My botox experience!!

[momw/ic]

I posted this in reply to another post with questions about insurance coverage and botox. After posting I thought I would repost it here in the hopes that someone could learn from my experience. So, here it is:

My doc quoted me $1500 for my botox and said that if my insurance company denied it he would charge $750. So, we arranged to borrow the $750 from my parents and paid that up front "just in case". Well of course the insurance denied it and the doc's office said they sent in all of the info that the insurance co. wanted including medical necessity letters and medical journal articles.

Here is where my advice comes in: My doc came back and charged me another $750 saying that what I paid the day before the botox was my first installment. When we tried to fight them on it because we had proof of his original agreement he honored the agreement but sent me a certified letter releasing me as his patient. Now, I called the insurance co. and asked about appealing the decision and in the process I found out that they can send you the documentation from your doc. that they used to make their decision. So I had them send me copies of what my doc. sent them. Well, it was a small, flat envelope because my doc sent them nothing. Not even a letter of medical necessity! So, my warning is to plan to pay the full amount and get any agreements in writing. Since all of this we have received an additional notice that we owe $750 for my botox treatment. Apparently writing still means nothing. Also, ask your doc for copies of what they sent the ins. co. and keep them accountable. There is no telling how many times they don't really try to get ins. coverage for us.

The sad part about the whole thing is that the botox injections changed my life and really helped me and now I can't have it done again. Firstly because it is too expensive to continue to have to pay for and secondly because this fraud of a doctor is the only one within 6 hours of me who does the botox. The docs that are 6 hours away are not even on my out of network insurance coverage so that is not an option at all. So you see, I have found a treatment that gave me my life back. For the last 6 months I have been sleeping through the night and peeing about every 4-5 hours during the day. I have still had pain but with my pain management it has been much more manageable. Now that the botox is wearing off I am stuck to go back to living a life of sleep deprivation and constantly going pee and feeling like I need to pee. And the pain is much worse. It hurts so much to know that there is a treatment out there that works for me and I can't get it!

So that is my experience with botox, doctors and insurance.

[CinSin]

So sorry that this has happened to you.

I suggest you formally inform the insurance company of your decision to appeal. Make note of the first time you discussed appealling with your insurance company because most companies have a six month from date of EOB to file an appeal.

[IC SARAH-CPP]

Can you tell me how the actual surgery was? I am getting botox done and I am kinda scared of the pain from the needles and the surgery. Can you let me know how it went?
Love Sarah

[Kara29]

Sarah,

I did not suffer any pain per say with the Botox Surgery. I did have a PCP though for one night so that may have helped. I also had 3 polyps removed, sticture removed, dialation, and then the Botox on top of all of that. But still I did not suffer much regarding pain and needles. Of course I was put to sleep so I don't remember.

HUGS, :grouphug:

Kara

[icjen]

That is so sad. What would he get out of charging you that way? He could have gotten your insurance money, kept you as a patient, and made more with you returning to have more of them done!! I just don't get it. What a jerk! I'm so sorry for your horrible experience that could have been great. I can only imagine how frustated you must be. :kissing:

[Baba Yaga]

What would he get out of charging you that way?
The chance to inflict distress onto an already vulnerable human being....? Isn't that worth some personal sacrifice? I mean come on, if he had done what made sense to you or me, he would have been deprived of this important opportunity. While behaving this way may be completely alien to you or me, I have encountered more than person, definitely including doctors, that would fall into it very naturally.



momw/ic, It's awful to hear what this person has done and is doing to you, or trying to. Stand your ground, and stick to your story: that you would never have gone ahead with the botox if your doctor had not given you that reassurance in the first place.


As to how much it helped you, I know this is a naive question, but are you sure you exhausted all other options that would relax the muscles this botox is relaxing? If this doctor is that much of a jerk, and illogical weirdo, perhaps he also did not give adequate thought to all of your options in the anticholinergic/muscle relaxant/opiate area....?


Thank you for sharing your cautionary tale with everyone.

[kimberlyJB]

So I know that your post about botox is old. I am wondering how you are doing. Also, what are the after affects of Botox. I imagine that you have to self cath. I am going to do some research on it today, but wanted to get some feedback. In a bad bad bad flare.

kim