Vaginismus may or may not be covered by your insurance plan
Even though our Botox Treatment for Vaginismus Research has been approved by the FDA, and even though high success rates have been reported using the Botox treatment program, some insurance companies continue to cover only a portion of the costs of treatment. Nevertheless, there are usually a number of elements in the program that may be covered such as the dilation program and the counseling sessions which are the mainstay of many treatment programs for vaginismus. Each policy is different and a pre-certification and/or a prior authorization of benefits is usually a good idea.
Dr. Pacik’s office does not handle insurance claims but has contracted with a third party service, Diane Tremblay to handle all insurance inquiries and claims. Diane Tremblay has created a Welcome Letter describing her services which we have included on this website which I urge you all to read. Diane has 25 years of coding experience with medical insurance and has been working to help our patients get reimbursement since July 2012. Diane has done an excellent job representing our patients and many of them have received insurance reimbursement for their Botox treatment for vaginismus.
Different insurance plans require different criteria for recognition of vaginismus-related procedures. Every effort is made to secure the maximum reimbursement for every patient, including the appeal of any denied claims. However, since each situation is unique, no guarantee can be made regarding full or partial reimbursement.
Should your insurance company initially deny your claim, which often happens; your claim will be resubmitted with any additional information required. Follow-up phone calls, as well as an appeal, to the insurance company will be made on your behalf. Every denied claim is apealed in an effort to secure the maximum allowable reimbursement. Insurance first and second level of appeals are also explained in Diane’s Welcome Letter.
In the event that your Insurer applies all or a portion of the allowed amount toward your deductible/co-insurance, you will still enjoy the benefit of having satisfied a portion or all of your annual deductible/co-insurance requirements.
Remember that your health care policy is a contract between you and your insurance company. It is ultimately the patient’s responsibility to pay for services provided by the Plastic Surgery Professional Association. The patient is responsible for the co-pay, deductible, and co-insurance. The patient may also be responsible for any amount that is not covered by insurance.
Our office will supply you with a copy of Diane Tremblay’s Welcome Letter and Billing Information Checklist, her phone number and her email address; just fill in the Contact Form and request Diane’s information in the Comment field.