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Insurance company tattles
11-08-2008, 08:49 AM
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#1
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Thinks s/he gets paid by the post
Join Date: Mar 2007
Location: Nebraska
Posts: 1,543
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Insurance company tattles
This is a new one for me. Yesterday I received a letter from my internist. He enclosed a letter that he received from my insurance company. The insurance company notified my doctor that I hadn't refilled my prescriptions as often as they thought I should. Gee...now I have to think about my insurance company tattling me out on how often I take me meds.
I take a bone med for osteopenia once a week and I do miss once in a while but I was really surprised that my insurance company would rat me out to my doctor.
Is this a common practice?
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11-08-2008, 09:16 AM
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#2
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jun 2006
Posts: 12,880
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They'll send a letter to your wife if you go through your Viagra too fast.
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Al
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11-08-2008, 09:34 AM
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#3
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Recycles dryer sheets
Join Date: Aug 2005
Posts: 380
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Imagine the near future, when the chip in the pill bottle sends a message to the Dr. that you didn't open it today.
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11-08-2008, 10:33 AM
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#4
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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Dunno if it is common practicem, but with many chronic/long term conditions "patient compliance" is a huge problem for caregivers. In the case of diseasesthat are relatively easily controlled/managed if you just keep up with your meds, insurers and caregivers have gotten religion and are working on making sure you control your disease and try to help. I know that at least in the case of diabetes there are companies taht specialize in helping improve patient compliance.
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11-08-2008, 12:37 PM
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#5
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Thinks s/he gets paid by the post
Join Date: Mar 2007
Location: Nebraska
Posts: 1,543
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Quote:
Originally Posted by brewer12345
Dunno if it is common practicem, but with many chronic/long term conditions "patient compliance" is a huge problem for caregivers. In the case of diseasesthat are relatively easily controlled/managed if you just keep up with your meds, insurers and caregivers have gotten religion and are working on making sure you control your disease and try to help. I know that at least in the case of diabetes there are companies taht specialize in helping improve patient compliance.
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Yep...I think that's what's going on. The letter sites potential medication noncompliance. I agree that taking your meds is important. The insurance company doesn't want to shell out big bucks later if your condition worsens from not taking your meds correctly.
I suppose if you skip enough times, that they could possibly stop covering you for that condition?? Maybe..? Anyway, it's interesting that they are getting more involved in this. I just don't like taking the stupid pills.
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11-08-2008, 12:55 PM
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#6
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Moderator Emeritus
Join Date: Dec 2002
Location: Oahu
Posts: 26,856
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Quote:
Originally Posted by TromboneAl
They'll send a letter to your wife if you go through your Viagra too fast.
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Just as long as they don't send copies to my girlfriends...
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11-08-2008, 01:09 PM
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#7
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Feb 2008
Location: East Nowhere, 43N Latitude, NY
Posts: 9,037
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we get courtesy calls from the drug store asking if we want the Rx refilled. it's an automated system. i thought that was kinda cool.
but the insurance company ratting on ya to the doc? that sounds like a prelude to looking for an excuse to deny coverage. sheesh!
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11-08-2008, 01:29 PM
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#8
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Mar 2007
Posts: 14,328
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Some insurance companies allow auto refill via US mail. Maybe you could sign up for that and dump the excess pills in the toilet.
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11-08-2008, 02:24 PM
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#9
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Recycles dryer sheets
Join Date: Mar 2006
Posts: 194
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I find that amusing...your insurance company calling your doc about your lack of Rx refills considering they are the same entity that limits the number of pills you can obtain on some meds. My insurance company allows me 4 migraine pills per month. Like I have any freakin control over how many headaches I get. To top it off, my wonderful Rx discount gets me these pills for 21 bucks each.
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11-08-2008, 02:36 PM
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#10
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2004
Location: South Texas~29N/98W Just West of Woman Hollering Creek
Posts: 6,671
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Quote:
notified my doctor that I hadn't refilled my prescriptions
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Wait until we are all enrolled in a federal universal health plan. The feds will probably withhold your IRS refund if you have not taken all of your meds in a timely manner.
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11-08-2008, 05:51 PM
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#11
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Moderator Emeritus
Join Date: Jun 2007
Location: At The Cafe
Posts: 6,873
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My HMO won't allow re-fills that are too soon; it's a pain because I have to re-fill each prescription one at a time; but have them mailed instead of going cross-town on two buses to pick them up.
Pharmacists are very careful; I went to fill a prescription for antibiotics from the dentist and the pharmacist at Walgreen's told me I should get it from my HMO; I gave her the transit argument and she filled it.
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11-09-2008, 08:48 AM
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#12
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Thinks s/he gets paid by the post
Join Date: Mar 2007
Location: Nebraska
Posts: 1,543
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This is a mail type prescription program. I have a doctor's appt in December so I'm gonna ask my doctor about this then. In the mean time, I have 3 more weeks of pills to take. I'd better refill now.
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11-09-2008, 09:14 AM
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#13
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Recycles dryer sheets
Join Date: Nov 2005
Posts: 331
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I've had this happen to me, no big deal, just chuck it and go on with life. My doctor said they were crazy to bother him with this waste of time.
Jug
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11-09-2008, 09:23 AM
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#14
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Recycles dryer sheets
Join Date: Dec 2006
Posts: 293
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Wow, I didn't realize that insurance companies would do this and frankly I'm not sure I'm comfortable with it. But, Brewer makes a real good point about the noncompliant issue. Better fill the rx and then take it or not as you see fit. I think it is still your body!
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11-09-2008, 10:57 AM
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#15
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2004
Location: South Texas~29N/98W Just West of Woman Hollering Creek
Posts: 6,671
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Quote:
Originally Posted by CuppaJoe
My HMO won't allow re-fills that are too soon; it's a pain because I have to re-fill each prescription one at a time
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I had this same problem years ago, but have managed to blend in all 7 of my Rx as I can reorder approx. 60 days after the last time that I filled up. I just figured out what the most recent refill was by looking on the label on the bottle and called in all 7 at once. Since some were 75 days, others 70 days, and one was 60 days, I refilled all 7 on the same day.
Now all are ready to refill on the same day in 60 days or so.
__________________
Part-Owner of Texas
Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read. Groucho Marx
In dire need of: faster horses, younger woman, older whiskey, more money.
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11-09-2008, 12:19 PM
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#16
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Feb 2004
Location: Portland, Oregon
Posts: 7,111
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I probably take the same ostio med as the OP. What irritates me is that the mail order folks dispense in 3-4 week packages and call that a 90 day supply.. they short me one month a year.
Thanks for reminding me to refill before the end of the year as I intend to switch insurers from BC.
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11-09-2008, 12:50 PM
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#17
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Moderator Emeritus
Join Date: Feb 2006
Location: San Francisco
Posts: 8,827
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I get these letters from time to time about my patients. It did strike me as a marginal thing to do. On the surface it just seems like a nice thing to do - help keep you on track by tattling to your doctor. But, pardon my cynicism, keeping the drugs flowing is also in their best financial interest so their motives may not be pure.
Also, some patients choose to obtain their drugs outside the reporting plan (sometimes the co-pay is almost as much as the medication cost). Or maybe you use your spouse's plan instead of yours. Or maybe a $4 generic at Wally World.
It also makes my feel that it is my duty to call the patient and say "Hey - your drug insurance notified me you are not refilling your pills as often as you should." Awkward at best, yet another administrative task to add to the to-do list, and unproven as to its value.
My personal feeling is that they are a financial intermediary, your decision about if, when and from whom to obtain your pills is none of their business, and that it's between me and my patient. If they are going to do this at all, they should notify the patient and ask permission to notify your doctor as well.
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Rich
San Francisco Area
ESR'd March 2010. FIRE'd January 2011.
As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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11-09-2008, 05:56 PM
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#18
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Dryer sheet aficionado
Join Date: Nov 2008
Posts: 31
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Rich
I am on an HMO w/ drug coverage. I take a med that 1 month supply on my insurance is $10 for the generic. With all the CHEAP generic drug fills available I can actually buy a 100 day supply for <$10.
What do you think I am buying/paying?
If my druggist/ins co EVER contacted my Dr i would REPORT them for violation of HIPA regulations, sue them for $xxxxxxxxx and be able to retire VERY early in the laop of luxury.
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11-09-2008, 06:08 PM
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#19
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Moderator Emeritus
Join Date: Feb 2006
Location: San Francisco
Posts: 8,827
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Quote:
Originally Posted by marvholly
Rich
I am on an HMO w/ drug coverage. I take a med that 1 month supply on my insurance is $10 for the generic. With all the CHEAP generic drug fills available I can actually buy a 100 day supply for <$10...If my druggist/ins co EVER contacted my Dr i would REPORT them for violation of HIPA regulations, sue them for $xxxxxxxxx and be able to retire VERY early in the laop of luxury.
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Well, don't know about the suing part , but yours is a typical situation I had in mind in my comments above.
__________________
Rich
San Francisco Area
ESR'd March 2010. FIRE'd January 2011.
As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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11-09-2008, 06:47 PM
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#20
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Dryer sheet aficionado
Join Date: Nov 2008
Posts: 31
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If I EVER receive such a letter or my Dr gets one or a call I would be on the phone to my brother, the $600/hour attorney ,so fast the insurance company lawyer's heads woudl spin. I REALLY suspect this is a MAJOR HIPA violation and would be willing to put money where my typing is.
Privacy is Privacy and if I cannot call a hospital to check on a relative admision wise how can an ins company question how often I am filling an Rx to my Dr for all the reasons (wally $4/month, spouse plan....) you noted? i cetainly do NOT want my Dr wasting his time following up on that kind of .....trash and/or playing phone tag w/ me. his time would be MUCH better spent w/ his family, relaxing and/or taking CEUs.
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