One of the many bonkers things about US healthcare is how insurance dictates the standard of care, so you get silly things like me having to go talk to the dentist so he can pre-auth the work he wants to do; he cannot simply do it because the insurer might reject it.
Likewise when I was treated for what was a pretty high-risk cancer, I had to wait for approval several times for certain things. So some anonymous pen-pusher has more power than an MD. It's complete shite.
I also got a $5000 bill from a lab because my oncologist had to send biopsy items to them to be identified; I had no say in the matter. The lab were really good about this though, and sorted it out for me.