Re: Sharing RX medication to save $


<Hawk...@xxxxxxxxxxxxx> wrote:
> "elgoog" <bjdefend-newsgroups@xxxxxxxxx> wrote in message
> news:1114527695.007065.32410@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
> >
> > tonywes...@xxxxxxxxx wrote:
> >> elgoog wrote:
> >> > Without a crooked doctor to write the script incorrectly, it
would
> >> > never get past the Drug Utilization Review (DUR) alerts.
> >>
> >> Many medications have a sufficiently wide range of dosages to not
> >> trigger an alert. For instance, I take a BP med, avalide, (FYI,
I'm
> >> not sharing it) and get 60 pills monthly. Going from 30 to 60 is
> >> within normal dosage.
> >
> > True. But, in this case the person sharing half of their
prescription
> > would be doing so only at the risk of their own health (i.e. they
> > receive only half of the prescription). This behavior might be more
> > common where the patient is conning the doctor for pain killers, or
> > some other drug that is being abused.
> >
> >> > When the
> >> > pharmacy receives a script, they verify the prescription with
the
> >> > prescribing doc,
> >>
> >> 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.
>
>
> I had to go back and find your original post on this point
>
> pharmacists do NOT validate the original script with the provider's
> office(and please release that many providers are NOT doctors...but
NP and
> PA providers)

Correct. It depends on which drug and the presence of a Prospective
Drug Utilization Review (ProDUR) alert. It is not a matter of routine
practice - and, I mispoke when I said "with the doctor's office." I
should have said, it is validated electronically through the patient
history on record with the payer.

> if all scripts needed to be verified...the provider would have no
time to
> see patients

As it is, providers spend too little time with patients.

> you MAY be referring to a very new system of electronic "sending " of

> scripts wherein patients do not receive a paper script...but the
order is
> sent electronically to the pharmacy..

Correct. This system is live and available in some areas.

> I have collagues all over the US...almost NONE use this system
"yet"..

The system is in use.

> just a thought...but HOW would scripts be verified on weekends,,after

> hours..or when the original prescriber is not available???

The scripts are checked for the presence of electronic data that
validates it - just like ProDUR and Prior Authorizations are done
today. The absence of some data does not prevent the script from being
approved for the pharmacist to dispense - unless there is a
contra-indicated or a negative contra-indicated audit alert.

> how many folks run right to the pharmacy ??? many hold on to the
script for
> days...I know I do

Doesn't matter.

> having written scripts for 20 years...the ONLY time I hear from a
pharmacy
> is when an error has been made..ie the patient is allergic..I wrote
the
> wrong dose...etc...

Yep. That is not likely to change.

> "pre authorization" is a whole nother story...it is used for meds
that are
> NOT on the patient's insurance formulary...in my experience that
occurs
> maybe 2% of the time
<<snip>>

Agreed. However, some states have taken notice to the fact that they
can use ProDUR alerts - enforced by boards and supported by legislation
- to further their control in attempts to control costs. The board's
decisions bind not only public health programs, but can extend to other
payers. This authority is not uniform across the states.

Up until now, the federal government and federal agencies, the state
governments and state agencies have not done the best job at creating
conformance across the states. We now believe that the lack of
uniformity is an impediment at trying to get a handle on health care
expenditures. It is not always clear to me whether legislation
ameliorates the problem or exacerbates it. HIPAA has cost us billions
of dollars, and will cost us billions more.

-elgoog, still learning

"Sto ancora imparando (I am still learning)" - Michelangelo

.

Relevant Pages

  • Re: Ranking formular in Access?
    ... >> Hi, Paul. ... >>> Express Scripts, ... >>> Charting the future of pharmacy ...
    (microsoft.public.access.queries)
  • Re: Happy Friday!
    ... The safe deposit box is a great idea! ... page size scripts about 2 years, ... I haven't talked with my pharmacy yet about using them. ... I've never had any concerns about my meds in my home. ...
    (alt.support.chronic-pain)
  • Re: Ranking formular in Access?
    ... >> Express Scripts, ... >> Charting the future of pharmacy ... >>> Community, please sign in to the Community and mark these posts as ...
    (microsoft.public.access.queries)
  • Re: Images in Access
    ... you need to register with our web site in order to use it. ... is that you cannot register unless your insurance does offer our services. ... Express Scripts, ... >> Express Scripts is a PBM or pharmacy benefits manager. ...
    (microsoft.public.access.gettingstarted)
  • Re: VA Care for Chronic Pain
    ... Nick I have a VA Center about 45 minutes from ... Have you taken any scripts from your VA Doc and had them ... pay out of pocket? ... tried to fill them by a civilian pharmacy cause the VA has there own ...
    (alt.support.chronic-pain)