In this analogy we're basically the insurance company. "No, we won't pay for that on the current plan". "That's a preexisting issue, we're not going to do anything to help with that"
"live" is doing a lot of work there.
Every time I called they claimed that there was a completely different process that I should have done the previous time and that they had no record of me being told otherwise. After they got notice of the complaint with the state (over two months in), they finally assigned someone directly the case who I could call rather than waiting for an hour on hold to get someone who would invent new processes that they claimed I didn't follow. She insisted that none of the other processes I was told were correct and that if my wife's doctor filed out this one proper form and faxed it over, the appeal would get handled correctly. Her doctor faxed it over literally the next day, and around a week later we got a letter in the mail (the only way they'd ever send us denials, despite us being opted into "100% paperless" on their site and claiming that they never received the initial letter from the doctor that they insisted he snail mail) that was once again identical to the same ones we had always gotten. I got upset at the person they had assigned to the case because they insisted that this was the proper way to appeal and accused to the company of fraudulently claiming that a doctor had properly reviewed the case because I could not believe any competent doctor would have nothing to say about the whole "patient will die of organ failure" thing. They agreed to let her doctor talk directly to one of their doctors on the phone, and lo and behold, two days later, we hear from the infusion service company that they heard from the insurance company that it's finally been approved (around three full months since the date of the initial appeal).
So the short answer is...yes, and there's absolutely nothing most of us can do same it