Has anyone had to submit to your State Medical Board prior to submitting to insurance

Hi Everyone>......I am wondering if anyone has every encountered this besides the ones living in the same state as me (North Dakota). I called the surgeons office on Monday, and I was told that they submit the WLS packet to the state medical board for approval BEFORE even submitting it to the insurance company. Has anyone ever been in this situation? How easy was it to get passed? Has anyone ever been denied by the state medical board. This is a new process for me as my previous state of residence did not have this requirement. Thanks in advance...Linda

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