Before the final rejection, Quantum routed the appeal to an outside company called Allmed Healthcare Management and hired it to conduct an independent review. All supported the denial, claiming that Johnson had made progress in his treatment and that he had no longer experienced suicidal ideation. The letter found him “compliant with his treatment plan.”
Trestman said indications that treatment is working could be a basis for insurers to move patients to lower levels of care, but he warned that mental health is liquid, and patient progression could lead to backslides if treatment is done too quickly.
“When we document on our charts, the care we provide is trying to help positive change and reflect what we are looking for, but that doesn’t mean it sticks, that doesn’t mean it will last.
The appeal of 270 pages
Before that final denial, Benz Bushling had framed a 270-page appeal document showing Jonathan’s long-standing mental health struggles. His depression first became apparent in 2022, when he began retreating from his family life and began vaping marijuana almost constantly. Once he entered high school, his addiction issues became even more severe.
“We got to the point where he had to be escorted everywhere he went,” Benz Bushling said. “He was never alone. He still found a way to steam our house and he couldn’t spend the day at school without getting high.”
To keep his son away from his friends who said he had supplied him with drugs and alcohol, they packed up their house in Virginia and decided to move to Michigan earlier this year.
While still in Virginia, Jonathan was doing treatment, intensive outpatient treatment, and one previous stint in a residential facility. When the family arrived in Michigan, they thought it was a fresh start.
