@stuckonu In my opinion, doctors have lost their ability to treat and diagnose to the health insurance companies. Instead of using the education, training and experience of physicians, patients have to be approved for treatments by (essentially) proofreaders that work off a list of complicated steps prepared by the insurance companies. Reviews of denials do not review the documentation provided, but rather the steps taken by the initial reviewers to see if they followed protocol. Part of it is a national push to stop opioid abuse. Unfortunately, the insurance companies still want us to use medications rather than look for and receiving the "best choice" of care. The only suggestion I have for you is to learn your system as well as possible and advocate for yourself. Good luck.