I apologize if this is the wrong forum for this, but is it legal for a CA optometrist to withhold patients' prescriptions? Assume a patient wants an rx copy to buy lenses somewhere else, has no balance and the rx hasn't expired.
The same holds true for spectacle prescriptions with the following exception:I'm assuming you are referring to contact lenses.
Thanks for the replies, I appreciate it. And yes, I was referring to contact lenses.
At the end of a follow up visit to ensure proper CL comfort/fitting, a family member of mine requested an rx copy to purchase Cls elsewhere. The OD said it would ruin some form of research funding and said he'd match the competitor's price.
While matching is nice, it would appear that my family member's exam and fitting procedure had completed and the rx should've been released......
Is there an allowance within the FCCLA that makes it legal to refuse to release a contact lens prescription based on the circumstances? I not saying it's illegal, I am just curious as to what our rights are as prescribing OD's.I can think of several circumstances under which I would not release a keratoconic contact lens prescription, especially for purchase elsewhere. So to the poster make sure that your family member does not have an extenuating circumstance (eye condition) that might complicate the more routine interpretations of the "laws" posted here.
No, but without knowing all of the details of the situation, it is impossible to for us to comment on what the doctor was doing. I do, however, agree with Ken that the explanation makes no sense. I have been a clinical investigator for several contact lens studies, and while the patients only get free lenses during the course of the study, the company that is contracted by the contact lens manufacturers to run the study could care less where the patient purchases their contacts.Would near-sighted w/ astigmatism having used toric lenses be an extenuating circumstance/condition?
Is there an allowance within the FCCLA that makes it legal to refuse to release a contact lens prescription based on the circumstances? I not saying it's illegal, I am just curious as to what our rights are as prescribing OD's.
OK, I won't argue if you believe you are acting on the patient's behalf. I do have to ask, however, under what circumstances would you honestly believe you have a good reason to restrict contact lens Rx release? You mentioned previously that a KCN patient could justify a restriction. Aside from the fact that in my experience, KCN patients almost never want to purchase outside the prescribing doctor's office, how can you justify not releasing the Rx once you have finalized it? Let's say they purchase a pair from you and then want a backup pair. Would you require them to buy that from you? If so, how would you explain that to the patient? "I can't let you give these parameters to another provider because they may not copy them down correctly on the order form". How would you handle it if they requested a copy of their records? Would you black out the CL parameters so no other provider could order for them based on your work?As a doctor if you feel it is necessary to restrict contact lens rx release (and you have a good reason, not because you just want them to buy from you). Then you are acting on the patients behalf, not your own. If thats not in the FCCLA fine print somewhere then who cares. I'm still not going to release a prescription for someone that I dont think should have one. I'd be happy to smash any comments to the contrary.
I guess my question is, under what circumstances would you feel that a patient should not be able to order contact lenses except from your office?I'm still not going to release a prescription for someone that I dont think should have one.
OK, I won't argue if you believe you are acting on the patient's behalf. I do have to ask, however, under what circumstances would you honestly believe you have a good reason to restrict contact lens Rx release? You mentioned previously that a KCN patient could justify a restriction. Aside from the fact that in my experience, KCN patients almost never want to purchase outside the prescribing doctor's office, how can you justify not releasing the Rx once you have finalized it? Let's say they purchase a pair from you and then want a backup pair. Would you require them to buy that from you? If so, how would you explain that to the patient? "I can't let you give these parameters to another provider because they may not copy them down correctly on the order form". How would you handle it if they requested a copy of their records? Would you black out the CL parameters so no other provider could order for them based on your work?
I only ask these questions because I have never run into a situation where I felt it was justified to not release a CL prescription, except in the case of a patient that had an unpaid balance or did not complete my fitting requirements.
I am not baiting you, and I did not say that ALL cl rx's should be released. I was curious as to which circumstances you would feel it was appropriate to withhold a cl rx. To be honest, I didn't think aout a bandage cl. Of course that could be because I don't consider that a cl fitting, nor would it fall under the FCCLA. I am not sure if the pediatric occluder falls under the FCCLA, however, once you have finalized the lens and the power that will work for your treatment, what does it matter where they get the lens from? If you are concerned that this is a dynamic condition and you are constantly making changes, then the fitting is not complete and it would not be subject to the law. Once a KCN lens in finalized, the actual ordering is not really rocket science, and I do believe you would be violating the law by not releasing that rx.I get the feeling you are baiting me, because I dont see how you can sit there and say that ALL cl rxs should be released so they can see what they cost somewhere else?
Of course, if records are requested then any/all tx are included as part of the record (for a small fee).
I was referring to the op who wanted to go shop the cost of lenses, which would normally be allowed, but might not be such a great idea if his friend has some existing eye condition. What part dont you get? bandage cl's, pediatric occluders, some kcn lenses, etc. All represent some examples that you might not get an "rx" to go shop the lenses. I consider certain dynamic conditions of the eye to be just that....dynamic. As such the contact lens "fitting" is not always going to result in an a paper copy "cl rx", for the patient to buy off of 1800contancts. I get the feeling you are baiting me, because I dont see how you can sit there and say that ALL cl rxs should be released so they can see what they cost somewhere else?
I only ask these questions because I have never run into a situation where I felt it was justified to not release a CL prescription, except in the case of a patient that had an unpaid balance or did not complete my fitting requirements.
I think we agree. The situations you are describing should fall outside the FCCLA. I was just looking for clarification.Let me see if I get this straight, you will actually write out the 10 or so parameters (that are often necessary for some kcn lenses) onto an rx pad, inluding the fabricating laboratory, with say a 6 month expire date, so that joe blow can try and buy them from wallyworld? What if wallyworld cant get the lens (and they often cannot)? Or worse what if joe blow just takes that rx and buys several "backups" and never follows up until he/shes having a "problem" (you know like apical neo, or dangerously thin ectasia) with the lenses you prescribed? Also the pediatric occluders Ive used are custom made by hand, how do you write a "cl rx" for that? Ive had a few older aphakes try this crap you know. They are on a budget so they go to walmart get there rx and wear the lenses until they disintegrate, or have 10mm of neo surrounding a 3mm ulcer, or whatever. I agree with your balance issue though, I dont give a rats ass about any law says I have to do something for free, or tries to force me to cause harm to someone. IF the op was referring to routine cls then we agree that the OD is probably a slime ball, but its still an IF situation. IMO some "higher risk" patients should not be given a cl rx for shopping around. If they want to go to another doctor thats fine, Ill send along every pertinent shred of info I have, but I will not give out an Rx.
My fitting process as a matter of policy is not complete until the patient pays their balance in full.Though I am not sure, my understanding was that you could not withhold a prescription simply because a patient has a balance due.
