Just want to warn you, this is exactly the approach Dr. Donahue proposed for me when I saw him in late March. I had the CT scan the same day I saw him, since it's such a long drive for me (170 miles each way). A week later he called with preliminary results from the CT scan, and proposed the botox injection. Warned me that insurance often objects to it, but they keep trying until they get approval, but this can take weeks to even months.

Insurance did indeed refuse to approve the botox injections, got the letter within two weeks. A week or so later called the Boston office to make sure they would appeal it. Was told to fax up my letter and she would make sure the right people got it just in case they hadn't already gotten to appealing it. Sent up further info a bit later, and another, local doctor's further notes in May. So, they have had contact and reminders with me.

Last week and this week, I have spent several hours during 4 phone calls with my insurance company. DONAHUE'S OFFICE DID NOT APPEAL THE REFUSAL. THEY HAVE DONE NOTHING SINCE THE ORIGINAL REQUEST!!!!! I don't know if Donahue himself is aware of this, or has anything to do with this, or if it's just the office people. When I talked to the right one today, she started giving me this story about how long appeals take when dealing with the insurance companies until I finally shouted/wailed at her "BUT YOU DID NOTHING!!! YOU DIDN'T APPEAL!!!! I HAVE BEEN ON THE PHONE WITH THEM FOR HOURS!!! YOU DID NOTHING SINCE EARLY APRIL!!!" And she dropped that approach and just said she would try to get it settled for me by tomorrow (yeah, excuse me for not holding my breath).

I wonder if he knows that this is how his staff "handles" things, by not doing anything, and that's why it takes so long and is so hard to get approval. If HE had called in, a "Peer to Peer" call to my insurance's doctor in the first 10 days after the initial refusal, this whole thing could have been settled right then and there. Now it has to be a full-fledged appeal, records and paperwork and all. Now, on top of two and a half months lost, now it means tons of procedure and regulations and waiting until they get to it time.

So...
Do not wait and trust them to handle things. Be a pest, be persistent, deal with your insurance company yourself, don't trust that they are doing it.
The Boston office does not deal with the insurance issues. The Salem office does. So don't talk to Boston when checking up on them, call Salem (Kathy).
Since you seem to be closer than I am, if it seems to be dragging on, just make an appointment and check in with him directly.

I'm hoping he's a good doctor with bad staff, because it's kinda hard to have any faith in this whole situation, now.