Everyone gets paid to do a job but not all of them want to do their job, and find it easier to just say no rather than work for alternatives to help the patient. I have seen the same thing with someone in the private insurance field. Icd 9
codes and cpt codes that do not cover everything the patient needs is a common issue. For instance, someone needing a rotator cuff repair, may have to try therepy, injections, etc before being covered for the actual sx. This is common nowadays.