After the pre-determination request is submitted by your doctor, it usually takes 30 or more days to receive a first response from the insurance company.  Your insurance company may deny a pre-determination request.  This is very likely when insurance companies have policies that consider new asthma or allergy procedures or services “investigational.” Depending on the insurance company, the doctor may appeal the denial 1 to 3 or more times.  Work with your doctor to exhaust ALL appeals .