BOTOXâ Reimbursement Hotline   800-530-6680

The BOTOXâ Reimbursement Hotline has proven to be a valuable asset in assisting us with insurance verification, prior authorization and claim preparation.  The specialist at the Reimbursement hotline will handle the time consuming task of contacting the insurance company and reporting to your staff the results of the patient specific research.  All of the BOTOXâ Hotline Reimbursement Services are provided free of charge to providers and can be accessed by calling a toll free number   800-530-6680.

Whether you decide to use the BOTOXâ Reimbursement Hotline or have your staff handle the insurance research, it is important to establish an office protocol that reduces the risk in dealing with third party payers.  Before we inject, we make certain that the insurance research  has been completed by the Hotline so we can anticipate timely reimbursement for both the procedure and the toxin. 

BOTOXâ Insurance Research Timelines 

·        4 weeks prior to injection date:  Send in insurance research request.  Be sure to include the patient’s ICD-9 and CPT codes, as well as insurance identification numbers and phone numbers from the back of the subscriber’s card.

 ·        Within 1 business day of research request:  A BOTOXâ Reimbursement specialist will contact your office if any necessary information is missing from the request form. 

·        Within 3 business days:  A hotline specialist will contact you with the results of your research request.

If prior authorization (PA) is needed, allow up to 4 weeks for insurer response.  A Hotline specialist will follow up with you during this time with status updates and will contact you with the PA results from the insurer.  The specialist will also ask you if you would like to be contacted prior to the patient’s next scheduled injection to initiate the next PA. 

·        On injection day:  Collect all applicable co-payments and schedule the patient for the next injection. 

·        After injection day:  Submit claim to primary and secondary insurers 

·        6 to 12 weeks after submission of claim:

-Payment should be received for the claim

-If claim is denied or underpaid, notify the Hotline and a specialist will research the cause with the insurer.

-If an appeal is necessary, the Hotline specialist can assist you with this process.