Three things. I do work on the business side of doctors offices and for more then one specialty.
1) Prior Authorizations are easy to get granted. The problem is 90% of the people I have worked with in these offices don’t take the time to do them correctly or wait way to long to do them because they feel like they are wasting time. I probably get 98% of mine thru on the first time.
2) Insurances change their policies and the language in the policy every year. They literally make it almost impossible to figure out what they are saying is covered is not covered and when it is covered. The employees in their call center helping providers are even more clueless. Your only chance is to try it and find out. They need real people to write these policies and not lawyers.
3) Pharmacies often give you the wrong information about cost and if your prescription has been approved or sent for approval. When I was in Mental Health I had patients who needed their prescriptions ASAP and the number of times they lost or mishandled the scripts were insane.