I'm with an HMO, so it's very straightforward. If a provider prescribes from the formulary, it's covered, so there's no guessing. If it's a test or referral, it's covered as long as it's someone in the network. If it's self-referral, I just go to whoever is in the network and choose someone. If it requires pre-approval, I just need my primary care or pdoc to write an order.

On the downside, it's an HMO. But at least I can go to one place and get everything done. Some of the providers are sucky, but some are fantastic. I guess you get that everywhere in health care.