Botox

continuation of botox

  1. You will need a '“Established New Patient” appointment to establish care at Headache Specialists of Oklahoma, PLLC.

  2. After your appointment, we will submit a prior authorization to your insurance for continuation of Botox injections (please note our administrative fee for PAs of $25 per medication or procedure per year).

  3. Once PA is approved, you will be scheduled for your appointment.

    1. If your insurance is ‘in network,’ you will simply schedule an appointment for Botox.

    2. If you insurance is ‘out of network,’ we will need to use a specialty pharmacy that is ‘in network’ with your insurance to supply the medication (Botox). Once your shipment of Botox has been received, you can be scheduled for the procedure itself.

      1. You can submit a claim for the Botox procedure through your insurance as an ‘out of network’ claim for reimbursement. We do recommend checking with your insurance about out of network benefits.

NEW TO BOTOX

  1. If after your consultation you have chosen to proceed with Botox for management of chronic migraine, we will submit a prior authorization to your insurance for initiation of Botox injections (please note our administrative fee for PAs of $25 per medication or procedure per year).

  2. Once PA is approved, you will be scheduled for your appointment.

    1. If your insurance is ‘in network,’ you will simply schedule an appointment for Botox.

    2. If you insurance is ‘out of network,’ we will need to use a specialty pharmacy that is ‘in network’ with your insurance to supply the medication (Botox). Once your shipment of Botox has been received, you can be scheduled for the procedure itself.

      1. You can submit a claim for the Botox procedure through your insurance as an ‘out of network’ claim for reimbursement. We do recommend checking with your insurance about out of network benefits.

**it is important to keep in mind with the beginning of a new year your deductible will reset and your out of pocket costs may be higher early in a new year. we highly recommend you utilizing www.BotoxSavingsProgram.com to help pay for out of pocket costs associated with botox (please note that government insurance is not eligible for this program including medicare, medicaid, va and federal plans).

FAQs

Botox is approved for the preventive treatment of chronic migraine and a treatment that many of our patients have found to be life-changing.  There are a fair amount of preconceived (if not always accurate) notions, half-truths and strong opinions surrounding Botox, so we thought we’d address some of the most commonly asked questions.

What is Botox?

Botox belongs to a class of Botulinum neurotoxins, the same little proteins that can cause botulism if you ingest them (think, poorly canned or refrigerated foods). Botulism is a medical condition that causes paralysis of the body. Obviously, we aren’t giving people botulism! You don’t ingest the toxin.

Instead, we use a purified, diluted form of the toxin (Botox) and inject it into specific muscles to get a specific effect. They’re very helpful little molecules.

 

Isn’t Botox just for cosmetic reasons (wrinkles)?

While everyone’s heard that Botox reduces brow lines and crow’s feet, Botox has been used to treat a variety of conditions for decades and is in fact FDA approved to treat chronic migraine, overactive bladder, spasticity, hyperhidrosis, cervical dystonia, blepharospasm, and strabismus. Botox was first approved for medical indications in 1989.  Our focus is to inject Botox for the treatment of chronic migraine, but occasionally we can satisfy other issues at the same time.

 

But the ‘neurotoxin’ part sounds dangerous. Is Botox safe?

Absolutely! Again, Botox used for chronic migraine is a purified protein that when injected locally, generally stays where it’s injected.  This means there are no systemic side-effects. That means no liver, kidney or heart toxicity, no weight gain, nausea, diarrhea, insomnia, rash, joint pain…well, you get the idea. And, there are typically no drug-drug interactions with any of the medications you take (Dr. Duvall will review your medications to ensure this).

 

Really?

Honest. When done properly, Botox is safer than Tylenol (which can hurt the liver), by a long shot. The side effects experienced are typically local, at the injection site, and could include a bruise, local pain, or weakness, which are temporary. And if weakness occurs, we can modify the injections so that it doesn’t happen to you again. I once heard “all medications are poisons with positive side effects”. Consider potassium – found in bananas and vegetables – our muscles use potassium to function and this is generally safe but given at too high or by IV infusion potassium can stop the heart.  Really, this concept applies to pharmaceuticals, vitamins, minerals, herbs, water, and anything else you put in your body. Botox is no different.

 

Okay, you convinced me about the safety thing, but does it hurt?

In studies, most people rated the injection pain as mild or non-existent, and only 5% of folks report the pain as anything more than moderate. We chat during the injections, and do them fast. Most people describe them as a pinch, or occasionally a small sting.  The most common reaction we hear after injecting a first-timer is, “That’s it? That was not nearly as bad as I thought it would be.” We smile. And most of the time, it hurts a bit the first time and gets easier with each time you get it done. 

  

How long will it take to work?

One of the most common misconceptions surrounding Botox is that not seeing improvement after one round of Botox means you will not see a benefit from this treatment. This could not be farther from the truth. Botox is a treatment that builds and is generally more helpful in reducing headache and migraine days the longer you are receiving the treatment. A general rule of thumb is that you will have an idea of the benefit of Botox injections following the third round of Botox.

That is not to say that you won’t experience improvement before that and typically people can start to see benefit about 7-10 days after injections.

Is Botox permanent?

No. The body naturally breaks it down over time, and that usually takes about three months, give or take. Most Botox patients receive their injections about four times per year. It is a long term treatment, so you can expect to get to know us very well!

 

Okay, I’m in. Will my insurance cover Botox?

Botox for chronic migraine is generally covered by 99% of commercial insurance plans and most government insurances as well. We’ll do a prior authorization and have all that sorted out for you before the injections.

Is Botox expensive?

Most patients are shocked to find out that they pay little to nothing out of pocket for Botox by utilizing the Botox savings program. You will typically have a copay for this procedure and those with commercial insurance are eligible for this program that can reimburse up to $1,000 per treatment ($4,000 per year). In our experience a typical copay for Botox is $300-$600, so again many people end up with Botox completely covered. One exception that we sometimes see is early in a calendar year with insurance plans consisting of high deductibles, so we absolutely want you to check with your insurance about out of pocket cost and we are often able to provide you with this estimate as well.