Legal ways to get vacation supply for patients.

[Sparda29]

If it is considered fraud to give the patient a 6 month supply upfront and then bill the insurance for a 30 day supply every 30 days for 6 months, what are some legal alternatives that will get the patient the meds, other than the patient paying cash for the 5 extra months?

What about me or another person designated by the patient refilling the prescription on the patient's behalf every 30 days and personally mailing it out to wherever they are going?

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[farmadiazepine]

If these people have enough money to go on vacation for 6 months then let them pay out of pocket for their medication. I don't feel sorry for them.

If they are traveling within the US, they can get a prescription filled anywhere. If it's out of the country, then let them pay.

That's my take on it.

What do I do? I honestly give it to them and bill it every 30 days. I don't bend over backwards to get vacation supplies.

 

[WVUPharm2007]

If it is considered fraud to give the patient a 6 month supply upfront and then bill the insurance for a 30 day supply every 30 days for 6 months, what are some legal alternatives that will get the patient the meds, other than the patient paying cash for the 5 extra months?

What about me or another person designated by the patient refilling the prescription on the patient's behalf every 30 days and personally mailing it out to wherever they are going?

Definitely insurance fraud.

You can call their insurance company and see if they are willing to give a vacation supply.

Mailing it would be fine.

If they are in another country, the medication may very well be cheaper to buy there.

If you are an independent, you have more freedom. At CVS or Wags, you just follow the corporate policy...which is either the insurance pays or they do. Payment in full on receipt.

 

[Sparda29]

Definitely insurance fraud.

You can call their insurance company and see if they are willing to give a vacation supply.

Mailing it would be fine.

If they are in another country, the medication may very well be cheaper to buy there.

If you are an independent, you have more freedom. At CVS or Wags, you just follow the corporate policy...which is either the insurance pays or they do. Payment in full on receipt.

I had an interview for an overnight CVS position few years back. When the guy asked me for an example of great customer service I did, I said that thing about the vacation supply and billing it every 30 days. He looked at me stone cold and said that was insurance fraud and asked me to leave.

 

[grumpyRph]

wow the things you learn. i didn't even think of that. lol. vacation supplies are so freaking annoying. not quite as bad as lost meds. ugh. nothing crushes my soul more.

 

[ranger99rx]

If it is considered fraud to give the patient a 6 month supply upfront and then bill the insurance for a 30 day supply every 30 days for 6 months, what are some legal alternatives that will get the patient the meds, other than the patient paying cash for the 5 extra months?

What about me or another person designated by the patient refilling the prescription on the patient's behalf every 30 days and personally mailing it out to wherever they are going?

I would call the insurance to see how many months pt can get for vacation override and have them pay the rest or another person pick up monthly.

 

[Saisri_PharmStdnt]

With the plan that I work for, I have seen up to 6 month supplies allowed for a vacation override, usually to those traveling overseas. The patient should call their insurance company themselves and request the override to be in place before you run it through. That works best for our members anyway..

 

[BenJammin]

What are you supposed to do when the insurance asks for signature logs because they see a claim from another country yet you're billing them when they're not home ?

 

[JustFillIt]

If these people have enough money to go on vacation for 6 months then let them pay out of pocket for their medication. I don't feel sorry for them.

If they are traveling within the US, they can get a prescription filled anywhere. If it's out of the country, then let them pay.

That's my take on it.

What do I do? I honestly give it to them and bill it every 30 days. I don't bend over backwards to get vacation supplies.

This made me lol

 

[Sparda29]

If these people have enough money to go on vacation for 6 months then let them pay out of pocket for their medication. I don't feel sorry for them.

If they are traveling within the US, they can get a prescription filled anywhere. If it's out of the country, then let them pay.

That's my take on it.

What do I do? I honestly give it to them and bill it every 30 days. I don't bend over backwards to get vacation supplies.

It's not really vacation. If you work in NYC, you would know that quite a lot of the senior types live in NYC during the warm months and go back to their home country in the Caribbean/South America for the winter.

 

[Sparda29]

What are you supposed to do when the insurance asks for signature logs because they see a claim from another country yet you're billing them when they're not home ?

That's a risk you take on a charge back for the patient staying with you. Worst case scenario, you print out a delivery slip, mail it to their house with a self addressed envelope, someone at their house signs it, sends it back.

 

[SCRph2014]

I've had an insurance company authorize multiple vacation overrides and had me run the same RX 3 or 4 times on one day to account for the travel time. That was awhile ago though. If it's expensive, obviously try to get something done with the insurance. If it's cheap, out of pocket it.

 

[Deja]

im surprised sparda has never been arrested or gotten in trouble before

 

[ValeRx]

My parents lived overseas for nearly 11 years and had maintenance meds. Their insurance would allow 6 month fills.