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I know there was a discussion regarding the issue of Invoice requests that appeared on the list several years ago, but my question is similar and I wondered if there were any new thoughts about how to handle an insurances inquiry for an invoice. We have a case in our office concerning the billing of a new technology billed as L5999 to a private insurance carrier.  The insurance carrier has asked for an invoice of the item before they determine approval.  We sent them an MSRP which they deemed unacceptable.   Has anyone else had this experience with an insurance company recently?  What approach have others taken regarding this issue?  Does anyone know if it is contractually legal for an insurance company to require a document with our cost of the item? Thank you, Susan Stenman, CP, MSBME