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#916788 - 08/11/09 02:42 AM Re: Direct script paid w/insurance comes back to haunt... [Re: Bryan72577]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
oh god forbid DNA its bad enough my pain management doc does spuractic drug tests...strict too..if you have too much in your system youre in trouble....if you dont have anything they think your selling...so for example if we skip an afternoon pill 2days in a row b4 tests then it looks fishy!! Thankfully ive always come clean but still....its bad.
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#920428 - 08/21/09 02:49 PM Re: Direct script paid w/insurance comes back to haunt... [Re: GoogleRose]
PNWRain Offline
GRAND Pooh-Bah

Registered: 10/18/07
Posts: 1578
Loc: Eugene, OR
This whole thing just gets old, doesn't it? The thing is - it doesn't feel like it's for a patient's health. It's the "gotcha" syndrome.

If the attitude was different - drug interactions, etc - well I surely see the value in that. It is all about control issues. Hey, I'm a grown up the last time I looked in the mirror. Just gets old.

Guess we just have to hang in there and hope it will change. And the thing is - it is not only the US.

Legalize, tax, ensure purity, clean up the deficit. Hmmmm. A bunch of idiots.

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#920437 - 08/21/09 03:16 PM Re: Direct script paid w/insurance comes back to haunt... [Re: PNWRain]
jakeyr Offline
Enthusiast

Registered: 11/05/04
Posts: 265
Yup, using insurance came back to bite me in the a$$ as well so I don't use it for any type of scheduled meds any longer. I was receiving Tramadol from pcp and then had a bad tooth ache so I went to dentist. He prescribed hydro until I could see endodontist for a root canal. Saw endo over a week later and he prescribed more hydro for pain after root canal. They all 3 got a letter notifying them of everyone I was seeing and what was being prescribed. This was from express scripts, a$$holes. So now I only fill blood pressure meds from express scripts and if I get and type og narcotic I go to a different pharmacy that does not have my insurance info. But now I'm afraid I could get in trouble for phamacy shopping. Which I think is bogus anyway because pharmacies are always trying to get you to switch from the competitor by basically giving you gift cards and cash. I just got an offer from target for a $20 target gift card if I bring in a new prescription or switched over an old one. How can they bust you for using multiple pharmacies when pharmacies themselves are begging you to jump from one to another?

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#920442 - 08/21/09 03:31 PM Re: Direct script paid w/insurance comes back to haunt... [Re: jakeyr]
zzelda01 Offline
Member

Registered: 02/17/06
Posts: 118
Loc: USA
Why can't we check our own PMP data. Banks make mistakes, doctors make mistakes - who is to say the state doesn't make mistakes. Anyone have an answer?
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#920645 - 08/22/09 02:05 AM Re: Direct script paid w/insurance comes back to haunt... [Re: zzelda01]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
With my pcp, I can only get narcs there, I dont even see the script. She faxes downstairs. I have to drive there every 2wks (wont give a months worth) which is a pain in the butt!. And then before the pharmacy fills it they check on the computer (using your SSN) to make sure you havent gotten any narcs or benzo's etc filled somewhere else.....for instance ER etc. I broke my toe and told the ER i couldnt take a script. I had to suffer. She gave me nothing. And I only take Methadone for my back pain.only 10mgs x3 does nothing for acute pain. ALL dr's in the US are coming down to this cuz some people use it to get high. Sooo frustrating to those of us that need it!!
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#926859 - 09/07/09 09:56 PM Re: Direct script paid w/insurance comes back to haunt... [Re: GoogleRose]
Missy1 Offline
Journeyman

Registered: 11/22/07
Posts: 69
Loc: Beautiful Pacific NW
I work in Healthcare. I know Blue Cross definitely tracks your rx's and they go to the PCP. Or even urgent care docs where I work.
Where does HIPPA come in to play? The pharmacies make you fill out a form that you understand your health information is private. Does that only apply to certain meds?? As in not controlled substances and then we lose our rights? Does seem to be hypocritical IMO.

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#928690 - 09/12/09 03:33 AM Re: Direct script paid w/insurance comes back to haunt... [Re: Missy1]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
they dont even have us sign those hippa papers anymore. And as far as I know it applies to ALL of our meds. I just know that if I go to a specialist they have ALL your meds already on their laptops. Some meds that you dont even take anymore. So, yes we have zero,nada, zip rights!! They dont even have charts anymore. Im thinking because of all the time, cost etc to get copies of your files is a pain in the butt for them. All they need is the laptop. We are just #'s like press 1 for this option, press 2 for blah blah. BTW I used to be a NAC for many yrs till my back gave out on me lifting those darn patients. Hey missy i live in your neck of the woods...LOL NW I meant
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#928710 - 09/12/09 07:26 AM Re: Direct script paid w/insurance comes back to haunt... [Re: GoogleRose]
resorts Offline
Pooh-Bah

Registered: 01/11/05
Posts: 1159
Loc: Earth - Usually

Yup....and press "0" to Euthanize.

Originally Posted By: GoogleRose
they dont even have us sign those hippa papers anymore. We are just #'s like press 1 for this option, press 2 for blah blah.

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#932218 - 09/20/09 12:57 PM Re: Direct script paid w/insurance comes back to haunt... [Re: GoogleRose]
PNWRain Offline
GRAND Pooh-Bah

Registered: 10/18/07
Posts: 1578
Loc: Eugene, OR
Rosie, I'm a Pacific NWer too. Oregon.

We are not YET a PMP state, but I predict soon we will be.

Yes, insurance tracks your scripts. Anything can happen from that point. I never and I mean never, get my scripts (controlled or not) filled anywhere but at the same pharmacy. IMHO, if you go to more than one pharmacy, you get "labeled". Avoid that.

There is a code of conduct - with the doc, with the pharmacy. Adhere to it and the majority of the time you'll be OK. Yes, there are Ahole docs and pharmacists, but most are caring people who want to help. We, as patients, must do our part. In my wee mind, a contract with the doc should be on both ends. The patient agrees and signs and the DOC has a contract too. No, I live in the same world as y'all, lol.

Good to "meet" another PNWer.

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#932316 - 09/20/09 04:39 PM Re: Direct script paid w/insurance comes back to haunt... [Re: PNWRain]
Tiades Offline
Pooh-Bah

Registered: 09/14/07
Posts: 1174
Loc: West Coaster
Remind me what PMP stands for. My brain is useless these days!
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#932467 - 09/21/09 01:49 AM Re: Direct script paid w/insurance comes back to haunt... [Re: Tiades]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
LOL old hand.......PMP? Search me your guess is as good as mine and your an "old timer" LOL sorry couldnt resist!! Go ahead wet noodle for that one.

Rain. Im the same way about pharmacy's. I go to my pcp pharmacy for the narc....then the mom and pop for all my maintance meds (they deliver). Been going to the same mom and pop for 10yrs. They all know me by name lol. I refuse to go to the ER unless forced to by my pcp. I dont want to be "flagged". I know someone who used to go 1x a week for shots, scripts etc. She is flagged now. Er cannot refuse to see you but the very least they give out Ibuprofins. If I have to go for my chf they treat me like gold cuz Ive often refused scripts. So they drug me up via IV write in the chart I refused script. And the ER gets so excited about it LOL......oh why do I always go off topic!!!!
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#932512 - 09/21/09 08:35 AM Re: Direct script paid w/insurance comes back to haunt... [Re: GoogleRose]
jakeyr Offline
Enthusiast

Registered: 11/05/04
Posts: 265
PMP stands for prescription monitoring program.

Somehow though our info has been being kept track of for a long time even before pmps. I have a friend who's parents just applied for private health insurance because they are self employed and they were questioned about prescriptions they took 25 years ago. I guess at one point they thought my friend's mother had lupus and she was taking a bunch of differnt meds for it, but like I said this was like 25 years ago and the insurance company had all of this info handy to decide wether or not they were going to provide them with health insurance. I was floored by this information.

I can only see this getting worse if the government is in charge of our health care. Although, I did hear Obama say that maybe taking the pain medication was a better option than surgery because of costs, so who knows!!!

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#932517 - 09/21/09 08:50 AM Re: Direct script paid w/insurance comes back to haunt... [Re: jakeyr]
stevo1 Offline
GRAND Pooh-Bah

Registered: 08/08/06
Posts: 2767
Loc: Top of The World!
MIB Group, Inc. ("MIB") is a membership corporation owned by approximately 470 member insurance companies in the US and Canada. Organized in 1902, MIB's core fraud protection services protect insurers, policyholders and applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability income, critical illness and long-term care insurance.

This is where the Info came from!!!!
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#932520 - 09/21/09 08:58 AM Re: Direct script paid w/insurance comes back to haunt... [Re: stevo1]
jakeyr Offline
Enthusiast

Registered: 11/05/04
Posts: 265
Jeez, How does this MIB get our info? I would assume the way they get it is because all of the different insurance companies conspire and share information with eachother so they know about everything we have ever used our insurance for. So this goes back to the question of if we don't use our insurance to fill a script, is there any way this mib would know about the prescription? Or can they access the pmp data as well? Thanks for the info Stevo!

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#932589 - 09/21/09 11:21 AM Re: Direct script paid w/insurance comes back to haunt... [Re: jakeyr]
stevo1 Offline
GRAND Pooh-Bah

Registered: 08/08/06
Posts: 2767
Loc: Top of The World!
jakeyr....I don't know how they get all their info....But you can request your MIB report! ...Or so I thought I saw that on their Web Site!!
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#932598 - 09/21/09 11:38 AM Re: Direct script paid w/insurance comes back to haunt... [Re: stevo1]
Tiades Offline
Pooh-Bah

Registered: 09/14/07
Posts: 1174
Loc: West Coaster
That would be a nice report to have. MIB! Anyone else immediately think of Men In Black?
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#932894 - 09/22/09 12:00 AM Re: Direct script paid w/insurance comes back to haunt... [Re: Tiades]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
LOL old hand.....yes I loved that movie.....especially Will Smith!!!! Stevo! Explain in English please Im being a dumb redhead here LOL j/k. I dont know about the MIB thing but I do know that with modern technology all pharmasist and dr and ins co have their ways of find out stuff. Gvt issues. About 5yrs ago I went to Cali to visit my parents and one of my scripts was due while I was there. It was a pain in the butt cuz the pharmacy had to call the pharmacy here in WA (I had re-fills for Soma) plus have to pay cash, ins wont cover. They were trying to re-fill a script from my reg pharmacy and it was a HUGE orderdeal. They had to wait for the pharmacy to fax over info........then they had to wait for the OK from the the state of CA for me to get it filled there instead of WA. It took 2 days for all that to happen.

Finally got that done. When I got back home I still had 1 more re-fill left and went to my mom and pop pharm asked if they can transfer it back. Nope once transfered re-fill was null and void here. Luckily my pcp understood and re-filled for here.


So, is that what MIB refers to? I dont know.
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"beware of those minions" I like to hunt them down!

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#935154 - 09/25/09 11:23 PM Re: Direct script paid w/insurance comes back to haunt... [Re: Bryan72577]
lmarie43 Offline
Stranger

Registered: 09/07/09
Posts: 5
what are HIPPA laws for this is a crock of bull. I am from alabama too and I do not think it is right that an insurance company can give your pcp all your info. Can they give it to your job too?

I though we were protected through HIPPA looks like it just gives them more permission to screw with us! It is said for people with CP issues to have to go through all this bull just to get the treatment we need and DESERVE.

THANKS FOR LETTING ME VENT.

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#937253 - 10/01/09 03:48 AM Re: Direct script paid w/insurance comes back to haunt... [Re: lmarie43]
GoogleRose Offline
Pooh-Bah

Registered: 07/19/09
Posts: 1281
Loc: NW USA
There is no more hippa law. Its all about the DEA ever since the Ryan thingy. I dont believe they can give your personal info to your job cuz you could claim a major law-suit. Unfortunatly the Gvmt knows EVERYTHING about us!! Even spying on the boards. Mums the word unless you want to get an LL. LOL....Oh no they are tapping our phones too!! LOL send me to the looney bin for a vacay. LOL J/K couldnt resist. Vent all you want, well maybe not on this thread tho. Im still learning the ins and outs too.
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"beware of those minions" I like to hunt them down!

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#948294 - 10/23/09 05:38 PM Re: Direct script paid w/insurance comes back to haunt... [Re: lmarie43]
91791627 Offline
Journeyman

Registered: 12/11/05
Posts: 88
Insurance companies can get information from your doctor, because you, or more likely, your doctor is charging them money to take care of you. Insurance companies will send letters to doctors under the guise of "caring about you" and ask the doctor to change medications (like from a brand to a generic), take you off of medications, and send lists with all the medications you have had filled in the last 6 months and all the makes of prescribing doctors. They say this is to help the patient. Not really, it is to let the doctor know if you are doctor shopping or going to the ER often. It is also intended to reduce the number of medications people take so they spend less money. After all, most insurance companies are out to make a profit.

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#948301 - 10/23/09 05:47 PM Re: Direct script paid w/insurance comes back to haunt... [Re: 91791627]
Tiades Offline
Pooh-Bah

Registered: 09/14/07
Posts: 1174
Loc: West Coaster
[quote=91791627. After all, most insurance companies are out to make a profit. [/quote]
rofl5
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#954146 - 11/03/09 01:15 AM Re: Direct script paid w/insurance comes back to haunt... [Re: 91791627]
winterlong1 Offline
Board Addict

Registered: 07/10/04
Posts: 355
Loc: mid atlantic
Originally Posted By: 91791627
Insurance companies can get information from your doctor, because you, or more likely, your doctor is charging them money to take care of you. Insurance companies will send letters to doctors under the guise of "caring about you" and ask the doctor to change medications (like from a brand to a generic), take you off of medications, and send lists with all the medications you have had filled in the last 6 months and all the makes of prescribing doctors. They say this is to help the patient. Not really, it is to let the doctor know if you are doctor shopping or going to the ER often. It is also intended to reduce the number of medications people take so they spend less money. After all, most insurance companies are out to make a profit.


ha...yet another reason why i should be glad i've never gone with a "mailed script" and used my Rx card.

given some of my other conditions (HBP, asthma, migraines), i'd be soooo in trouble if my dr. got letters because i'd filled stuff from someone else for the same condition.

at least my insurance (and Rx card) is through my husband; my job won't ever see that. but my dr....that's a really scary thought.
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#954902 - 11/04/09 08:28 AM Re: Direct script paid w/insurance comes back to haunt... [Re: winterlong1]
WarVet Offline
Member

Registered: 08/30/09
Posts: 193
Now this is insane - just like the book 1984. Big brother is indeed watching.

Here's a scenerio I wonder if they ever thought about....

You are out of town and get injured. Instead of going to the ER, you go to an urgent care center or a doctor that was referred to you by a friend, relative, etc. After the doctor examines you, writes the script, etc you come to find out that he does not accept your insurance. So you pay him cash.

When you get the script filled, the pharmacy accepts your insurance so you use it.

Would that flag you as a "drug abuser"??

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#955014 - 11/04/09 10:57 AM Re: Direct script paid w/insurance comes back to haunt... [Re: WarVet]
tammy390 Offline
Board Addict

Registered: 08/11/02
Posts: 320
Loc: Florida
Insurance companies can get info from the big pharmas directly. 3 years ago when I applied for health insurance with a new company they called to let me know about all the perscriptions that I had filled during the course of several years. They were at Walmart, walgreens, ect. I had not used insurance and paid cash. When I asked how they got this information they said that it is common practice to run your name through the big name pharmacies to see what meds you have been taking. And the pharmacies give out this information. Like I said, No insurance, primary care Dr had no record of these meds, got them direct script, paid cash and the insurance company knew, they knew everything.

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#955090 - 11/04/09 12:55 PM Re: Direct script paid w/insurance comes back to haunt... [Re: tammy390]
Tiades Offline
Pooh-Bah

Registered: 09/14/07
Posts: 1174
Loc: West Coaster
That's not good news that insurance can do that.
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#955276 - 11/04/09 04:57 PM Re: Direct script paid w/insurance comes back to haunt... [Re: WarVet]
Sweetz Offline
Diamond Mind
GRAND Pooh-Bah

Registered: 05/11/02
Posts: 1843
Loc: Texas!
Originally Posted By: WarVet
Now this is insane - just like the book 1984. Big brother is indeed watching.

Here's a scenerio I wonder if they ever thought about....

You are out of town and get injured. Instead of going to the ER, you go to an urgent care center or a doctor that was referred to you by a friend, relative, etc. After the doctor examines you, writes the script, etc you come to find out that he does not accept your insurance. So you pay him cash.

When you get the script filled, the pharmacy accepts your insurance so you use it.

Would that flag you as a "drug abuser"??


Your doctor may very well see it and think that. I had to call the after hours call line once and the partner of my doc called in a small script for me. My doc saw it on the letter sent and almost dismissed me. Apparently the partner never told my pcp she called in an emergency script for me. This was over 5 yrs ago.

My doc now gets a letter too. I know because she mentions meds my psych gives me. I never act freaked out about it, just act like it's nothing, but it pisses the hell outta me!
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#955283 - 11/04/09 05:02 PM Re: Direct script paid w/insurance comes back to haunt... [Re: Sweetz]
Tiades Offline
Pooh-Bah

Registered: 09/14/07
Posts: 1174
Loc: West Coaster
I hear ya Sweetz!
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#956719 - 11/06/09 05:14 PM Re: Direct script paid w/insurance comes back to haunt... [Re: Tiades]
jackie01 Offline
Enthusiast

Registered: 07/05/05
Posts: 265
I also used my insurance for a direct script a long time ago but I have been in a ER since then and not had a problem.

I live in the great state of TN.

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#993036 - 01/16/10 05:29 PM Re: Direct script paid w/insurance comes back to haunt... [Re: jackie01]
TraxLink
Unregistered


I hate to sound like such a newbie when it comes to this all.

I have insurance with a big-name company. If I ordered Tramadol from Friendly and used a debt-visa that I have (rather than my insurance), how exactly will it show up with my insurance company?

Just because of where I sent it?

I know about PMP's but my state doesn't have one where I live.

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#993046 - 01/16/10 06:07 PM Re: Direct script paid w/insurance comes back to haunt... [Re: ]
pnfree Offline
Board Addict

Registered: 11/04/09
Posts: 374
Loc: midwest
Friendly does not bill your insurance or report to your insurance company. If your doctor or insurance company was checking out what meds you have been on what you get from Friendly would not be available to see. Technically what you order from Friendly is against the law because you need a prescription in the USA. Don't worry your debit visa will not be able to report it either because they can't tell what you are ordering by who it is charged to.

Don't worry your insurance and doctor will not know what you have ordered.
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