I need help understanding prior authorization and why it takes so long

So quick background – we are from Ohio. She is no income and pending disability, I am a nurse with like 45k a year my(23m) fiance (23f) has chronic back pain from a severe herniated disk and about 2 weeks ago it got so bad she couldn’t walk and her leg was getting numb (she took a bit of a tumble in the tub at a similar time so we think that’s what causes the exacerbation). After several PCP appointments, er visits, and a few days hospitalized she got her pain manageable to make it to the outpatient appointments we scheduled as soon as they could (we made the outpatient appointments right as the pain started).

We are trying for epidural steroid injections for her back but they need to get precertification/prior authorization (I think they are the same thing) before they can do the procedure. Medical mutual is her primary but she also has Medicaid care source as well.

What exactly does this entail, like what does the insurance company actually do during this process. After starting the process last week (doctor only does procedure on Wednesdays) they still haven’t gone through that process and we know I can be even more weeks of waiting.

I looked into the the prior auth stuff with MM and what I concluded is that they don’t see the epidural injections as medical necessity so they are listed under non payable.

Is that it? Insurance goes ‘nope not covered ‘ and moves it down the line and care source takes a look?

What actually takes so long since I got the answer (assuming my thinking is correct – which it totally might not be) after 10 minutes of reading MM policies.

It’s just so frustrating since all doctors keep saying that they can’t do much and for us to do outpatient care – wanting to leave her in crippling pain where she can’t even walk to the bathroom for the weeks it takes to get to an open appointment then the weeks after waiting for the actual procedure. And each day it’s getting worse and worse since all her prescriptions pain meds were only for like a week