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> but their hands are tied by the insurance company.

Doctors' ability to prescribe or refer is never restricted by an insurance company. If they think a patient should get whatever healthcare, they are free to say it.

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In CA, my doctor can refer me to get a Cologuard. But it's private pay, and they want payment up front since isurance companies don't restrict doctor's ability, only reimbursement.

So they may not be willing (even though they are able) perform procedure/test if they aren't confident they'll get paid.

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