Medication Trail

[PikminOC]

I have some parents who don't want any records of psych treatment. They fill medication like Zoloft with cash. I thought that would still leave a paper trail.
However, the parents today said there is only a trail if social security number is used as it's tracked that way.
I disagree as I can look people up on the prescription monitoring with only their name and date of birth.
Who is correct?

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[WorthlessOxygen]

I disagree as I can look people up on the prescription monitoring with only their name and date of birth.
Who is correct?

I think this answers your question already?

I never ask for social security numbers unless the insurance claim happens to need it. So basically just certain worker's comp and military claims.

 

[mentos]

It's listed on their medical records and the pharmacy has a record of the scripts they fill.

 

[PikminOC]

It's listed on their medical records and the pharmacy has a record of the scripts they fill.

I see people without them using iinsurance. I am out of network. So I don't use emr or epic. Just paper charts.

 

[sunnyandseventytwo]

Are you a real doctor or a love doctor?

Seriously though, I’d avoid the National chains. I haven’t worked for one in years, but I assume a rogue pharmacy employee in A Walgreens in Denton can look up prescriptions filled anywhere in the chain.

Are these parents celebrities? Maybe they should set up their kids with some new identities. If you’re only writing non-controlled substances, I doubt they’d be breaking any laws anyone would care about.

 

[PikminOC]

Seriously though, I’d avoid the National chains. I haven’t worked for one in years, but I assume a rogue pharmacy employee in A Walgreens in Denton can look up prescriptions filled anywhere in the chain.

Are these parents celebrities? Maybe they should set up their kids with some new identities. If you’re only writing non-controlled substances, I doubt they’d be breaking any laws anyone would care about.

It's people who don't want others to know their kids have psychiatric problems. It's weird.

 

[PikminOC]

Seriously though, I’d avoid the National chains. I haven’t worked for one in years, but I assume a rogue pharmacy employee in A Walgreens in Denton can look up prescriptions filled anywhere in the chain.

Are these parents celebrities? Maybe they should set up their kids with some new identities. If you’re only writing non-controlled substances, I doubt they’d be breaking any laws anyone would care about.

I thought you can look up prescriptions anywhere. When I look up the pmp I get lots of different pharmacies that show up.
I am prescribing non controlled

 

[PikminOC]

I will not write prescriptions under a patient with a fake identity

 

[sunnyandseventytwo]

I thought you can look up prescriptions anywhere. When I look up the pmp I get lots of different pharmacies that show up.
I am prescribing non controlled

PMP in my state is controlled substances only. We share data with like 6 others states. I can't speak for the rest of the country.

 

[WorthlessOxygen]

PMP in my state is controlled substances only. We share data with like 6 others state. I can't speak for the rest of the country.

Same for me in NY although I think we share with quite a few more states

 

[mentos]

I see people without them using iinsurance. I am out of network. So I don't use emr or epic. Just paper charts.

Huh? Whatever scripts get filled at a pharmacy are kept on record whether they use insurance or not. If it's a paper script then it gets scanned, and the hard copy is kept on file for 10 years. You can walk into any chain pharmacy and request your fill history for the past 2 years. If you need to go past 2 years that is possible too.

 

[sunnyandseventytwo]

I will not write prescriptions under a patient with a fake identity

How do you know? Is your staff checking IDs at the door? How about for minors (which was what your question is about)?

And your business is paper charts and cash only. This thread is getting crazier and crazier. I’m sad my previous question got deleted. Apologies for offending you…you are kind of trolling the pharmacy boards, though. What were you expecting?

 

[PikminOC]

Huh? Whatever scripts get filled at a pharmacy are kept on record whether they use insurance or not. If it's a paper script then it gets scanned, and the hard copy is kept on file for 10 years. You can walk into any chain pharmacy and request your fill history for the past 2 years. If you need to go past 2 years that is possible too.

That's what I told them.

 

[PikminOC]

How do you know? Is your staff checking IDs at the door? How about for minors (which was what your question is about)?

And your business is paper charts and cash only. This thread is getting crazier and crazier. I’m sad my previous question got deleted. Apologies for offending you…you are kind of trolling the pharmacy boards, though. What were you expecting?

We do check id as people use credit cards to pay.
Many psychiatrist practices are out of network if they don't work for a corporation.

 

[PikminOC]

PMP in my state is controlled substances only. We share data with like 6 others states. I can't speak for the rest of the country.

Yes but my point is it will show any pharmacy, not just the chain that you work at.

 

[Dred Pirate]

the more I read this guy say- the more I am convinced he is not a licensed medical doctors (MD or DO)

 

[sunnyandseventytwo]

Yes but my point is it will show any pharmacy, not just the chain that you work at.

My point is, you wrote: "They fill medication like Zoloft with cash."

Zoloft is not a controlled substance in the USofA. I am sure there are some middle eastern countries where this is not the case, but I assumed your practice is in the above referenced USofA. So why are you talking about PMP for non-controlled substances? Is it just me or has this forum been invaded by trolls? Anyway, if this is a real post and you are indeed a pediatric psychiatrist and the parents of your patients are worried about somebody someday finding a record of their psychiatric treatment, have you considered that the parents might be suffering from DSM-5 listed paranoid disorder and maybe you should be referring them for treatment?

 

[PikminOC]

the more I read this guy say- the more I am convinced he is not a licensed medical doctors (MD or DO)

Then sdn is wrong in their verification process?

 

[sunnyandseventytwo]

the more I read this guy say- the more I am convinced he is not a licensed medical doctors (MD or DO)

I'm new here. I need a better hobby or a more difficult day job.

 

[owlegrad]

I am not aware of any database that tracks non-control psychiatric meds other than the database of the pharmacy <chain> that you fill at provided you pay cash. If you use insurance your insurance will also have record in their database.

That doesn’t mean it doesn’t exist, I just don’t know about it.

Having said that my most recent quote for insurance required my doctor to send in my medical history so perhaps it’s not as crazy as it seems to think about these kinds of issues.

 

[PikminOC]

I'm new here. I need a better hobby or a more difficult day job.

You joined Nov 2021. Still new?

 

[sunnyandseventytwo]

Then sdn is wrong in their verification process?

Isn't the verification process like: What's your occupation? Why do you want to join this forum?"

I wrote: pharmacist and to brag about how much money I make.

 

[PikminOC]

I am not aware of any database that tracks non-control psychiatric meds other than the database of the pharmacy <chain> that you fill at provided you pay cash. If you use insurance your insurance will also have record in their database.

That doesn’t mean it doesn’t exist, I just don’t know about it.

Having said that my most recent quote for insurance required my doctor to send in my medical history so perhaps it’s not as crazy as it seems to think about these kinds of issues.

Another patient of mine was admitted medically to the hospital. They were able to pull all of his meds, cash or not, from all of the pharmacies to reconcile with him.

 

[PikminOC]

Isn't the verification process like: What's your occupation? Why do you want to join this forum?"

I wrote: pharmacist and to brag about how much money I make.

You are making many incorrect assumptions.

 

[PikminOC]

I am not aware of any database that tracks non-control psychiatric meds other than the database of the pharmacy <chain> that you fill at provided you pay cash. If you use insurance your insurance will also have record in their database.

That doesn’t mean it doesn’t exist, I just don’t know about it.

Having said that my most recent quote for insurance required my doctor to send in my medical history so perhaps it’s not as crazy as it seems to think about these kinds of issues.

Insurance quotes also get pharmacy records. My point is that this medicine will show up.

 

[sunnyandseventytwo]

Insurance quotes also get pharmacy records. My point is that this medicine will show up.

Two words: Mexican Pharmacy

 

[Dred Pirate]

Another patient of mine was admitted medically to the hospital. They were able to pull all of his meds, cash or not, from all of the pharmacies to reconcile with him.

EPIC contracts with pharmacies to pull their data over

 

[PikminOC]

EPIC contracts with pharmacies to pull their data over

Yes so it doesn't matter they pay cash

 

[VA Hopeful Dr]

Isn't the verification process like: What's your occupation? Why do you want to join this forum?"

I wrote: pharmacist and to brag about how much money I make.

Nope. If you'll notice, the poster you are responding to has a "Physician" tag under his username (under the 10 year member one). That tag requires verification with SDN.

Contrast that with @Dred Pirate who has Pharmacist written but doesn't have the Pharmacist tag like @owlegrad does under his 10 year member tag.

 

[PikminOC]

Two words: Mexican Pharmacy

Too far from me

 

[sunnyandseventytwo]

Nope. If you'll notice, the poster you are responding to has a "Physician" tag under his username (under the 10 year member one). That tag requires verification with SDN.

Contrast that with @Dred Pirate who has Pharmacist written but doesn't have the Pharmacist tag like @owlegrad does under his 10 year member tag.

Is the verification process worthwhile? Will it be easier to find a hospital job if I'm verified?

 

[VA Hopeful Dr]

Is the verification process worthwhile? Will it be easier to find a hospital job if I'm verified?

In terms of life outside of SDN it won't make any difference.

The purpose is so that other users here can see that you have actually been proven to be a Pharmacist. That lends some weight to your posts about pharmacy since people will then know that you are what you say you are.

 

[Dred Pirate]

Yes so it doesn't matter they pay cash

Nope. Generally it is not a good idea to hide your medications from other health care providers Anybody with half a brain should know that

 

[sunnyandseventytwo]

In terms of life outside of SDN it won't make any difference.

The purpose is so that other users here can see that you have actually been proven to be a Pharmacist. That lends some weight to your posts about pharmacy since people will then know that you are what you say you are.

Is the test very difficult? I used to make physicians tell me what lovastatin was prescribed for when they wanted to phone something in. I figured anyone could get a DEA number off a prescription (which is what everyone else would ask to verify the prescription/caller was legitimate). You'd be surprised how many times psychiatrists yelled at me because they were psychiatrists and didn't know the indication for lovastatin. Fortunately, I'm pretty quick and could easily tailor my quiz to the audience at hand. You'd also be surprised how many psychiatrists don't know the therapeutic level for lithium.

 

[VA Hopeful Dr]

Is the test very difficult? I used to make physicians tell me what lovastatin was prescribed for when they wanted to phone something in. I figured anyone could get a DEA number off a prescription (which is what everyone else would ask to verify the prescription/caller was legitimate). You'd be surprised how many times psychiatrists yelled at me because they were psychiatrists and didn't know the indication for lovastatin. Fortunately, I'm pretty quick and could easily tailor my quiz to the audience at hand. You'd also be surprised how many psychiatrists don't know the therapeutic level for lithium.

It's not a test, you just have to prove that you're what you say you are. Part of it is submitting documentation proving you are a licensed pharmacist.

 

[VA Hopeful Dr]

Nope. Generally it is not a good idea to hide your medications from other health care providers Anybody with half a brain should know that

I don't think it's news to you that a large number of patients won't see it the same way we do.

The impression I'm getting here is that the OP has a parent of a patient that wants to keep their kids medical history more secretive than it would be using insurance to pay for the medicine. My guess is he is now going to go back to them and say "I talked to some pharmacists and even paying cash it will not be difficult for insurance companies or even other doctors to see what medications you're taking".

 

[owlegrad]

Another patient of mine was admitted medically to the hospital. They were able to pull all of his meds, cash or not, from all of the pharmacies to reconcile with him.

As far as I know they used a process called ‘magic’ to pull a record of every medication filled at every pharmacy for any patient. No such system exists that I have ever heard of. I do have hospitals calling my pharmacy and asking for med histories all the time though so perhaps that is how they did it.

I actually think it’s a great idea though.

Edit: apparently this does exist. My bad.

 

[owlegrad]

EPIC contracts with pharmacies to pull their data over

Learn something new everyday. I did not know this.

 

[sunnyandseventytwo]

As far as I know they used a process called ‘magic’ to pull a record of every medication filled at every pharmacy for any patient. No such system exists that I have ever heard of. I do have hospitals calling my pharmacy and asking for med histories all the time though so perhaps that is how they did it.

I actually think it’s a great idea though.

We use Epic here and are able to pull records from the pharmacies in the area. I don't know what technology is involved to allow the transfer. We

Too far from me

Four words: mail order Mexican pharmacy.

 

[JustFillIt]

We use Epic here and are able to pull records from the pharmacies in the area. I don't know what technology is involved to allow the transfer. We

Four words: mail order Mexican pharmacy.

This is clever - I suppose you could just purchase directly a bunch of psych meds from Mexico and it would not be on the books. If you were extra paranoid you could even pay cash in person and wear a hat with one of those glasses/mustache combos to conceal your identity.

 

[PikminOC]

As far as I know they used a process called ‘magic’ to pull a record of every medication filled at every pharmacy for any patient. No such system exists that I have ever heard of. I do have hospitals calling my pharmacy and asking for med histories all the time though so perhaps that is how they did it.

I actually think it’s a great idea though.

Edit: apparently this does exist. My

As far as I know they used a process called ‘magic’ to pull a record of every medication filled at every pharmacy for any patient. No such system exists that I have ever heard of. I do have hospitals calling my pharmacy and asking for med histories all the time though so perhaps that is how they did it.

I actually think it’s a great idea though.

Edit: apparently this does exist. My bad.

Holy cow! You admitted you were wrong! My life is now complete.

 

[sunnyandseventytwo]

This is clever - I suppose you could just purchase directly a bunch of psych meds from Mexico and it would not be on the books. If you were extra paranoid you could even pay cash in person and wear a hat with one of those glasses/mustache combos to conceal your identity.

Really the thing to do is set up an in office pharmacy. OP would have to check with the laws of his state, but my understanding is most are okay with limited in office dispensing. And if your patients are paying cash, you could turn a serious profit. My dog’s vet made a killing selling my wife Trazodone and doxycycline.

 

[sunnyandseventytwo]

Holy cow! You admitted you were wrong! My life is now complete.

Epic isn’t really the issue, HIPAA is. When I’ve got someone on the ICU that can me what meds they’re taking, I start calling pharmacies. We’ve only got a few in the area and one of them will have the a file. I’m no attorney, but my understanding is both the outpatient pharmacy and I are covered entities under HIPAA and can freely exchange this list without fear of retribution should the patient be angry when he wakes up.

 

[owlegrad]

Holy cow! You admitted you were wrong! My life is now complete.

I don’t mind admiring when I am wrong, it happens so rarely

 

[Dred Pirate]

Learn something new everyday. I did not know this.

I think they utilize surescipts - but I don't know the ins and outs. Not all pharmacies are contracted (VA for example) and some smaller independent's. There are a couple of other companies out there that do similar, they gave me a sales pitch to help with our medication reconciliation. We ended up just using the funtionality in EPIC as it has seemed to be more through as the years go by, I personally catch tons of errors because of it.

 

[Dred Pirate]

I don't think it's news to you that a large number of patients won't see it the same way we do.

The impression I'm getting here is that the OP has a parent of a patient that wants to keep their kids medical history more secretive than it would be using insurance to pay for the medicine. My guess is he is now going to go back to them and say "I talked to some pharmacists and even paying cash it will not be difficult for insurance companies or even other doctors to see what medications you're taking".

insurance companys wouldn't see it - they don't have a right to see it unless it directly affects what they (insurance company) are paying for- doctors - yes, they should be able to, although it might be difficult for them to actually get the information - it isn't like the doctor is just going to call up the pharmacy and ask what meds they are on unless they have a very specific rason to.

 

[RXDOC1986]

Another patient of mine was admitted medically to the hospital. They were able to pull all of his meds, cash or not, from all of the pharmacies to reconcile with him.

As a hospital pharmacist, YES we need to be able to access Rx history, or would you like us to go in blind and try to treat your patient with no MedRec. That would be malpractice. There is always HIPPA and PHI to protect patient information.

Funny (?) story. Years ago when Finasteride (Propecia) 1mg for hair loss was very expensive (Brand Only). I had my sister (an MD) call in Finasteride 5mg to my pharmacy (very cheap), which I would cut in 1/4s and take for my hair loss. I would pay cash. Somehow my insurance company found out and sent me a letter saying: "You are taking Finasteride 5mg which is for BPH, and enlarged prostate" Just that statement and nothing else!!!
Oh, they know everything about you, paying cash didn't help.