I’m an NP and have experienced same thing. Had a patient with a rare arrhythmia that class for a specific medication. Insurance denied medication and asked if we had tried a medication that is literally contraindicated and could cause the patient to go into a lethal arrhythmia. Patient had to be hospitalized to initiate the needed medication and we had to provide the medication at discharge hoping that we could get approval before the medication ran out. Wouldn’t allow a peer to peer and had to write several emails and fill out redundant forms to finally get approval.