Phone in for diabetes supply

[vinapharm]

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Hi guys,
I have a question. A patient has medicare ( a, b, d) and she was diagnosed with dm 2 by her primary m.d like a years ago. Today she came into the pharmacy and trying to buy lancets, strips because she is running out of them. She doesn't have a profile with my pharmacy so i decided to call her doc for the supply Rx. Question is does medicare allow phone in Rx for diabetes supply or the doc need an original rx for the supply ? I thought i saved patient some $ but now i start to panick that i might just committed some medicare fraud.
🙁

 

[Old Timer]

Hi guys,
I have a question. A patient has medicare ( a, b, d) and she was diagnosed with dm 2 by her primary m.d like a years ago. Today she came into the pharmacy and trying to buy lancets, strips because she is running out of them. She doesn't have a profile with my pharmacy so i decided to call her doc for the supply Rx. Question is does medicare allow phone in Rx for diabetes supply or the doc need an original rx for the supply ? I thought i saved patient some $ but now i start to panick that i might just committed some medicare fraud.
🙁

Part B: Verbal Orders NOT permitted
Part D: Permitted

 

[zelman]

Part B: Verbal Orders NOT permitted
Part D: Permitted

...technically, I think it's...
Part C: Permitted
Part D: Not covered

 

[Jibby321]

...technically, I think it's...
Part C: Permitted
Part D: Not covered

Part D does cover phoned in orders. At least the ones I have seen.

 

[zelman]

Part D does cover phoned in orders. At least the ones I have seen.

Those were probably part C plans that you thought were part D.

 

[Old Timer]

...technically, I think it's...
Part C: Permitted
Part D: Not covered

Not so, any Medicare Advantage Plan is a PDP and since it replaces Medicare entirely, it is required to cover test strips. Also, Medicare Welfare plans also cover testing supplies. So while you call it Part C and are technically correct, everybody looks at as a PDP.

 

[zelman]

...technically, I think it's...
Part C: Permitted
Part D: Not covered

Not so, any Medicare Advantage Plan is a PDP and since it replaces Medicare entirely, it is required to cover test strips. Also, Medicare Welfare plans also cover testing supplies. So while you call it Part C and are technically correct, everybody looks at as a PDP.

I admitted it was a technicality.

 

[Old Timer]

I admitted it was a technicality.

Sorry, reading with one eye.....

 

[Sine Cura]

"You can always pay cash" - go-to excuse when prescriber's offices don't comply with Part B billing requirements, or anything else related to reimbursement.