Filling Dulcolax and Fleet Enemas

In the UK Dulcolax is OTC, however if prescribed on a script would be regarded as such.

Fleet enemas very rarely sold OTC except on, say, midwife's request. Otherwise always on script.

I would sell a micro enema (Microlax) OTC on my suggestion after counselling pt.
johnep

If a doctor writes for Mucinex, do you fill that as a prescription too?

nsxiboi said:

For those of you who work retail, I have a question...

When we get prescriptions for GoLytely, some doctors also write for 2 tablets of dulcolax and 3 Fleet enemas.

Are the dulcolax tablets and fleet enemas considered prescriptions? One pharmacist I work with says that these are not prescriptions and we should not bill it because the pharmacy will be audited by insurance....

I have trouble believing this.

Click to expand...

Depends on the patient's insurance. Around here, I see plenty of scripts for OTC stuff for medicaid patients, for example. If insurance doesn't reject the claim, I'm not sure how they can audit you later for it and say you did something wrong. It's often cheaper and easier to just have the patient grab a box from the shelf even if their insurance does accept the claim though.

Just try to run it through as an RX. If the insurance rejects it, the patient will pay cash price. If the patient has an FSA, they'll be able to submit the claim to that for reimbursement.

I've never ever tried billing for these. Often they have a legitimate Rx for GoLytely or whatever, along with an instruction sheet mentioning the Dulcolax. I've never seen the Dulcolax on a legit prescription.

If it was of course you could try billing but if it's covered I wouldn't be surprised if the copay was higher than the cheapo OTC generic tabs.

Common practice is to just drop the two dulcolax in the bag with no charge and not worry about billing. But technically, you should run it as a script... and help increase your script count.

All4MyDaughter said:

Just try to run it through as an RX. If the insurance rejects it, the patient will pay cash price. If the patient has an FSA, they'll be able to submit the claim to that for reimbursement.

Click to expand...

That's exactly what I was going to say. BTW, sometimes the doctor wants the patient to have this or that OTC item, and simply writes it on the RX because that paper's handy, even if s/he knows it won't be covered.

direct them to the OTC aisle personally and grab the product for them, counsel them and tell them they can purchase it at the register

EDIT: I don't need my script count to go up and rather have my techs put in the real rx's

Again this is where professional judgement comes in. So generally, if the doctor writes a prescription for an OTC item with specific directions, the directions differ from the OTC labeling and signs it, I treat it as a prescription and I fill it as any other prescription. This is especially true if the patient has medical assistance or some other insurance that pays for the OTC in part or in full or has a HSA or similar account that allows them to pay for OTC items with pre-tax dollars.

If the doctor writes a prescription for an antibiotic and writes Mucinex, Robitussin, Tylenol or something else with no directions or quantity, I advise the patient to purchase it as an order would require a quantity and directions for use. If you get a prescription that says Coumadin with no sig or quantity, would you fill it?

As for boosting your script count, that is immaterial. If you get a valid order for an OTC item, fill it as prescription.

I never, ever, ever, put pills in a vial, unlabeled and give it to a patient.

If it is a prescription run it through the system. If it's just written down on a piece of paper, OTC.

If it has a doctor's name, signature, patient name, date, medication, sig (optional?) and quantity, it's a prescription, even if it's written on a graham cracker. Certainly, the patient has the option of buying it OTC (as dulcolax is OTC here). Often I've seen a pharmacy put two tabs in a vial, put on an OTC label with the directions and expiry dating and charge 99 cents or so.

SomeGuy said:

If it has a doctor's name, signature, patient name, date, medication, sig (optional?) and quantity, it's a prescription, even if it's written on a graham cracker. Certainly, the patient has the option of buying it OTC (as dulcolax is OTC here). Often I've seen a pharmacy put two tabs in a vial, put on an OTC label with the directions and expiry dating and charge 99 cents or so.

Click to expand...

That's more what I meant. If it's written as a prescription, it's a prescription.