Re: Sharing RX medication to save $


<Hawk...@xxxxxxxxxxxxx> wrote:
> ">>
> >.
> >
> >> > When the
> >> > pharmacy receives a script, they verify the prescription with
the
> >> > prescribing doc,
>
>
> no...properly written scripts are NEVER verified in any manner...to
do so
> would entail a LOT of unnecessary work...

Depends on the state and the drug.

> scheduled meds...sometimes...but routine meds,,never
>
> but as to the "crooked doctor" example...this is a valid statement...
>
> a prescriber will write on the script AND document in the chart
EXACTLY what
> the patient is taking..ie...1 tab twice a day or 60/month.....scripts
and
> charts have to match..in case of audits..another provider filling
> in...etc...not many prescribers are willing to risk being "caught" in

> insurance fraud...
>
> which is what it is...EVEN if the stated number and dosage on the
script is
> within the range...
>
> I once asked hubby's doc to write for TWICE the dose of an expensive
> med,,,then I would split the pills..he would get two months for one
co
> pay....
>
> doc's answer " I always promised my wife I would not go to jail...for

> insurance fraud"...
>
> this is NOT to say that some providers will not do this...but it is
> insurance fraud in a "small" context

I believe any fraud is significant and should be prosecuted; but, I
understand your sentiment.

I cannot imagine a provider cooperating in this type of mini-fraud to
save copay any more easily than I can imagine chickens eating coconuts.

> >> I'm sure mine doesn't. It just gets keyed into their computer.
They
> >> get it wrong often enough.
> >
> > It gets keyed into their computer and processed by the payer. The
> > pharmacist is supposed to validate the original prescription with
the
> > doctor's office (it may be done electronically). Refills don't need
to
> > be checked unless there is a change in dosage.
> >
> >>
> >> > they enter the patient's insurance information, the
> >> > Rx, dose and prescribing provider's ID: the payer's claim
payment
> >> > system would immediately detect the error, and the pharmacist
would
> >> not
> >> > fill the Rx.
> >>
> >> > Either you have a crooked doctor, or a crooked pharmacist.
> >>
> >> You jump to an erroneous and dangerous conclusion. I did not say
I
> > do
> >> this. I don't share my meds.
> >
> > Neither. The familiar "you" was not intended to refer to you
> > personally. I apologize for my lack of clarity.
> >
> >> > Why would
> >> > they risk their licenses, their practices, their livlihoods and
> >> > families for someone to save a $2 to $20 copay?
> >>
> >> For some people, a second $20 co-pay is the difference between
> > getting
> >> the presciption filled or going without.
> >
> > Possibly correct. The copay system is designed to introduce an
element
> > of patient responsibility without introducing undue financial
burden. A
> > person who is not in need of cash assistance might have a $20
copay,
> > another person who is on cash assistance might have only a $2
copay.
> >
> >
> >> > I admit, you could be right. I just don't get it.
> >
> > You're probably right. It probably does happen. Especially when one
of
> > the patients is conning the doctor for purposes of drug abuse - in
> > which case, I don't have much sympathy.
> >
> > I appreciate your response in this matter. You have helped me to
see
> > that it may in fact be happening. People do stupid things
sometimes.
> >

.

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