New Prior Authorization Requirements For Oklahoma Members Effective Jan 1 2020
There are important changes to the preauthorization requirements for some of your Blue Cross and Blue Shield of Oklahoma patients. Beginning Jan. 1, 2020 preauthorization will be required or expanded for:
- Outpatient provider administered drug therapies, including Cellular Immunotherapy, Gene Therapy and other medical benefit drug therapies.
is posted to the provider website, under the Clinical Resources / Prior Authorization tab.
For services requiring prior authorization through BCBSOK, use iExchange® to preauthorize those services. Refer to the iExchange web page for more information or to set up an iExchange account.
Prior authorization through BCBSOK may also be requested by calling the phone number listed on the BCBSOK member/participants ID card.
Use Availity® or your preferred vendor to check eligibility and benefits to determine if you are in-network for your patient and whether any prior authorization or prenotification is required. Availity allows you to determine if preauthorization is required. Refer to Eligibility and Benefits on the provider website for more information on Availity. You can also refer to the BCBSOK provider website for assistance, including an updated list of services that require preauthorization.
iExchange is a trademark of Medecision, Inc., a separate company that offers collaborative health care management solutions for payers and providers.
Boxed Warning: Spread Of Toxin Effects
This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.
After Botox is injected, the drug may sometimes spread to other parts of the body. This can lead to a serious condition called botulism, which may cause symptoms such as:
- muscle weakness
- difficulty breathing
- loss of bladder control
Its possible for botulism to occur hours, days, or weeks after receiving Botox. If you experience any of the symptoms above after having a Botox injection, you should talk with your doctor.
Rarely, the difficulty swallowing or breathing that botulism can cause can be life threatening. If you already have trouble swallowing or breathing, you may have an increased risk for these problems. Call your doctor immediately if you have trouble swallowing or breathing after receiving a Botox injection. If you think your symptoms are life threatening, call 911 or your local emergency number.
Other Things To Think About
- Even with treatment, you may still get migraines.
- It may take some time to find the right medicines to help you.
- Using medicines too often can cause rebound headaches. These are different from migraine headaches. They occur after pain medicine has worn off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine. Be sure to take your medicine only as your doctor prescribes.
- If you think your headaches could be caused by depression or anxiety, be sure to let your doctor know. Treatment for these health problems may get rid of your headaches or reduce how often you have them.
- If you think your headaches are related to stress, talk to your doctor about getting help to cope better with stress.
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Most Chronic Migraine Patients In The Botox Savings Program Pay $0 For Botox*
For questions about this program, please call or visit Allergan® for additional information.
*Please see full Terms and Conditions.See Privacy and Terms & Conditions:;www.botoxsavingsprogram.com/eligibility.Message & data rates may apply. Message frequency may vary. Text HELP for help, STOP to end.;
In A Survey 92% Of Current Botox Users Said They Wish Theyd Talked To Their Doctor And Started Botox Sooner*
I had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be. Jennifer
Remember, only a doctor can determine if BOTOX® is right for you, too. Not sure where to start? Download the Doctor Discussion Guide.;
*2020 BOTOX® Chronic Migraine Patient Market Research BOTOX® Current Users .
AbbySo, the first time I was going to get my BOTOX® I was super nervous. I did not know what to expect.
AliciaI was afraid for a couple reasonsone, I was afraid it was going to hurt.
JenniferI had the first injection and I had really kind of overthought everything and made it seem much worse than it was going to be.
KatieThey were fine. It just was little injections.
AbbyThe shots were tiny.
So, they start in the back of your neck. And then theyll do the sides, and then they do the top and the front. And it only took about 15 minutes.
CourtneyOnce were done, I go on with my day.
AliciaThe benefit outweighs the pain for sure. I find if I breathe through it, its certainly easy enough. Its not nearly as bad as a migraine.
Please see Important Safety Information including Boxed Warning at the end of this video or on the website below.
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What To Expect From Getting Botox
Botox injections themselves are almost painless. You may experience a very small sting or slight burning sensation with each injection.
Each session will last between 10 and 15 minutes. During the sessions, your doctor will inject multiple doses of Botox into specific points along your head and shoulders.
After the treatment, most patients are able to continue their day as usual without any issues.
What Are Migraine Headaches
Migraines are painful, throbbing headaches that last from 4 to 72 hours. When you have a migraine, it may be so painful that you are not able to do your usual activities. But even though migraines make you feel bad, they dont cause long-term damage.
Migraines are a health problem that can be treated. Talk to your doctor about your migraines.
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Who Are Appropriate Candidates For Botox Treatment
OnabotulinumtoxinA is the only treatment approved by the United States Food and Drug Administration for the prevention of headaches in adult patients with chronic migraine . CM assessment involves a detailed history to rule out secondary sources of headache, establish migraine features, and assess the total number of headache days. In order to diagnose migraine, the patient should have had at least five attacks that involve migraine features, as outlined below. In adults, untreated attacks usually last 4 or more hours.
A migraine requires only two of the following headache features: a unilateral distribution , pulsatile quality , moderate or severe pain , and aggravation by physical activity . In addition, to diagnose migraine, only one of the following is required: nausea or vomiting or sensitivity to light and noise.
Migraine can be subdivided depending on whether there is an aura or not and also on the frequency of the headaches.
Before Taking This Medicine
You should not be treated with Botox if you are allergic to botulinum toxin, or if you have:
an infection in the area where the medicine will be injected; or
if you have a current bladder infection or if you are unable to urinate and you do not routinely use a catheter.
To make sure Botox is safe for you, tell your doctor if you have ever had:
facial muscle weakness ;
a change in the normal appearance of your face;
bleeding problems; or
Botox is made from donated human plasma and may contain viruses or other infectious agents. Donated plasma is tested and treated to reduce the risk of contamination, but there is still a small possibility it could transmit disease. Ask your doctor about any possible risk.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
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What Side Effects Might I Get
The injections are slightly prickly or stingy and take about 5 minutes to complete.
It is possible, though rare, to have an acute allergic response so you should stay in the clinic for several minutes after the first set of injections.
Less than one in ten patients experience each of the following side effects:-
; Worsening migraine. This can begin within a day or two of the injections, usually lasts a small number of days. It can be treated with triptans and/or regular naproxen 250 mg or 375 mg three times daily after meals.
; Rash, itching
; As with all injections; pain, bruising, bleeding or infection where the injection was given are a possibility
1.;;;;;; Drooping of eyebrows or eye lids. This begins after a couple or a few weeks and can last for a small number of weeks.
2.;;;;;; Muscle weakness, pain, cramp, stiffness or tightness
3.;;;;;; Weakness and pain in the neck. This begins after a couple or a few weeks and can last for a small number of weeks. It can be treated with regular naproxen as in above.
Less than 1 in 100 may experience:
; Difficulty in swallowing
; Swollen eyelid
If you have any difficulty in breathing, swallowing or speaking after receiving Botox contact your GP immediately.
If you experience hives, swelling including the face or throat, wheezing, feeling faint and shortness of breath please also contact your GP immediately.
Can Botox Injections Relieve My Chronic Migraines
For the millions of Americans who suffer from chronic migraine headaches, extreme pain, nausea, light and sound sensitivity, and other symptoms can interfere with daily life. Most people with frequent migraines take medication to relieve their pain, and many modify their lifestyles to prevent migraines. But other treatments, like BOTOX, have shown promise in helping people relieve chronic migraines. If you or a loved one are suffering from persistent, painful migraines, board-certified physical medicine and rehabilitation physician Dr. Asare Christian and the team at Aether Medicine in Wayne, PA may be able to help.
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How Botox Works For Migraines
Botox works by reducing muscle contractions and stopping; neurotransmitters from sending pain signals to your brain. This can help reduce the pain caused by migraines and lets many patients enjoy daily life without interruption.
The effect is only temporary, so patients will need to receive ongoing treatment. The most common treatment timeline involves an injection every 12 weeks, or four times per year. It may take several weeks to experience migraine relief after an injection. Your doctor may adjust this timeline according to your individual needs.
I Have A Question About Botox Injections For Migraine
What is a chronic migraine?
A diagnosis of chronic migraine usually means that you get headaches on 15 or more days every month for at least three months; and eight of those 15 days have migraine symptoms, including severe pain.
If you suffer from chronic migraines, youll know that theyre more than just a headache. The pain of migraine can be severe, and you may notice that youre excessively sensitive to light, loud sounds or smells and may feel nauseous or vomit during an attack. Frequent migraines can have a real effect on your life and what you can do.
When you suffer from unpredictable bouts of migraine, you probably feel youre totally alone. But youre not. Its estimated that about 1-2% of people worldwide suffer from chronic migraine.
What is botulinum toxin type A or Botox®?
Botulinum toxin type A, also known as Botox®, is a natural protein thats made by a certain kind of bacteria. The protein is removed from the bacteria and then specially prepared before use.
How does Botox® help migraines?
This protein is the active ingredient the part of the medicine that does the work and its thought that Botox® helps migraines by blocking the chemicals that carry pain signals before they reach the nerve endings. This indirectly blocks the development of a migraine.
What happens before Botox® for migraine treatment?
You should continue with your migraine diary, noting down:
- How many times you get headaches or migraines each month
- How long they last
- How severe they are
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What Are The Risks Of Using Injectables For Migraines
Botulinum toxin injectables should be avoided by pregnant women and nursing mothers, as well as people with an allergy to proteins in cows milk.
When given by an experienced and qualified health care specialist, botulinum toxin injections are relatively safe. However, some people experience pain, bruising or swelling where the drug was injected. Other possible side effects are:
- Headache or flulike symptoms
- Drooping on one eyelid, eyebrow or side of the mouth
Very rarely, if the toxin accidentally spreads into your body, other, more serious symptoms might occur over the course of hours or days. :
- Vision problems
- Inability to control the bladder
- Difficulty breathing
What Is Botox Is It Safe
Botox is created from botulinum toxin. While the idea of being injected with a toxin may sound scary, Botox actually contains such a miniscule amount of toxin that there is little chance of dangerous side effects. Since 2010, the FDA has recognized Botox as a safe treatment for migraines when administered by a licensed medical professional.
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How Does Botox Work
Botox is injected around pain fibers that are involved in headaches. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.
Botox prevents migraine headaches before they start, but takes time to work. I look to the second and third treatments to maximize effects, says Dr. Andrew Blumenfeld. Patients see in
creasing benefit with an increase in the number of treatment cycles. One treatment lasts for 10-12 weeks, and;patients reported that two Botox treatments reduced the number of headache days by approximately 50%.
Botox Injections For Migraine Are Safe Before Or After Covid
There have been reported side effects when it comes to certain cosmetic fillers and the mRNA vaccines, says Estemalik. Some people who have received dermal fillers may develop swelling at or near the site of filler injection following a dose of the vaccine. This appears to be temporary and can resolve with medical treatment, according to the CDC.
Dermal fillers are a different kind of medication from Botox, says Estemalik. This side effect has not been reported in people who have received Botox injections for preventative migraine treatment. It is safe for patients who are getting Botox injections to take the COVID-19 vaccine, he says.
There are no reports of additional side effects or risks for the J&J vaccine in Botox users.
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How Well It Works
Within 72 hours after treatment, the injection of Botox partly or completely smooths wrinkles for most people. But the results are temporary, typically lasting only 3 to 4 months. You will have to return for injections every 3 to 4 months to keep the effect. The dose of Botox usually is the same each time you get an injection.
Botox Injections For Migraines
Although known primarily as a treatment for facial frown lines and “crow’s feet,” BOTOX® Cosmetic, which is made from a type of bacteria known as Clostridium botulinum type A, also helps, according to the American Headache Society, to reduce the severity and frequency of migraine headaches. Migraines are often caused by reactions to certain triggers that stimulate the production of neurotransmitters in nerve cells, producing pain and other debilitating symptoms.
BOTOX injections are believed to work by either reducing muscle contractions or blocking pain-transmitting chemicals, or by a combination of the two. Patients typically receive BOTOX injections every 3 months; benefits are usually seen by the second treatment. Eventually, some patients are able to extend the time between treatments by up to 6 months.
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Does Botox Reduce The Frequency Of Chronic Migraine
- By Paul Rizzoli, MD, Contributor
Doesnt it seem like Botox is showing up everywhere as a medical treatment? Botox is a brand of botulinum neurotoxin , a protein substance originally derived from the bacterium Clostridium botulinum. In its original form it was the toxin responsible for botulism, the paralyzing illness often caused by eating contaminated food.
BoNT is now used to treat a number of medical conditions including muscle spasms, excessive sweating, overactive bladder, and some eye muscle conditions. However, one of its most common uses is in the preventive treatment of chronic migraine. Chronic migraine, defined as headache occurring more than 15 days a month for more than three months, is rare, affecting only about 3% of the migraine population. Nonetheless, since migraine itself is so common, this condition ends up affecting a large number of people and can be extremely debilitating.
A recent meta-analysis pooled the results of multiple prior studies to investigate the usefulness of Botox, a brand of BoNT, in reducing the frequency of chronic migraine. The results suggested that there was benefit from this treatment; it not only improved quality of life and significantly reduced the frequency of chronic migraine headaches, but did so with few and mild side effects.
Finding A Doctor Who Treats Migraine With Botox
If you want to try Botox for migraine, you should look for a headache specialist or neurologist. We recommend using your insurances doctor listing, Yelp, or;the American Migraine Foundations doctor database.
Dr. Laura Banks, neurologist at Natividad Medical Center, suggests asking prospective doctors where they learned to give Botox, and how many times theyve given it. Youre looking for a lot of experience, she says. Dr. Andrew Blumenfeld suggests asking doctors how many injections they will give, and where they will give them.
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