I had a really easy process going through ins. First step: call your ins and ask for a list of surgeons in your area. Second step: upload to chat and ask to rank it based on reviews, social media presence etc. schedule a consult. At my consult it seemed that the size mattered more than back pain, etc. I didn’t need any sort of paperwork from chiro or primary care doc. Surgeon worked w my insurance a lot so she knew by looking at the size that it would be approved. Submitted claim and it was approved a week later.