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11-29-2006, 09:31 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Feb 2006 Location: Northern Utah
Posts: 842
| | | Is this legal???? It has come to my attention that a certain physician will only write prescriptions for patients if it is for items that must be purchased through the pharmacy as prescription required, whether the patient has insurance or not.
If a patient wants a prescription written for supplies (such as testing supplies) that can be purchased over the counter, this doc charges them a $15 fee for him to write one. In the US, if something is being billed to insurance, there always needs to be a prescription on file, even if it is something that can be purchased over the counter without one. So, basically, if this doctor's patients wants to buy their testing supplies, or even pump supplies, and have them be billed to insurance, they have to pay this fee. If they don't pay the fee, they don't get the rx, and their supplies can't be billed to the insurance so they have to pay for them out of pocket.
Now, I ask you, is this legal? I am personally disgusted by this!!  Healthcare costs enough without having to pay your doctor to sign his name to a prescription that his Medical Assistant probably filled in for him!! This is just so wrong in so many ways.
__________________ Laura Anne "Happy Day! All is well! Pumping with Paradigm 712 since November 17th, 2004 Type 1 since April, 1995 | 
11-29-2006, 09:33 AM
|  | Senior Member
I am a: Type 1.5 | | Join Date: Sep 2003 Location: Hogwarts, Hobbiton, the Galactic Milieu &Ks when I have to be here
Posts: 4,299
| | | While it may be legal, it certainly isn't ethical.
Might want to check with the State Medical Board.
__________________
"I am wounded," he said, "wounded, and it will never heal."
Frodo to Samwise
| 
11-29-2006, 09:36 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Sep 2005 Location: Cincinnati, OH
Posts: 8,291
| | | That to me would definitely in my mind constitute a form of medical malpractice. Doctors cannot charge for writing a prescreption anywhere that I know of. The only way is if you don't have a doctor's visit and you need a prescription, they may be able to charge that way since you are seeing/requesting their services of them without an appointment.
I definitely would call around to some law firms and medical malpractice boards and see what you can find. Heck, I'd even call the news media and plaster that guys face all over TV as doing that, then see how much longer he does.
__________________
●Blue Ash, Ohio Police Dispatcher
●Type 1 diabetic for 25 years (11 months old)
●Animas pumper since December of 2002
~IR 1000 (Dec. 2002-Jan. 2005)
~IR 1200 (Jan. 2005 - ?)
●LifeScan OneTouch UltraSmart Diabetes is an Art, NOT a Science. You must master the control by skills and not by knowledge alone. | 
11-29-2006, 09:37 AM
| | Senior Member | | Join Date: Sep 2004
Posts: 5,595
| | | Legal or not, I would not go to that doctor. | 
11-29-2006, 09:40 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Feb 2006 Location: Northern Utah
Posts: 842
| | | Hearing this made me even more grateful for my current doctor. This was not about me, but about another person. I just can't believe that a doctor would do that. I want to report him, but I wanted to see if it was legal for him to do that first.
__________________ Laura Anne "Happy Day! All is well! Pumping with Paradigm 712 since November 17th, 2004 Type 1 since April, 1995 | 
11-29-2006, 09:44 AM
|  | Super Moderator
I am a: Type 1 | | Join Date: Jan 2004 Location: Mid-West
Posts: 7,125
| | It seems like there's a very hazy line of what they can & cannot get away with these days.
We all know that ethically & from a professional standpoint, it's way wrong! It causes unnecessary extra fees to our insurance companies, which in turn causes us to pay more for coverage. It's a very vicious cycle, but one that's been going on for quite some time!
That said, I think you should report the guy. If nothing else (i.e. if it's legal), at least you tried and his name is "out there," so to speak (so that others won't encounter the same problems).
__________________ ALL my love, Carwy & Best wishes for a healthy new beginning!
Saying prayers for him & all our friends, every day.
_______
"We ALL have our own opinions & beliefs...But I'd appreciate folks a he** of a lot more if they didn't belittle one another when they disagreed!!!" ______
Pumps & Meters Used:
MM506,7,8,11 & 12, Cozmo, Animas 1200 & 1250 Many
A1C: 6.4
Type I 26yrs, pumping 12
| 
11-29-2006, 11:34 AM
| | Senior Member
I am a: Type 2 | | Join Date: Jun 2006
Posts: 980
| | | How often do you have an office visit with this doctor, a visit for which either you or your insurance company will pay? If you are trying to save money by not making in office appointments, or if for some other reason you are avoiding having in office appointments, then I would NOT think it is unethical for him to charge for a prescription for over-the-counter available supplies. If I did that, my doctor would be doing the record-keeping and submissions to the insurance company without getting reimbursed for her or her billing staff's time or office materials.
I would be free-loading if I did not have an arrangement with my doctor which assured her to be paid. When I am a paying patient (either out-of-pocket or by insurance) then my doctor would of course write prescriptions for over-the counter meds that I needed my insurance to pay for. I have in fact done that before. It was an item that most people would just pay for out-of-pocket, but I did not have the money at the time, and it was covered by insurance if there were a written prescription. | 
11-29-2006, 11:47 AM
|  | Super Moderator
I am a: Type 1 | | Join Date: Jan 2004 Location: Mid-West
Posts: 7,125
| | | On the other side of the coin, here's an example that happened to me when I started pumping with my Cozmo (and of why I feel the way I do):
I went to the endo's office (did Not even see him) to start on my new pump. Trainer (from Smiths) didn't show up, so I proceeded to fill in the CDE on how the pump worked and all the features I'd learned about (I already had knowledge of not only the Cozmo, but of all the MiniMed models I had used prior, so didn't need the training). Regardless of the fact that I trained my CDE on how the pump worked, and the rep. from Deltec/Smith's never showed, my insurance (& I) were still charged for the visit! Sorry, but I think that's just ludicrous. Needless to say, when my pump was due for an upgrade, I opted to meet the rep. at a restaurant instead of the doctor's office...
__________________ ALL my love, Carwy & Best wishes for a healthy new beginning!
Saying prayers for him & all our friends, every day.
_______
"We ALL have our own opinions & beliefs...But I'd appreciate folks a he** of a lot more if they didn't belittle one another when they disagreed!!!" ______
Pumps & Meters Used:
MM506,7,8,11 & 12, Cozmo, Animas 1200 & 1250 Many
A1C: 6.4
Type I 26yrs, pumping 12
| 
11-29-2006, 11:53 AM
| | Junior Member
I am a: Type 2 | | Join Date: Nov 2006 Location: Tucson, AZ
Posts: 2
| | | not legal but unethical Sure isn't ethical. I'm tired of doctors who don't give a hoot about the personage of the patient. I'm lucky in one I have tho she has so many patients it's hard to get to see her. | 
11-29-2006, 11:54 AM
| | Junior Member
I am a: Type 2 | | Join Date: Nov 2006 Location: Tucson, AZ
Posts: 2
| | | Starting new thread Sorry to "interrupt" but how does one start a new thread? | 
11-29-2006, 12:05 PM
|  | Super Moderator
I am a: Type 1 | | Join Date: Jan 2004 Location: Mid-West
Posts: 7,125
| | Quote:
Originally Posted by gentlefemme40 Sorry to "interrupt" but how does one start a new thread? | I Pmed you, but just in case you may not have received it:
Hi there & welcome aboard.
To start a new thread, click on the area you want to post in (i.e. Introductions and Announcements, or chit chat sub-forums, for example) and click "New Thread." It should be toward the upper left side of the browser window. Hope this helps and glad you're here! Welcome!
Sincerely,
Dewey
__________________ ALL my love, Carwy & Best wishes for a healthy new beginning!
Saying prayers for him & all our friends, every day.
_______
"We ALL have our own opinions & beliefs...But I'd appreciate folks a he** of a lot more if they didn't belittle one another when they disagreed!!!" ______
Pumps & Meters Used:
MM506,7,8,11 & 12, Cozmo, Animas 1200 & 1250 Many
A1C: 6.4
Type I 26yrs, pumping 12
| 
11-29-2006, 12:29 PM
|  | Senior Member | | Join Date: Oct 2003 Location: Manassas, in the Old Dominion
Posts: 6,534
| | Quote:
Originally Posted by lelggren It has come to my attention that a certain physician will only write prescriptions for patients if it is for items that must be purchased through the pharmacy as prescription required, whether the patient has insurance or not.
If a patient wants a prescription written for supplies (such as testing supplies) that can be purchased over the counter, this doc charges them a $15 fee for him to write one. In the US, if something is being billed to insurance, there always needs to be a prescription on file, even if it is something that can be purchased over the counter without one. So, basically, if this doctor's patients wants to buy their testing supplies, or even pump supplies, and have them be billed to insurance, they have to pay this fee. If they don't pay the fee, they don't get the rx, and their supplies can't be billed to the insurance so they have to pay for them out of pocket.
Now, I ask you, is this legal? I am personally disgusted by this!!  Healthcare costs enough without having to pay your doctor to sign his name to a prescription that his Medical Assistant probably filled in for him!! This is just so wrong in so many ways. | Now Laura, how in the world did you EVER get mixed up with Northern Virginia Endocrinologists, anyway?
(sarcasm above) That's something they do there...
__________________ I'll mend myself before it gets me... | 
11-29-2006, 12:38 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Feb 2006 Location: Northern Utah
Posts: 842
| | I understand what you are saying about trying to avoid going to the dr and such. There are lots of people out there who do that, and I completely support a doctor who denies a prescription to a diabetic patient whom he has not seen in at least 6-9 months. At that point, the patient is being reckless with their own care and it is on them.
But, I have to disagree with you about having people pay for a doc to write a prescription. The doctor is being paid by you and your insurance company to be your doctor. It is your doctor's responsibility, and comes as part of the job, for them to make sure you get all the medications/supplies that you need to maintain optimal care, even if this means that you just stop in and take up 2 minutes of their time without having a co-pay paying appointment. This person that I am asking this about is a good patient who sees her doctor regluarly and does her best for her care. She is just wanting to switch DME suppliers, and her rx with the old company is expired so transferring it wouldn't do any good. Thus, she needs a new prescription, but it is not time for her appointment for 2 more months. I just really feel that her doctor should not charge her an extra $15 for the time it would take for him to fill in a prescription. It is not a great, and difficult enough task.....
Also, she said that this $15 charge applies even if you are trying to get the rx at your copay paying appointment....... Quote:
Originally Posted by slipperyelm How often do you have an office visit with this doctor, a visit for which either you or your insurance company will pay? If you are trying to save money by not making in office appointments, or if for some other reason you are avoiding having in office appointments, then I would NOT think it is unethical for him to charge for a prescription for over-the-counter available supplies. If I did that, my doctor would be doing the record-keeping and submissions to the insurance company without getting reimbursed for her or her billing staff's time or office materials.
I would be free-loading if I did not have an arrangement with my doctor which assured her to be paid. When I am a paying patient (either out-of-pocket or by insurance) then my doctor would of course write prescriptions for over-the counter meds that I needed my insurance to pay for. I have in fact done that before. It was an item that most people would just pay for out-of-pocket, but I did not have the money at the time, and it was covered by insurance if there were a written prescription. |
__________________ Laura Anne "Happy Day! All is well! Pumping with Paradigm 712 since November 17th, 2004 Type 1 since April, 1995 | 
11-29-2006, 12:39 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Feb 2006 Location: Northern Utah
Posts: 842
| | Quote:
Originally Posted by duck Now Laura, how in the world did you EVER get mixed up with Northern Virginia Endocrinologists, anyway?
(sarcasm above) That's something they do there... | LOL  They are bad people too.
__________________ Laura Anne "Happy Day! All is well! Pumping with Paradigm 712 since November 17th, 2004 Type 1 since April, 1995 |  | | Thread Tools | | | | Display Modes | Linear Mode |
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