The solution to this is to form a Health Group that combines insurance with a whole bunch of provider services. Then approve those claims that result in you paying yourself.

These are terrible. Then you have a very small in network option and get screwed when going anywhere else. This is basically what happens with CVS Caremark drug coverage - any recurring prescription must go through them or they won't cover it. They'll only cover one off prescriptions at competitors. It's really pretty terrible, especially if you need a compounded medication. I'm not sure how such an anticompetive racket is legally allowed to exist.