I can relate to this discussion - I'm currently in Active Surveillance for Prostate Cancer after having a 18 needle biopsy last March based on a PSA of 4.1 ng/ml and a DRE where Dr. FingerLove thought he felt something. My most recent PSA in December came back as a 5.0 ng/ml (after a previous PSA of 3.7 in September) so I got a call to come in for a saturation biopsy next month. I had been biking a lot before the PSA, and only took two days off before getting blood drawn. I had taken 7 days off the bike for my PSA in September which had come back as 3.7 (dropping from 4.1), so I told the Urologists PA that I think we should do the PSA again, this time with a 7 day break from biking.
She said that she didn't think the Insurance Company would cover it as I had done one 3 weeks earlier (the one that came back as a 5.0 ng/ml). I then asked why aren't we doing an MRI fused biopsy, and she also thought that Insurance wouldn't cover the MRI portion. I asked her to submit a MRI request anyway, as no way I was doing another biopsy without imaging. I then went to my GP for an unrelated reason this week, told him about my situation, and he did a PSA for me which came back at 3.7! (I was off the bike a week).
Meanwhile, the MRI got approved by the Insurance Company...
So long story short, you can't just blindly go along with what the Urologist's practice thinks may be covered, you really have to advocate for yourself. It will be funny if the Insurance Company denies my 'good' PSA test but spends big bucks on a MRI which may have actually been unnecessary because I had PSA that was bogus.