Health Organization for Pudendal Education

For assistance in getting your Botox injections covered:

https://www.botoxreimbursement.us/SupportHotline.aspx

I called them today when I received a denial letter from BCBS. They pay for the Botox itself, but not for the rest of what's involved. I have the right to appeal. Any advice for how to make the appeal compelling?

Whoever did the botox injections should send all your medical records and have them write a letter of necessity. Talk with someone at your insurance company about the appeal process and see if they will work with you so you are only dealing with one person at the insurance company. Sometimes it isn't that easy to do that but it is really helpful if there is one direct person you can call to make sure they got everything or if they could use additional information. Many times it is the codes they use and if they don't use the exact codes they won't cover it.

Thank you for the advice! Fortunately, I had the doctor ask for preauthorization so I don't owe anything. I am so disappointed that it wasn't approved because the options from here are limited. I can't travel so I couldn't go to my oldest grandson's graduation and I wasn't able to be there for my newest grandchild's birth. My pelvic floor therapist told me the day before the denial from BCBS that until Botox there's little progress that can be made and insurance doesn't like to pay for maintenance. From your history, you must have gone through a lot of disappointments which actually hurt worse than the pain. How did you cope?