Hypothetically what would happen if I had surgery before my insurance approved or denied it?

I’m (37f) scheduled for an anterior cervical disectomy and fusion as well as a carpal tunnel release surgery for the 10th of October to deal with bone spurs on my C4 – 6 and carpal tunnel. I’ve had the spinal injection and it did absolutely nothing for me, pain returned in a matter of days physical therapy also will not cure bone spurs which is what the main surgery is for. I’ve lost almost complete strength and a lot of motor function on one side of my upper body due to these issues I’ve been dealing with. I have progressively gotten worse over the last 15+ years, I’m afraid I’ll wake up one day and won’t be able to move my right side eventually.

We have Tricare Prime, my husband is active duty military I also personally have CHAMPUS through the VA. I know CHAMPUS won’t cover anything even though the initial injury that caused the damage was while I was on active duty in the army but my surgeons administration nurse said its a 50/50 shot as to whether Tricare Prime will come back with a rejection and demanding I do physical therapy first or not. We have as of yet neither heard yeah or nay from them as the referral to surgery was put in 15 days ago. Fingers crossed they don’t come back with do not pass go, go straight to physical therapy jail. To hedge our bets she also put in for a physical therapy referral.

So, my question is what happens if we don’t get an answer by the point my surgery date rolls around? The procedure is 100% covered and medically necessary. BUT for whatever reason insurance companies like to demand physical therapy be done first even though especially in my case it will only cause more pain and do absolutely nothing. So what do we do? Will they just be forced to pay it if they don’t come back with a negative in time? Did I do my diligence to protect us from getting a bill we definitely couldn’t afford? Or could they wiggle their way out of it?