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Over the past holidays I spent a few hours tinkering with my office website. My goal was to completely remove the word "Botox" from it.
In 2009, I decided to start using Botox for migraine. I took a few classes, and Dr. David Dodick down the street was kind enough to let me watch him for an afternoon. I figured it was something else I could offer my patients and help with office revenue.
So, for 2-3 years, I did it. It never became a huge part of my practice – I did two to three cases a month – but I had some patients who it helped. I never looked into the other uses for Botox because my practice is small and I try to keep things simple. And now, I’m done with it.
In the last 2 years, the process of getting it approved became increasingly difficult. Insurance companies put up more and more restrictions to a point that it became near impossible to get it covered. Between the paperwork and rising costs, I had more and more patients deciding to stop.
In 2013, I hit the wall. A lady who’d met every single one of her insurer’s criteria for it had a claim turned down after she’d already had the treatment. By that time, the specialty pharmacy had already shipped the bottle to me, so I’d used it. The insurance claimed the specialty pharmacy hadn’t been authorized to ship it, and that they should have to pay for the error. The pharmacy said that the insurance company had okayed sending me the bottle, and so it was their bill. So guess who had to eat the $1,500 cost for the bottle and procedure? The patient (who’s a grade school teacher) and me.
A few months later, after submitting the usual boatload of paperwork, I received a written authorization to order Botox for a patient. So I dialed up Allergan to get a bottle.
The next morning my fax machine had a paper that came in overnight from the insurance company rescinding the previous authorization. It said that, after further review, the company felt the patient didn’t qualify for Botox and was changing its mind.
In a small practice, you can’t afford to get stiffed for $1,500 too often. Fortunately, Allergan was understanding and was able to cancel the delivery and have it returned.
At that point, enough was enough. The little bit of extra money I’d made doing Botox was no longer worth the headaches (pardon the expression) of dealing with insurance companies. I could go along with the previous rules: If I got the authorization, I could do it. Now, even that was worthless.
The few Botox patients I still had were disappointed, but they understood and moved to other practices. We continued to get occasional phone calls because it was on my website, so I used a few hours over the holidays to delete the information.
I don’t think Botox is a great migraine treatment, nor do I think it’s a bad one. Like anything else I have to offer, it has pros and cons, but the insurance headaches now outweigh any benefit it has to a small practice. I don’t miss it.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.
Over the past holidays I spent a few hours tinkering with my office website. My goal was to completely remove the word "Botox" from it.
In 2009, I decided to start using Botox for migraine. I took a few classes, and Dr. David Dodick down the street was kind enough to let me watch him for an afternoon. I figured it was something else I could offer my patients and help with office revenue.
So, for 2-3 years, I did it. It never became a huge part of my practice – I did two to three cases a month – but I had some patients who it helped. I never looked into the other uses for Botox because my practice is small and I try to keep things simple. And now, I’m done with it.
In the last 2 years, the process of getting it approved became increasingly difficult. Insurance companies put up more and more restrictions to a point that it became near impossible to get it covered. Between the paperwork and rising costs, I had more and more patients deciding to stop.
In 2013, I hit the wall. A lady who’d met every single one of her insurer’s criteria for it had a claim turned down after she’d already had the treatment. By that time, the specialty pharmacy had already shipped the bottle to me, so I’d used it. The insurance claimed the specialty pharmacy hadn’t been authorized to ship it, and that they should have to pay for the error. The pharmacy said that the insurance company had okayed sending me the bottle, and so it was their bill. So guess who had to eat the $1,500 cost for the bottle and procedure? The patient (who’s a grade school teacher) and me.
A few months later, after submitting the usual boatload of paperwork, I received a written authorization to order Botox for a patient. So I dialed up Allergan to get a bottle.
The next morning my fax machine had a paper that came in overnight from the insurance company rescinding the previous authorization. It said that, after further review, the company felt the patient didn’t qualify for Botox and was changing its mind.
In a small practice, you can’t afford to get stiffed for $1,500 too often. Fortunately, Allergan was understanding and was able to cancel the delivery and have it returned.
At that point, enough was enough. The little bit of extra money I’d made doing Botox was no longer worth the headaches (pardon the expression) of dealing with insurance companies. I could go along with the previous rules: If I got the authorization, I could do it. Now, even that was worthless.
The few Botox patients I still had were disappointed, but they understood and moved to other practices. We continued to get occasional phone calls because it was on my website, so I used a few hours over the holidays to delete the information.
I don’t think Botox is a great migraine treatment, nor do I think it’s a bad one. Like anything else I have to offer, it has pros and cons, but the insurance headaches now outweigh any benefit it has to a small practice. I don’t miss it.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.
Over the past holidays I spent a few hours tinkering with my office website. My goal was to completely remove the word "Botox" from it.
In 2009, I decided to start using Botox for migraine. I took a few classes, and Dr. David Dodick down the street was kind enough to let me watch him for an afternoon. I figured it was something else I could offer my patients and help with office revenue.
So, for 2-3 years, I did it. It never became a huge part of my practice – I did two to three cases a month – but I had some patients who it helped. I never looked into the other uses for Botox because my practice is small and I try to keep things simple. And now, I’m done with it.
In the last 2 years, the process of getting it approved became increasingly difficult. Insurance companies put up more and more restrictions to a point that it became near impossible to get it covered. Between the paperwork and rising costs, I had more and more patients deciding to stop.
In 2013, I hit the wall. A lady who’d met every single one of her insurer’s criteria for it had a claim turned down after she’d already had the treatment. By that time, the specialty pharmacy had already shipped the bottle to me, so I’d used it. The insurance claimed the specialty pharmacy hadn’t been authorized to ship it, and that they should have to pay for the error. The pharmacy said that the insurance company had okayed sending me the bottle, and so it was their bill. So guess who had to eat the $1,500 cost for the bottle and procedure? The patient (who’s a grade school teacher) and me.
A few months later, after submitting the usual boatload of paperwork, I received a written authorization to order Botox for a patient. So I dialed up Allergan to get a bottle.
The next morning my fax machine had a paper that came in overnight from the insurance company rescinding the previous authorization. It said that, after further review, the company felt the patient didn’t qualify for Botox and was changing its mind.
In a small practice, you can’t afford to get stiffed for $1,500 too often. Fortunately, Allergan was understanding and was able to cancel the delivery and have it returned.
At that point, enough was enough. The little bit of extra money I’d made doing Botox was no longer worth the headaches (pardon the expression) of dealing with insurance companies. I could go along with the previous rules: If I got the authorization, I could do it. Now, even that was worthless.
The few Botox patients I still had were disappointed, but they understood and moved to other practices. We continued to get occasional phone calls because it was on my website, so I used a few hours over the holidays to delete the information.
I don’t think Botox is a great migraine treatment, nor do I think it’s a bad one. Like anything else I have to offer, it has pros and cons, but the insurance headaches now outweigh any benefit it has to a small practice. I don’t miss it.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.
