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How does your physician's office handle medication refills?


mellifera33
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This seems like such a silly reason to change providers, but I have constant problems having prescriptions refilled. The most recent time I needed a refill, they said that my doctor wouldn't authorize my prescription. I called my doctor's office, and the office informed me that I needed to have an office visit to have any more refills, and that my last authorization was a "grace" refill. That would have been nice to know. I received no call from the drs office, no message on the patient system ("Better Connected" is the slogan of the network--what a bunch of bunk!) and no indication from the pharmacy that I needed to call for an appointment before another prescription would be authorized. So now I'm out of my prescription until after my office visit on Thursday. And I am steamed. 

 

Is this the way it always happens, or are you notified if you need an office visit to have a refill authorized? 

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We've only run into this issue once, but the one time we hadn't been seen in the past year and needed a refill, the doc's office called and told us they were doing one month for us as a courtesy, but we needed to schedule an appt within that 30 days to refill more. Then they worked with us to get us in fast. So, yes, they called us.

 

I'm sorry. I hope you can get by till your refill is in!

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I haven't had that happen.  In general, my prescriptions, and my mum's, have not been on repeat until the doctor was happy that the medication was correct.  If there was a need for a check up after six months - for example - that was a separate process from the repeating prescription: I would just be advised in advance or contacted to suggest an appointment.

Edited by Laura Corin
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I'm in the midst of dealing with this myself. The pharmacy faxed the prescription mid last week and they just refaxed it yesterday. I figure my doctor's office would call if they refused to refill. My hunch is that they are just waiting for me to call and have them say no because I told them I couldn't come in for an appointment in September. My insurance lapsed (whole other issue) but it's been less than a year since I was there. It's for thyoid meds, something I'll be on for the rest of my life and have been on for a few years without issue. I'm really fed up with them. I feel like my prescription is being held hostage because I don't want to come to their office every three months for bloodwork unrelated to my thyroid. 

 

My pharmacy (Walmart) gave me 3 days of meds to tide me over until the they hear from the doctor. 

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It's common which is why I'm glad some stuff has gone OTC.  Granted now insurance won't pay for it, but if you don't need to pay for an office visit it's cheaper and less of a hassle. 

 

Several years ago when I took BCP, even then, I had to go in for appointments.  Not every single month, but more than once a year.  Which is ridiculous.  I was told they were required to do that.

 

 

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I've gotten the "one month courtesy refill" a couple of times.   The pharmacy and doctors are pretty good about it.

 

I don't think it's a terrible reason for changing practitioners. But if you really like the person you see, and it's just the prescription refilling that's a problem, I'd keep track of the number of refills allowed and when the last one is filled, call the doctor's office to see if they will require you to be seen before they'll do another one.  

 

 

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Our physicians tells us exactly how many refills are authorized & the pharmacy where we fill our rx keeps track.
 

When we are picking up our last refill, the pharmacist will tell us that was the last & that we need to see the dr for more. Usually they're dispensing 1-3 months of meds at a time so if that's the last, you have 1-3 months to make your appointment to see the doctor and get a new rx.

The # of refills available is also printed on the packaging label so you can see if there are any left. 

 

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Our physicians tells us exactly how many refills are authorized & the pharmacy where we fill our rx keeps track.

 

When we are picking up our last refill, the pharmacist will tell us that was the last & that we need to see the dr for more. Usually they're dispensing 1-3 months of meds at a time so if that's the last, you have 1-3 months to make your appointment to see the doctor and get a new rx.

 

The # of refills available is also printed on the packaging label so you can see if there are any left. 

 

 

 

This. The # of refills is on the packaging and we know we need to get into the doctor to get the next refill.

 

 

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Yes, it is very common for doctors to require that you see them regularly if you expect them to prescribe for you, even if it is a long term prescription. How else are they supposed to determine if the prescription is working as it is intended to work? Ask your doctor at your  next appointment how often you need to come in. If you aren't happy with the answer then ask if there are alternatives to that frequency of appointment. Most doctors will work with you within certain parameters. No doctor would be able to get insurance if they continuously provided prescriptions without evaluating the patient for whom they are prescribing. 

 

 

 

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Disclaimer - I am on long-term meds and see the doctor twice a year.

 

I check the prescription bottle when I pick up my prescription.  If it says "zero refills remaining", I call in to the doctors office and set up an appointment if I don't have one already.   I tell the office when I call in that this appointment is because my Rx is out of refills.  Sometimes, I will get a call back later from the nurse telling me that I don't need to come in and they will refill the Rx, but usually I need blood work or something.

 

I used to do the "wait, call, wait, call, refax, wait, call" routine too, but it got stupid.  I find I waste less of my time and money by just going in for an appointment even if I have to pay out of pocket. 

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I have to go once a year for mine to get refilled, but they are good about letting me know if I need an appointment.  My new doctor will do phone visits for between annual checks if he has any questions before refilling.

 

Two of my kids are on meds.  For one medication DD has to go see a doctor every other month, now I think it is down to every three months.  It is because of the type of prescription it is.  But I know I can't get a refill unless she sees her doctor.  I am wondering how this is going to work when she switches insurance in a week.  DS's medication refills depend on the medication. Some he has to see a doctor every three months and some every six months.  He just got six months of refills on the majority of his meds.

 

I would be very frustrated if they didn't let me know that I needed an appointment before the next refill, and yes I might change doctors over that if it were a problem and I had the option to do so.

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Yes, it is very common for doctors to require that you see them regularly if you expect them to prescribe for you, even if it is a long term prescription. How else are they supposed to determine if the prescription is working as it is intended to work? Ask your doctor at your  next appointment how often you need to come in. If you aren't happy with the answer then ask if there are alternatives to that frequency of appointment. Most doctors will work with you within certain parameters. No doctor would be able to get insurance if they continuously provided prescriptions without evaluating the patient for whom they are prescribing. 

 

My doctor doesn't even run my thyroid when I go in, he just runs regular labwork and then gets "concerned" when my white and red counts are out of whack. Um, I have no spleen, my counts are normal for me and I have no symptoms. Last time he sent me to the oncologist who really asked why I was even there, my bloodwork was normal for me. Yup, no thyroid tests. I can see once a year or more often if I have symptoms, but my doctor is pushing for every 3 months. 

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My prescription bottle tells me how many refills I have left.  If I'm out of refills, the pharmacy makes the first move by calling my clinic.  If it's for something that doesn't need testing and my doctor knows me well enough, then he/she will most likely approve of another round of refills with that phone call.  If it's something that needs once/year testing or some other evaluation (like my synthroid), then they may give me a month grace period, but will expect me to come in for a blood test or office visit during that time, before the next month comes up.  My pharmacy will clearly tell me this.

 

 

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Yes, it is very common for doctors to require that you see them regularly if you expect them to prescribe for you, even if it is a long term prescription. How else are they supposed to determine if the prescription is working as it is intended to work? Ask your doctor at your  next appointment how often you need to come in. If you aren't happy with the answer then ask if there are alternatives to that frequency of appointment. Most doctors will work with you within certain parameters. No doctor would be able to get insurance if they continuously provided prescriptions without evaluating the patient for whom they are prescribing. 

 

I'm not upset about having to go to the doctor. I am upset that they did not TELL me that I needed to come in, leaving me in the lurch with no remaining medication between my script running out and when I could get in. 

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I'm not upset about having to go to the doctor. I am upset that they did not TELL me that I needed to come in, leaving me in the lurch with no remaining medication between my script running out and when I could get in. 

 

Do your rx labels not have that line about the # of refills left? 

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I know there is a yearly visit (with blood tests) requirement. So I make my next appointment when I'm checking out. Yes, it may be silly to make an appointment a year in advance, but I put it on my calendar so I know I won't forget it. 

 

For some medications you have to visit more often in order to get the new prescription. It has been that way for at least 20 years (family member takes asthma medicine). 

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Our physicians tells us exactly how many refills are authorized & the pharmacy where we fill our rx keeps track.

 

When we are picking up our last refill, the pharmacist will tell us that was the last & that we need to see the dr for more. Usually they're dispensing 1-3 months of meds at a time so if that's the last, you have 1-3 months to make your appointment to see the doctor and get a new rx.

 

The # of refills available is also printed on the packaging label so you can see if there are any left. 

 

 

 

in the past my script was written for twelve months. This time it was for two months at a time, with the pharmacy faxing an authorization each time. If I call the doctor's office for a refill, they tell me to call the pharmacy to fax an authorization request. It might be more efficient for the office, but it means that I don't get notice if the doctor decides he wants me to come in sooner than usual. It's been about nine months since my last visit. 

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Disclaimer - I am on long-term meds and see the doctor twice a year.

 

I check the prescription bottle when I pick up my prescription.  If it says "zero refills remaining", I call in to the doctors office and set up an appointment if I don't have one already.   I tell the office when I call in that this appointment is because my Rx is out of refills.  Sometimes, I will get a call back later from the nurse telling me that I don't need to come in and they will refill the Rx, but usually I need blood work or something.

 

I used to do the "wait, call, wait, call, refax, wait, call" routine too, but it got stupid.  I find I waste less of my time and money by just going in for an appointment even if I have to pay out of pocket. 

 

This is a good idea. That way I don't have the "Surprise! I want to see you at sooner intervals but didn't tell you and now you're out! Ha ha!" problem.

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To reiterate: of course I don't have a problem with seeing a doctor to get a prescription.  :confused1:  It's just that when the doctor decides that I need to come in at a shorter interval than I have for the past few years to get a refill, but I never get the message and so run out completely, and can't get any to last until the next appointment because I already got a "grace refill," again, with no notice that this was the case, I get annoyed.  More than annoyed. I'm rather pissed off. And feeling sick because I've already missed several days of medication and have a few more days to go. 

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Edited by mellifera33
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To reiterate: of course I don't have a problem with seeing a doctor to get a prescription.  :confused1:  It's just that when the doctor decides that I need to come in at a shorter interval than I have for the past few years to get a refill, but I never get the message and so run out completely, and can't get any to last until the next appointment because I already got a "grace refill," again, with no notice that this was the case, I get annoyed.  More than annoyed. I'm rather pissed off. And feeling sick because I've already missed several days of medication and have a few more days to go. 

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:grouphug:  I've been there - it's no fun  :grouphug:

 

I had good luck in the past with calling in and talking to the nurse and getting them to call in a 10-day supply (or whatever) to get me through until my appointment.  I can do "totally pathetic loser" on a phone call and I think they feel sorry for me.....

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:grouphug:  I've been there - it's no fun  :grouphug:

 

I had good luck in the past with calling in and talking to the nurse and getting them to call in a 10-day supply (or whatever) to get me through until my appointment.  I can do "totally pathetic loser" on a phone call and I think they feel sorry for me.....

 

Yeah, I tried but was informed that I had already used up my "grace prescription" and I'm out of luck. Never mind that the "grace prescription" went directly to the pharmacy as a regular authorization and I thought I still had a few months until I was due for my annual where we usually talk about it. I guess I should have JAWMd this thread. 

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Edited by mellifera33
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I have Kaiser. I do pharmacy refills online and it says if the prescription needs a doctor's authorization to refill. That usually means I need to be seen again. Sometimes they'll refill it but put on the medication label that no more will be given until seen, but not always. I try to look at how many refills each prescription has to gauge when I need to be seen again to not have a break in my meds.

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This won't help the issue of your not having the needed meds right now, but if I were you, I'd talk directly to the doctor about it when I went in. I would think that doctors don't want patients missing necessary doses of medication. He needs to know that the procedure that's currently in place isn't giving patients the heads up when a grace Rx is being filled and an appointment needs to be scheduled. Sorry you're dealing with that and feeling ill as a result of missing meds.

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Just a little FYI-- (I agree with you BTW, that the office should have left you a message to schedule an appointment if they were giving you a 1 month supply to last until they could see you.)

 

I work in pharmacy....

 

 

Sometimes the doctor puts a personal note on the rx and expects the pharmacy to give the patient the message. Sometimes those messages get to the patient, sometimes they don't (for various reasons). Quite often the person in the pharmacy who reads the note, isn't the one putting their hands on the final copy of the receipt given to the patient. Pharmacy computer systems are not set up to send personal notes to the patient from providers about doctors appointment requirements. The one place I can put a personal note, will take about 30 characters in size 12 font, is in the middle of the receipt where the patient is unlikely to look at. Ever. 

 

The doctors office should never expect the pharmacy to be their message service, but some offices seem to think this is an appropriate way to delegate their office's message delivery system. It is not standard operating procedure, some doctors just try to pretend that it is. 

 

If your doctor tries to tell you that they sent the note to the pharmacy regarding you needing an appointment ASAP, please ask them to send you their personal messages regarding your appointments themselves, and to not rely on the pharmacy to be a middle person.  

 

 

 

At your appointment....Ask the MD how often they want to see you in the future and schedule an appointment before you leave.  Even if you don't know what your schedule will be like at that time, just get one on the books and then reschedule if needed.  That way you at least have a reminder. 

 

 

Also, any time the doctor gives you a refill, check the number of refills each time. It is on each bottle.  If the doctor gives you short supply of a maintenance medication, especially 2-4 weeks worth, that it a very, very good clue that they expect to see you before the next fill. 

Edited by Tap
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For an ongoing rx, I'd expect to see the dr yearly and be able to phone in a refill if necessary during that time. I'd expect a "grace" refill to cover the time between when I run out and the scheduled appointment. How far did you push it? No provider is going to phone refill much beyond a year without seeing the patient. If it was significantly less than a year and you can't get refills, I might change over that. I have no trouble getting refills as long as we're seen yearly. The rx bottles tell me how many refills I have so I can look there if I forget.

 

 

ETA: Ok, I see you're talking two month intervals. THAT would be annoying and worth switching, unless it's some sort of pain medication. I think ALL of the drs are being more careful with those now and I'd expect serious hoops.

Edited by KungFuPanda
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If it's something that is needed all the time, then they give enough refills to cover a year.  And he tends to be pretty generous so if I think ahead of time I can usually get 18 months in before I need to go back.  And if I need a refill called in I need to give them two full business days from when I call to request and when they will call it in. But that info is plastered all over the office...hence the fact that I know it even though I have rarely needed it done, lol.

 

A year might be a state law b/c when I had a script for birth control pills from Planned Parenthood, I had to be seen once a year to renew my prescription.

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it should say on the bottle how many refills (if any) you have.

My last dr would only write a scrip for three months - then I had to come in, and have labs, before she'd write a new one.  (the only dr out of three who did that since I started that rx.) nice money maker for her.  I found a new dr.

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I'm only on two medications and neither of them are the super highly regulated stuff. My doctor wants to see me every six months for my hypothyroidism, so I always go ahead and schedule the next appointment when I'm checking out. As long as I have an appointment scheduled they will go ahead and refill my medications. Usually she sends in new prescriptions at each appointment, but if we get to talking and she forgets it's no big deal. If I get down to 0 refills I just need to allow an extra day for the pharmacy to contact the doctor. But the big thing is having that next appointment scheduled.

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Change in government regulation has affected a couple of my husband's scrips. The pharmacist tells me if the doc office said he has to go in for an appointment. Once the appointment is scheduled I can get enough of a refill until the appointment.

 

It is kind of a pain but at the same time the doc needs to speak with you to make sure everything is working as it should.

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