I’ll never forget the time I did a PA for a pt, who met the insurance company’s (very reasonable) criteria for an expensive drug. It was denied. I appealed and it was denied again. I spoke to someone on the phone, explained that the pt met the criteria — got nowhere. I was about to give up, but I called the medical director, explained the case, & he approved it. I thanked him & hung up, but wondered if I should have asked him why I needed to call him to get the clearance…