Can a pharmacy fully fill out PA forms for a provider to be ready for signature?

[JustFillIt]

Is this legal? It’s been a long time since I have dispensed and I can’t remember if this is against the rules per insurance.

These forms are 100% intended for the provider to review, fill out, and sign…. Some pharmacy’s are starting to bend over backwards (and forwards) to fill out the forms for the provider because they don’t want to piss off the customer.

Why do we keep giving up ground? What is so hard about saying, “this form is intended for your review, this is your responsibility as the prescriber to fill out”.

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[StockPharmD2020]

I would not.

 

[projektreverb]

Don’t they accept the liabilities for it? I personally wouldn’t fill it out for them. And if you do, send them a bill.

 

[Dred Pirate]

Don’t they accept the liabilities for it? I personally wouldn’t fill it out for them. And if you do, send them a bill.

they pay somebody to do this in their office, why should you do it for free?

 

[Chrish]

Pretty sure it’s illegal but independents do it all the time and in return doctors send their business to them since they don’t want to deal with it. They even give their login info to pharmacists for cover my meds.

I knew someone who was doing marketing for his Indy and this was the first questions doctors asked if they would provide this “service”. My friend didn’t feel comfortable and needless to say, the business shut down after operating for about a year.

 

[Sine Cura]

There are many reasons to shut down.

Had this indy open up next to a FQHC look-alike. The clinic is gone. Indy done for.

 

[Sabril]

Small infusion pharmacies do this. they just get the necessary lab from the doc and get the PA done.

I see it both ways. The whole arrangement is sketchy. As a patient, I would be glad if my PA can get done quickly. It's a PIA to get anyone in the doctor's office to do all this "extra" work.

But then I have been at a pharmacy that was so "efficient" that it looks like they got everyone and their mother on IVIG.

 

[Always Choose Vanco]

Are we talking like CoverMyMeds? We fill out the basic stuff like provider name, NPI, patient info then send it, but not like diagnosis and ICD code info. Is this illegal?

 

[zelman]

As long as the info is accurate, it shouldn’t matter.

 

[BidingMyTime]

My understanding was, you can fill it out (just like any office staff could fill it out), assuming you have the actual diagnosis. If you are taking a best guess at the diagnosis, that opens you up to a host of legal trouble. If you have access to the patient records (unlikely), then no problem. Anything in the PA must match the actual patient record.

 

[GrandTheftAutumn]

What happened to "Just Fill It"?

 

[JustFillIt]

What happened to "Just Fill It"?

I dunno - what happened?

Filling out a PA for a providers office is bitch behavior. It’s Justfillit - not Justbeabitch

 

[Chrish]

I dunno - what happened?

Filling out a PA for a providers office is bitch behavior. It’s Justfillit - not Justbeabitch

Where do you work bro? Indy? Chain? Hospital?

 

[Sine Cura]

Don't have records? Can't reach the office? Don't give a ****

Just don't give a ****

Unfortunately the way ****ed society is you could get in trouble for not documenting that the office failed to do a PA instead of placing the lion's share of blame on this byzantine system of health care payment/denial (see the whole topiramate garbage in MA)

The Death of Yarushka Rivera: Prior Authorization Run Amok

A teen suffered tragic consequences from a failed prior authorization; Melissa Walton-Shirley says lawsuits miss the mark.

www.medscape.com

"Modern" society is mega-****ed

 

[SClENCE]

What do you say when it needs a prior auth and they called back asking what is covered? This annoys me. Why are you calling the pharmacy to ask what the insurance covers? How the **** would I know? Why do they never call the insurance company?

I regret becoming a pharmacist. Half the stores in my district are over 1000 scripts behind. One customer told me to kill myself today

 

[JustFillIt]

What do you say when it needs a prior auth and they called back asking what is covered? This annoys me. Why are you calling the pharmacy to ask what the insurance covers? How the **** would I know? Why do they never call the insurance company?

I regret becoming a pharmacist. Half the stores in my district are over 1000 scripts behind. One customer told me to kill myself today

I am honestly sorry you feel this way. I understand 100%. I would recommend that you secure some backup opportunities. I did this myself and I feel so much better I can not describe.

 

[JustFillIt]

Don't have records? Can't reach the office? Don't give a ****

Just don't give a ****

Unfortunately the way ****ed society is you could get in trouble for not documenting that the office failed to do a PA instead of placing the lion's share of blame on this byzantine system of health care payment/denial (see the whole topiramate garbage in MA)

The Death of Yarushka Rivera: Prior Authorization Run Amok

A teen suffered tragic consequences from a failed prior authorization; Melissa Walton-Shirley says lawsuits miss the mark.

www.medscape.com

"Modern" society is mega-****ed

A piece of me dies inside on a busy day when an expensive antibiotic comes in and insurance denies it for some reason.

15 years ago we had the time to manage a scenario like this - and insurances declined maybe 20% of the rxs which are declined now.

I honestly can’t stand it now

 

[Sparda29]

Fk the insurance companies and the prior auth pharmacists who deny PA claims.

 

[Sparda29]

Is this legal? It’s been a long time since I have dispensed and I can’t remember if this is against the rules per insurance.

These forms are 100% intended for the provider to review, fill out, and sign…. Some pharmacy’s are starting to bend over backwards (and forwards) to fill out the forms for the provider because they don’t want to piss off the customer.

Why do we keep giving up ground? What is so hard about saying, “this form is intended for your review, this is your responsibility as the prescriber to fill out”.

We do it because we have to compete against the chains somehow. It's not hard to do, it doesn't have to be the pharmacist who is doing it. It's obvious what the insurance wants to hear to get an approval.