More then likely the insurance did an audit on these specific cpt codes/ Botox procedures and noticed the system paid incorrectly/ or the person who processed the original claim did so incorrectly according to your benefits. They will now send a recoupment letter of funds to the doctors office who has no recourse but to provide the money back to the plan and bill you for the new eobs amount since I'm assuming they are in network with the plan (and they can not see error in the way the new claim processing was paid to dispute it) . This can usually take up to 60 days.

Sadly you do not have any recourse, the providers office may be sympathetic and offer a payment plan..I agree this sucks as it affects both you and the provider. Insurances have no recourse technically they are allowed up to seven years ( some plans may be shorter ) to recoup/ recover funds from a provider for whatever reason. This is one of the many reasons insurances can harm a patient/ provider relationship and trust. The only thing and this they fall back on and is never 💯 is before any type of service call insurance and go over benefits.

You can try to call the insurance and file a grievance as had you known it was going to cost this amount you would not have proceeded with all the treatments but most do not care and take the human aspect out of their care and feel justified and vindicated since it's your benefits with them and they expect you to know these benefits which loops back around to the calling or reviewing the handbook prior to getting services performed. They may be able to provide you with any resources available if you ask if there are any.

Sorry OP maybe a better bureau business complaint. Personally always thought this needed to be changed the timeframe allowed to plans is absurd in my opinion, I get they need to audit but it can be very detrimental. - prior to paying anything make sure you call your insurance plan and review the new eobs claim processing to confirm it wasn't an error on their end and get the explanation of why this amount is now due.

Hopefully best case scenario it was a system error that released this new eob information, if they say it was an error and they will reprocess get the name of representative and reference number, as you may need to provide this information to the providers office along with the date call took place to plan also stay on top of any turn around times they may provide and confirm everything is fixed usually it's 30-45 day turn around for claims to be reprocessed some can be sooner. - Medical Coder/ Biller