Insurance denial for botox
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TracyB7777
- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: Insurance denial for botox
Hmmmmm, we have the University of Arizona medical center partnered with the University here. I wonder if I can find someone or somehow to get the info there? Maybe I'll set my neurologists resident on this one seeing as he was feeling pretty bad at not being able to help me.
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: Insurance denial for botox
Did you ever do a periodicals search back in the day before before everything went digital, when every library would get an annual book called something to the effect of "The Reader's Guide to Periodical Literature", which you could use to look up magazine articles printed in the prior year? For all I know, maybe those are still around. If you have access to the University of Arizona Medical Library, there is a big fat equivalent of that book called the Biological Abstracts, which lists only medical / biological journal articles. They are listed by subject, title, author, etc. Then you can go directly to the journal article itself as the medical libraries carry archives of the major journals. That one article i really would like to get my hands on, which is June 1974, you would be lucky to find archived...but they might have archives of the Biological Abstracts themselves dating that far back, and the abstract of each article is reprinted in the Biological Abstracts volumes if I recall. meaning you would not get the entire article but the abstract itself might be helpful depending on whether it puts any focus on the pudendal nerve.
So if you can get admission to the library you can do the research yourself. I will have to look around here: not sure if UNLV or any of the hospitals have a decent medical library, or what the Librarian of our local public library system can order for me. When I lived in NJ you could find ANYTHING in the Princeton University Biology Library; but this ain't Princeton, LOL.
So if you can get admission to the library you can do the research yourself. I will have to look around here: not sure if UNLV or any of the hospitals have a decent medical library, or what the Librarian of our local public library system can order for me. When I lived in NJ you could find ANYTHING in the Princeton University Biology Library; but this ain't Princeton, LOL.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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TracyB7777
- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: Insurance denial for botox
WOW!! Looks like I have my work cut out for me. I'm on it. I'll let you know if I can get access. Thanks!!!
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
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TracyB7777
- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: Insurance denial for botox
This is the article that Dr. Hibner's office just sent me.
- Attachments
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- Botox_for_PFTM_2[1].pdf
- (121 KiB) Downloaded 279 times
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
Re: Insurance denial for botox
Great article! Good luck with your insurance fight, Tracy.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: Insurance denial for botox
Thanks Tracy That is soooooo helpful! Still waiting for the Dr.'s office to call me back and let me know if I should do the appeal...but I am starting to think I should just go ahead and write the stupid letter and attach all this stuff...in my experience nobody helps a person in chronic pain, you have to help yourself. So I am not holding my breath waiting for my Doc to get an approval.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: Insurance denial for botox
I found out there are actually 3 medical libraries in town, 2 of which are open to the public and one which I can probably harass into giving me admission if necessary. I will be out and about Tuesday and Thursday, so one of those days i am going atricle hunting, will let you know what I find 
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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TracyB7777
- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: Insurance denial for botox
For a fee, I can buy a card to our medical library, although no one knows the fee. Guess I'll call back tomorrow when the regular staff is there. I also have a friend that's a nurse who is going to try to do some research for us. I'll keep you posted.
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: Insurance denial for botox
I went to one of the medical libraries today and turns out there is no shortage of articles...I printed out a stack of abstracts, must have been 50 pages; and that was only from one of the databases the Librarian suggested to me 
I think I have enough ammo for one stinkin'' appeal. I was out all day today and will be again tomorrow, but hope I can get some of what I found posted by the end of the week. I also have some resources to post for locating journal articles.
I am not going to wait for the Doc's office but will send out my own appeal instead or in addition, as i think I can win this.
I think I have enough ammo for one stinkin'' appeal. I was out all day today and will be again tomorrow, but hope I can get some of what I found posted by the end of the week. I also have some resources to post for locating journal articles.I am not going to wait for the Doc's office but will send out my own appeal instead or in addition, as i think I can win this.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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TracyB7777
- Posts: 196
- Joined: Mon Sep 27, 2010 3:42 am
- Location: Vail, Arizona
Re: Insurance denial for botox
Official denial letter arrived in today's mail...finally. Time to get writing. 
Have been dealing with burning pain since Jan 2010.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.
No sitting since April 2010.
Seen the following dr's: DO, GYN, Dermatologist, Accupuncturist,
URO GYN (his RN is the one who suggested the pain could be PN), Neurologist
Had ECG and MRI both inconclusive, only the SSEP said Pudendal reaction was abnormal and they lost that test result.
Saw Dr. Castellanos April 6, 2011. Next steps, MRI and botox. Having PT while waiting.-Botox denied, appealing to Insurance company now.