In my experience this behavior is due to the fact that they don't really know on the insurance side how the care provider is going to code something until they

In my experience this behavior is due to the fact that they don't really know on the insurance side how the care provider is going to code something until they have actually done the procedure and have submitted it with the coding. And there is a very high wall between the insurance/patient billing side and the care providers, even in a case like Kaiser where they're all employees of the same company.