The challenges of obtaining authorizations can be time-consuming and overwhelming for providers’ staff, with long hold times and multiple follow-ups required. In many cases, insurance networks are inadequate for patients to utilize a network provider and the need for a GAP exception is required, an often underutilized and misunderstood strategy for maximizing reimbursements. We have a track record of securing authorizations for medical necessity and GAP, as well as success in negotiating single case agreements for these complex surgeries.