PPO PSs NOT allowed to refuse insurance

I called my insurance company and asked about the PSs who are refusing to submit claims for panniculectomies because THEY say it's "cosmetic". I asked for someone in their compliance unit, and she said that the PS *can* make you pay up front (and they *can* make you pay the full fee up front), but if the proceedure is approved by the insurance company as medically necessary, and therefore covered under the plan, Aetna will reimburse me the contracted rate and then the surgeon MUST reimburse me whatever I paid over what the EOB says is my portion. She said that if the surgeon refuses to reimburse me (*****ally thinks they are actually going to give me several thousand dollars back?  uh, nto me!), they are in violation of their contract and their participation in the plan can be terminated. So, step one is to enlist my PPC and RNY/hernia surgeon's help in getting the medical necessity documented so I can (hopefully) get it approved by the insurance. But then... what? Do I pick a surgeon, give them my insurance info, allow them to tell me they won't submit and I have to pay full fee up front, PAY them the full fee and then take a chance on having to sue the surgeon to get my money back?!?   On the other hand THAT is a better option than me having to pay the full fee myself if I can, indeed, get the panniculectomy approved as medically necessary. Lora