Frustrating Scripts

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Yeah, either way, $5 per month or $10 for 60 days, it's all the same. I suppose if you think about it, making it into two transactions is more work and expense, you're filling another rx, you need to waste an extra vial on them, another label, another patient info packet, another receipt from the register, and the manpower to do it all twice. Seems like that could add up if you did that for every patient, considering the pharmacy isn't earning more by doing so. I've wondered if that was part of the reason why pharmacies had the push to 90 day rxs instead of the traditional 30.

Of course, maybe the extra cost is offset by more front-end purchases and traffic due to the patient being in the store more. Tough to say.

The fixed costs on dispensing one script is almost a wash, but you are right to consider those costs because they add up. But in this case it the only difference would be two separate Rx numbers and the only added cost would be the time it takes for the technician to enter the titration and then the maintenance. (not very long at all) And from then it is business as usual, the maintenance dose goes on hold and you fill the titration dose first for 30 day supply, then when they come in for their refill you take the other one off of hold it fills like a refill. No extra vial, it would be the same as a patient coming in every 30 days.

I would think in an independent or chain pharmacy setting, the 90 day supply would be more beneficial in terms of reducing fixe costs of dispensing. Stores like Walmart and the grocery store chains would do better on 30 day supplies because they would have more traffic for their retail products. I don't know about other markets, but at Walmart, you are not getting your rx in 15-20 mintutes, it is a minimum 45-60 minutes wait time.....oh look they are having a sale on......anything.

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QUOTE=Ackj;12068544]Drives me crazy when one vial or one box of pens lasts like 40 days, and the insurance company limits them to 30 days. You're basically being forced to submit a fraudulent claim because it rejects otherwise.[/QUOTE]

Insulins are tricky though. I have seen some pens each time you use it you have a waste some to set it up. It makes me a little nervous to calculate the day supply down to the units, but when we get audited that seems to be the way to calculate it. Some insurance plans charge more if you put in more than 30 days. I don't feel it's right to charge people twice as much for the same amount. What have you all been doing with those scripts?
 
Insulins are tricky though. I have seen some pens each time you use it you have a waste some to set it up. It makes me a little nervous to calculate the day supply down to the units, but when we get audited that seems to be the way to calculate it. Some insurance plans charge more if you put in more than 30 days. I don't feel it's right to charge people twice as much for the same amount. What have you all been doing with those scripts?
That's true, I never thought about adding in how you have to waste a few units. Some of them say to prime before every injection, so that's at least 60 units a month right there.
 
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There are extra units built in for priming.
 
I was a floater pharmacist this weekend and the saturday was one of the worst day for me. I received atleast ten script from a doctor who started free clinic at church and wrote scripts for C-II and other controlls and there was a Dea# and NPI3 , but no Phone# and most of the patients I got are new to the pharmacy and cash customers.

On top of this, I got c-II scripts from new patients whose prescriptions were written from doctors away 80 miles from my store. patients also from the same location as doctors.

need advice what you guys do in this case???
 
I was a floater pharmacist this weekend and the saturday was one of the worst day for me. I received atleast ten script from a doctor who started free clinic at church and wrote scripts for C-II and other controlls and there was a Dea# and NPI3 , but no Phone# and most of the patients I got are new to the pharmacy and cash customers.

On top of this, I got c-II scripts from new patients whose prescriptions were written from doctors away 80 miles from my store. patients also from the same location as doctors.

need advice what you guys do in this case???

This reeks of something shady. Why would a patient drive over an hour to your pharmacy from the doctor's office and then an hour back to his/her home and pass up possibly hundreds of closer pharmacies? Clearly something is up. I know some people who will refuse to fill those rxs because they're either fakes or from a pill mill.
 
what do u say about the doctor who started free church clinic, writing c-ii and controlls without ph.#??? also the patient who travelled an hour says that she is in this town to attend a funeral and wants her medication today. Rx was for Exalgo and when I run the state report she was getting this medication from last six months, but filled at all the different pharmacy and either independent pharmacies or 1 hour away from her location. when I tried to call the doctor on the ph. # written on Rx , it was ringing without any voice mail. and then patient told me that on the rx there will be a dr.'s personnel Ph. and asked me to contact immediately.

so I tried that no. and the person who answered the ph., doesn't sounds like a dr. so I requested the dr. to send some documents indication what are the diagnosis to write the medication and asked him to send it via FAX so that I confirm that it came from real clinic. the strange part is why a docotor will mention his cell no. on the Rx pad?

Any help will greatly appreciated as this patient says that she will complain to state board for not filling my rx.
 
what do u say about the doctor who started free church clinic, writing c-ii and controlls without ph.#??? also the patient who travelled an hour says that she is in this town to attend a funeral and wants her medication today. Rx was for Exalgo and when I run the state report she was getting this medication from last six months, but filled at all the different pharmacy and either independent pharmacies or 1 hour away from her location. when I tried to call the doctor on the ph. # written on Rx , it was ringing without any voice mail. and then patient told me that on the rx there will be a dr.'s personnel Ph. and asked me to contact immediately.

so I tried that no. and the person who answered the ph., doesn't sounds like a dr. so I requested the dr. to send some documents indication what are the diagnosis to write the medication and asked him to send it via FAX so that I confirm that it came from real clinic. the strange part is why a docotor will mention his cell no. on the Rx pad?

Any help will greatly appreciated as this patient says that she will complain to state board for not filling my rx.

This patient has no grounds to complain to the state board. She can complain all she wants, nothing will happen to you. You can refuse to fill anyone's script, you have the right to do business with whomever you want.

Everything about this sounds sketchy. If you cant, with confidence, verify the Rx with the physician or physician's nurse and you dont feel good about it tell this woman to take a hike. NO legitimate Dr. is putting their cell number on their blanks.

You know what you should be doing in this case, just don't be afraid to do it. :thumbdown:
 
*Edit* I'm licensed now.....haven't figured out how to change my status from student to pharmacist

At the top of the screen click "My Account" then "Edit Your Details". Then select pharmacist and click "Save Changes". You can also get a badge by filling out a helpdesk request if you want.
 
thank you for yr reply. however, it doesn't seems as easy as you mentioned. I work in a retail chain store and were customer satisfaction is the priority for the pharmacist and pharmacists are questioned from district manager and store director for making the customer unhappy. I run the state control substance reporting system and patient was using the medication from last six month from the same doctor, but filling the script at all different pharmacies. The worst part was dr. mentioned his cell phone on script and when I googled on dr.'s clinic, it pops up with the exact location as mentioned on script. Even if the real doctor has written this real script , I m not comfortable to fill it because we all know that in this country, there are many doctors who writes the c-ii scripts for money.

I also need help about the doctor who started free clinic in church and writing anti-depreesant in huge quantity and also writing controlls, but no phone no. on script. this doctor seen the patient first time and wrote celexa 40mg 1&1/2 tablet daily Qty. # 100 with 3 refills.
 
thank you for yr reply. however, it doesn't seems as easy as you mentioned. I work in a retail chain store and were customer satisfaction is the priority for the pharmacist and pharmacists are questioned from district manager and store director for making the customer unhappy. I run the state control substance reporting system and patient was using the medication from last six month from the same doctor, but filling the script at all different pharmacies. The worst part was dr. mentioned his cell phone on script and when I googled on dr.'s clinic, it pops up with the exact location as mentioned on script. Even if the real doctor has written this real script , I m not comfortable to fill it because we all know that in this country, there are many doctors who writes the c-ii scripts for money.

I also need help about the doctor who started free clinic in church and writing anti-depreesant in huge quantity and also writing controlls, but no phone no. on script. this doctor seen the patient first time and wrote celexa 40mg 1&1/2 tablet daily Qty. # 100 with 3 refills.

It's your license on the line. Not the DM's. Not the store manager's. If you're uncomfortable filling because you think there's an issue with the dose being too high or a fake script, it is up to you to make the judgement call. If you can't verify that this is what the doc intended or if the doc has a reason to dispense such doses, then it is within your rights to not dispense. Your job is to prevent drug errors and prevent people from being hurt. Tell the patient that you're worried about the dose being wrong and won't dispense out of safety concerns until you can contact the doctor. If you spin it that you're doing this because you're worried about the patient's safety, then most people will understand.
 
It's Exalgo, who writes for that anyways? Tell them it's out of stock and on-back order. This is how I handle people with Roxis and Opanas who have an address 45 minutes south of me written by a doc 45 minutes north of me (whom I know is a pill mill). I tell them it's out of stock and on-back order after writing my latest order form. If they insist that I try ordering it for them....I offer to take their Rx and also document all Identification information. I tell them I'll call them IF the medication comes in (I tell them it can take several days). That gives me plenty of time to do all the necessary verification procedures, including running state electronic controlled substance database monitoring. If I'm still not sure 100 % that the prescription is issued legitimately by a practicioner authorized by the DEA to issue prescriptions for a controlled substance for a legitimate medical purpose...I call them and tell them that medication did not come in. I then tell them the pharmacy is charged a processing fee even if the medication does not come in/is on back-order, so I won't be ordering it again until further clarification about its availability.

No one has contested me with after that point and they always come to get the scripts back. If they ever do, I'll just keep letting the scripts rot. *Shrug*

Pretty fail safe manuever.

*Edit* I'm licensed now.....haven't figured out how to change my status from student to pharmacist

It is a common practice for a pharmacy to verify scripts, but many will not even attempt to check if the customer is truely in pain or a drug seeker. There have always been addicts trying to get a fix but the pharmacists now are treating everyone as junkies. I am a chronic pain patient and have documented proof of such. I have been on medicine for my conditions for 10years and cannot find a pharmacist who gives a **** about my care or my conditions. Maybe instead of lying to the patients u should do ur job and check the references and then if it pans out fill their scripts..after all that is ur job..if ur not in the business of helping people u should be a politician..some jacked up big chain pharmacies have gone as far as to say that they are only filling for their "members"..since when does Walgreens have a members only club and where the **** do I sign up..I bet I wouldnt need to be a member to get a script for beta blockers..fill me in on something..how would u know the difference between a true chronic pain suffer and a drug seeking junkie?
 
how would u know the difference between a true chronic pain suffer and a drug seeking junkie?
You don't, except that one is illegal. Kind of like being on the bomb squad: do I clip the blue wire or the red one?
 
It is a common practice for a pharmacy to verify scripts, but many will not even attempt to check if the customer is truely in pain or a drug seeker. There have always been addicts trying to get a fix but the pharmacists now are treating everyone as junkies. I am a chronic pain patient and have documented proof of such. I have been on medicine for my conditions for 10years and cannot find a pharmacist who gives a **** about my care or my conditions. Maybe instead of lying to the patients u should do ur job and check the references and then if it pans out fill their scripts..after all that is ur job..if ur not in the business of helping people u should be a politician..some jacked up big chain pharmacies have gone as far as to say that they are only filling for their "members"..since when does Walgreens have a members only club and where the **** do I sign up..I bet I wouldnt need to be a member to get a script for beta blockers..fill me in on something..how would u know the difference between a true chronic pain suffer and a drug seeking junkie?

As the pharmacist, I can fill or not fill any script I want. Period. I don't have to give you a reason or explain. I can just hand you the script back, and say I am not filling it. There are pharmacies all over the place...try one of them.

That piece of paper doesn't mean I have to give you crap. It means I can give you the drug if I so choose.
 
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