Prescriptions


Normally, we write your prescriptions with a maximal allowable number of refills, typically 12 times per year.  Some controlled drugs can only be written for 6 months; pain medications are not refillable.  If you are out of refills, you need a renewal.  This is usually done at your yearly Wellness visit.  We are starting to try to work with drug stores to synchronize all of your prescriptions, so that renewals are all done at the same time, instead of scattered throughout the year.

Our preference is that you contact your pharmacy and have them contact us.  This is the safest and quickest option.  We send the request electronically to them the same day, even on weekends.  If this is not possible, we prefer that you send the request through the portal.  Your medications should be listed there and you only need to select those needing renewals.

We do not encourage telephone renewals.  Most drug stores allow telephone requests for refills and renewals using the number on the bottle.  If you are calling us for a telephone renewal, your call will be transferred to a refill line.  If we are unable to understand the name of the drug, or what you need, you will be asked to schedule an appointment.  Medication management is one of the most important parts of your care and should probably be done in person

 Remember that no prescriptions should be filled unless you have been seen in the office within 12 months.

PRIOR AUTHORIZATIONS

Many insurance companies have formularies in which certain drugs are covered and others are not. In 2017, we are running into many seemingly arbitrary refusals to cover even cheap generic drugs.  Some insurances are simply not covering sleeping pills, or stomach pills or certain types of pain medications.  We are spending hours and hours online and on the phone on your behalf trying to get coverage for your medicines and frankly cannot afford to work with some pharmacy benefit systems since the typical call is longer than 30 minutes. We may ask you to be the point man for your own medicine and call the representative yourself to find out why the drug is not covered and what alternatives are available to you.

CHRONIC CARE MANAGEMENT/ CPC+

New medicare programs offer some reimbursement for the excessive time we spend on your behalf getting drugs authorized or refilled as well as phone calls before and after office visits to make sure we are all on the same page. In 2018, the program has expanded and no longer requires a co-insurance payment.  We hope to enroll everyone with chronic medical problems. In addition, the practice was selected to participate in CPC+(Comprehensive Care Plus),a CMS innovative pilot program to encourage care BETWEEN visits. We will all work together to keep you healthy.