how does it work??

Trying to get straight how the insurance thing works....  I have PacificCare with an IPA - i know my IPA is the one that approves all the "pre" appointments  like surgeon consult, nutritionist etc.   but when all your pre-surgery steps are done, who gets all that info for approval or not??  Also, Gary, if I am trying to get around this HealthyRoads thing of PacificCare's - should i wait for denial or talk to you now???   Thanks all