Shoreline
10-27-2003, 10:12 AM
HI PR, For some reason I'm not able to respond on your thread but thought I would explain about partial fills. Your pharmacist has actually gone way out on a ledge risking sanctions and not having his C-2 logs being accurate. Although more often than not we are told that partial fills cannot be done on C-2 medication. This is not true. A partial can be done as long as it's completed within 72 hours. To have his C-2 logs off for over 2 weeks places the pharmacist under the gun. Having an overage of C-2 is just as bad as having a shortage. Dispensing more according to the computer than he actually has on hand is just as bad as being caught short.
When he completes this fill the bottle should either not have a label since these are already billed meds or should have a copy of the original label on it. You have done nothing wrong by excepting a partial fill but the pharmacist is left hanging with his cheeks flapping in the wind.
He can't reconcile his C-2 log as long as this discrepancy remains on the books. So having the owed meds dispensed on the same day you fill your new script does not draw attn. to you, but rather draws attn. to your pharmacist as it looks like he's cooking the books to hide discrepancies.
You shouldn't feel bad about picking up your remaining meds nor should you feel bad about picking up your new script. It's really not his buisness how you got by.
For folks that a pharmacist has been decent enough to allow a partial fill should be picked up as soon as possible so the Rph can reconcile his books, Leaving an IOU for C-2's in his pharmacy can cause him problems not you.
If he billed your insurance for more than you received than he has committed fraud especially since the 72 hour time frame has elapsed. He can't kill the remainder of that script because he has already billed you. He's the one in sticky territory.
Certainly be grateful that your pharmacist was willing to go through the headache and follow up on a partial C-2 and let him know you appreciate it. After this experience he may be a little less inclined to do a partial fill though.
Next time you speak let him know you will pick them up as soon as they arrive so that he can clear his books. In my state C-2 counts have to be done weekly and turned into the Board of pharmacy, the DEA and the store national headquarters. So his inaccurate log will more than likely cause him a problem before it causes you one. It would be best to complete both transactions, the pick of the partial and the new fill with the same pharmacist to prevent another hand in the pot trying to figure out why the log is off.
Partial fills are meant for when the truck is due the next day and they know they can complete the fill. They cannot mix a name brand med and a generic. They have different costs and it creates a problem when billing the insurance. Just like they can't give you twice as many 15 mgs Roxicodone tabs if they don't have the 30mg tabs that were prescribed. They would need an entirely new script to do this.
IF he wrote on the bottle and crossed out the quantity and wrote the number dispensed you have all the proof you need that you have done nothing wrong and the Rph, if he was going to take action should have rebilled the script immediately after the 72 hours time frame had passed and kill the remaining pills you did not pick up, By rebilling he has not committed fraud with the insurance company by billing them for more than you recieved. believe it or not, you are in the cat birds seat at this time.
Just let him know you will pick up the remainder the day they come in so he can reconcile his books.
That remainder has nothing to do with a new script. The day supply was calculated and billed when he filled the original script so you wouldn't be Picking up anything early according to the insurance or the computer.
# of days supply is calculated when each new script is filled so regardless of when you pick up the remainder, your original day supply stays in tact and you can fill when that # has been depleted regardless of when you pick up the IOU.
As you see this gets very complicated and can see why so many patients are told by pharmacists they can't do partial fills on C-2 when in fact there is a legal provision but still leaves the Rph's books inaccurate until the fill is complete.
Take care, Shore
When he completes this fill the bottle should either not have a label since these are already billed meds or should have a copy of the original label on it. You have done nothing wrong by excepting a partial fill but the pharmacist is left hanging with his cheeks flapping in the wind.
He can't reconcile his C-2 log as long as this discrepancy remains on the books. So having the owed meds dispensed on the same day you fill your new script does not draw attn. to you, but rather draws attn. to your pharmacist as it looks like he's cooking the books to hide discrepancies.
You shouldn't feel bad about picking up your remaining meds nor should you feel bad about picking up your new script. It's really not his buisness how you got by.
For folks that a pharmacist has been decent enough to allow a partial fill should be picked up as soon as possible so the Rph can reconcile his books, Leaving an IOU for C-2's in his pharmacy can cause him problems not you.
If he billed your insurance for more than you received than he has committed fraud especially since the 72 hour time frame has elapsed. He can't kill the remainder of that script because he has already billed you. He's the one in sticky territory.
Certainly be grateful that your pharmacist was willing to go through the headache and follow up on a partial C-2 and let him know you appreciate it. After this experience he may be a little less inclined to do a partial fill though.
Next time you speak let him know you will pick them up as soon as they arrive so that he can clear his books. In my state C-2 counts have to be done weekly and turned into the Board of pharmacy, the DEA and the store national headquarters. So his inaccurate log will more than likely cause him a problem before it causes you one. It would be best to complete both transactions, the pick of the partial and the new fill with the same pharmacist to prevent another hand in the pot trying to figure out why the log is off.
Partial fills are meant for when the truck is due the next day and they know they can complete the fill. They cannot mix a name brand med and a generic. They have different costs and it creates a problem when billing the insurance. Just like they can't give you twice as many 15 mgs Roxicodone tabs if they don't have the 30mg tabs that were prescribed. They would need an entirely new script to do this.
IF he wrote on the bottle and crossed out the quantity and wrote the number dispensed you have all the proof you need that you have done nothing wrong and the Rph, if he was going to take action should have rebilled the script immediately after the 72 hours time frame had passed and kill the remaining pills you did not pick up, By rebilling he has not committed fraud with the insurance company by billing them for more than you recieved. believe it or not, you are in the cat birds seat at this time.
Just let him know you will pick up the remainder the day they come in so he can reconcile his books.
That remainder has nothing to do with a new script. The day supply was calculated and billed when he filled the original script so you wouldn't be Picking up anything early according to the insurance or the computer.
# of days supply is calculated when each new script is filled so regardless of when you pick up the remainder, your original day supply stays in tact and you can fill when that # has been depleted regardless of when you pick up the IOU.
As you see this gets very complicated and can see why so many patients are told by pharmacists they can't do partial fills on C-2 when in fact there is a legal provision but still leaves the Rph's books inaccurate until the fill is complete.
Take care, Shore
Sponsor
igy76
10-27-2003, 11:39 AM
Hey, I just wanted to add on this topic for what it's worth that I too have gotten partial refills multiple times in the past on opiate meds. Now that I think about it, I don't think it's happened here in PA yet, the only times were when I still lived in CA. But I'd say of all the RX's I ever had, maybe 5-6 were partials (and not all at the same pharmacy... keep in mind I'm talking over a span of 2 years). And it was never even a question, they told me "oh, we're doing this for you, we don't have the full amount of that in now, but you can have this amount now and get the rest later." The strongest med I ever had that done with was OxyIR, the day when my doc first RXd OxyContin and 100 OxyIR's for BT, the pharmacist only had about 45 of them on hand. He gave me all of them, scratched out 100 on the bottle, wrote in 45 and then the rest were ready to be picked up in 3-4 days. AND, I was told I didn't even have to pay for the RX until I received the balance of the meds.
Shoreline
10-27-2003, 03:46 PM
Just to be clear I was speaking of partial fills on class 11 meds only. They can do a partial on a class 111 or IV and have no time restraints in which to complete it.
But when they did the partial of the OxyIR for Igy they did do something that many pharmacist would not want to bother with the follow up and descrepencies in their counts. You have run into some good pharmacists Igy and PR.
Take care, Shore
It does stink knowing the law and having a jerk RPH tell you he can't do a partial even when the truck is coming the next day. My PM docs practice has grown to the point that they now have incorporated a new section of their PM contract that reads if you except a partial fill we are not bound to write a new script for the replacement.
These contracts are getting rediculous. Won't replace but don't use a different pharmacy. When you need 450 10mg Meth tabs a month it does get difficult. Especially during a huricane when there is no power or an open store for miles.Trucks stopped running and the phone line to the PM was down and the tunnel to his part of town was filled with water. Some things can't be avoided or acounted for by a contract.
I have a feeling the last huricane caused many partial fills which creates extra work. Imagine asking a doctors office to actually do a little extra work.LOL
Shore
But when they did the partial of the OxyIR for Igy they did do something that many pharmacist would not want to bother with the follow up and descrepencies in their counts. You have run into some good pharmacists Igy and PR.
Take care, Shore
It does stink knowing the law and having a jerk RPH tell you he can't do a partial even when the truck is coming the next day. My PM docs practice has grown to the point that they now have incorporated a new section of their PM contract that reads if you except a partial fill we are not bound to write a new script for the replacement.
These contracts are getting rediculous. Won't replace but don't use a different pharmacy. When you need 450 10mg Meth tabs a month it does get difficult. Especially during a huricane when there is no power or an open store for miles.Trucks stopped running and the phone line to the PM was down and the tunnel to his part of town was filled with water. Some things can't be avoided or acounted for by a contract.
I have a feeling the last huricane caused many partial fills which creates extra work. Imagine asking a doctors office to actually do a little extra work.LOL
Shore
pain research
10-27-2003, 11:20 PM
Shoreline, I am so very grateful for your wise and intelligent advice. That was just the sort of in-depth answer which I needed, and which fascinates me.
I had a problem with a doctor a couple years ago, simply because I asked for a specific drug. I didn't know all the secret unwritten unknowable rules. Unfortunately, we learn this stuff after the fact, and in our situation, we can't afford that. So I am doubly grateful to you.
Thanks also to Igy.
I had a problem with a doctor a couple years ago, simply because I asked for a specific drug. I didn't know all the secret unwritten unknowable rules. Unfortunately, we learn this stuff after the fact, and in our situation, we can't afford that. So I am doubly grateful to you.
Thanks also to Igy.
Mo7609
10-28-2003, 10:19 AM
I wonder why some pharmacys won't do a partial fill and some will. I have to call my pharmacy every month and let them know that they need to order my meds for the next week. I ran into a problem the first time I got my new script for oxycontin and I wasn't able to get them for a few days and even though they had some they wouldn't do a partial not even 4 until my script came in. I was miserable to say the least! I did have no problems getting my BP meds filled partially though. I guess since we are dealing with a class 2 med it is up tp the individual pharmacist. Anyways I am babbling now. Have a great day. http://www.healthboards.com/ubb/heart.gif Mo
susieq03
10-28-2003, 02:53 PM
I read this post with interest. When I went in to have my script of Oxycontin and of ms contin ir, they said they didn't have enough of either med and gave me a slip, saying that they owed me meds and wouldn't charge for it. They said it would be about a week until they had the rest. Should i be concerned? This has happened before but never thought about it. Thanks for the advice, SusieQ
chriztene
10-29-2003, 08:22 AM
Wow, it amazes me on how informative this board is! Yes, those of you whose pharmacist gives you a partial are very fortuante indeed.
These are great issues discussed. I had never thought of a hurricane and some of the other issues posted such as the pharmacy filling large amounts.
I try and get my rx's on the 27th as the pharmacy isnt out of the oxy's. I have noticed if I get them filled on the 29th, sometimes they are out of them. I recall one time they only had part of the rx and told me I either had to wait until the remainder came in - or they could rx me what they had, period.
Of course going to another pharmacy is out of the question:*( I really am disheartened at the restrictions being placed on us chronic pain sufferers. I have always thought the only people who have them - are the ones who dont need them...I havent figured that one out yet.
Thank you all for the great advice/information.
~C
These are great issues discussed. I had never thought of a hurricane and some of the other issues posted such as the pharmacy filling large amounts.
I try and get my rx's on the 27th as the pharmacy isnt out of the oxy's. I have noticed if I get them filled on the 29th, sometimes they are out of them. I recall one time they only had part of the rx and told me I either had to wait until the remainder came in - or they could rx me what they had, period.
Of course going to another pharmacy is out of the question:*( I really am disheartened at the restrictions being placed on us chronic pain sufferers. I have always thought the only people who have them - are the ones who dont need them...I havent figured that one out yet.
Thank you all for the great advice/information.
~C
igy76
10-29-2003, 10:05 AM
Well I just wanted to say that I guess I realize now how lucky I've been. I've been to 3 different PM docs in my life (2 in CA, 1 here in PA), and while yes I had to sign the usual contract with the basic rules, never once among the three did it strictly say that I had to use the same pharmacy (not that I would've used this ability to do anything bad). I just went to where it was convenient for me at the time, and not just different branches of the same one (and in Los Angeles Sav On is a huge drugstore chain), but other companies altogether.
Shoreline
10-30-2003, 11:35 AM
Hey I'm allowed back. Having AOl really makes it tough to post sometimes. The forum just isn't designed to be compatible with my ISP the way blocks if ISP numbers get banned. If you have AOL, don't give up on posting, just sign off and try again, and always save your post as an unsent email just in case. Enough of that ramble.
Anyway, The only time I have seen someone have a problem with using more than one pharmacy was when they were told they could not do a partial fill.
This one person was able to fill their base med but had to take their BT med to a competitor, that or do without until they could fill the script all at once or except what the pharmacy had and hope the doc would rewrite the script for the balance of the BT med.
So this person had to take their BT med somewhere else or deal with the hassles of trying to get a new script for the balance of the partial fill. So she figured what was the harm in taking her BT med elsewhere. It turned out that the PIC, pharmacist in charge, and there is always one designated responsible for each store. Had a question about the base med the on-duty pharmacist had filled the previous day.
When The pharmacist called the PM doc to confirm some info on the med they filled, the doc asked did he have the same problem with the way he wrote the BT med. The pharmacist said we didn't fill a BT med.
ON the patients next scheduled visit the BT med was taken away because the doc figured you didn't fill it so you must not need it, or that they had filled it at another pharmacy for some diversionary reason. Sold the script to someone or whatever he had imagined. The patient lost their BT med over the pharmacy she had used for years not being willing to do a partial fill and telling her to except what they had or nothing at all.
Even knowing the laws doesn't help. It comes down to the pharmacist on duty as to whether to do a partial fill or not. The willingness to do a little extra work and follow up and make sure the partial fill was completed in the allotted amount of time the board of pharmacy allows.
There is some variation from state to state regarding filling prescriptions, partial fills, the need for triplicates and what not. You can check your own state at this EDU site Just click on your state. http://www.medsch.wisc.edu/painpolicy/matrix.htm
Unfortunately the ultimate decision to fill a prescription, regardless of how legit and how long you have taken the same med, filled at the same place, is still up to the pharmacist on duty. I've seen pharmacist just flat out refuse scripts because they believe the quantity or dose is excessive or they feel the patient doesn't need the med.
Pharmacists have a tremendous amount of control over whether you get your prescribed meds or not. So once you find a good RpH, develop a relationship so that you will get your scripts filled regardless of what kind of day the RpH is having.
Take care, Shore
[This message has been edited by Shoreline (edited 10-30-2003).]
Anyway, The only time I have seen someone have a problem with using more than one pharmacy was when they were told they could not do a partial fill.
This one person was able to fill their base med but had to take their BT med to a competitor, that or do without until they could fill the script all at once or except what the pharmacy had and hope the doc would rewrite the script for the balance of the BT med.
So this person had to take their BT med somewhere else or deal with the hassles of trying to get a new script for the balance of the partial fill. So she figured what was the harm in taking her BT med elsewhere. It turned out that the PIC, pharmacist in charge, and there is always one designated responsible for each store. Had a question about the base med the on-duty pharmacist had filled the previous day.
When The pharmacist called the PM doc to confirm some info on the med they filled, the doc asked did he have the same problem with the way he wrote the BT med. The pharmacist said we didn't fill a BT med.
ON the patients next scheduled visit the BT med was taken away because the doc figured you didn't fill it so you must not need it, or that they had filled it at another pharmacy for some diversionary reason. Sold the script to someone or whatever he had imagined. The patient lost their BT med over the pharmacy she had used for years not being willing to do a partial fill and telling her to except what they had or nothing at all.
Even knowing the laws doesn't help. It comes down to the pharmacist on duty as to whether to do a partial fill or not. The willingness to do a little extra work and follow up and make sure the partial fill was completed in the allotted amount of time the board of pharmacy allows.
There is some variation from state to state regarding filling prescriptions, partial fills, the need for triplicates and what not. You can check your own state at this EDU site Just click on your state. http://www.medsch.wisc.edu/painpolicy/matrix.htm
Unfortunately the ultimate decision to fill a prescription, regardless of how legit and how long you have taken the same med, filled at the same place, is still up to the pharmacist on duty. I've seen pharmacist just flat out refuse scripts because they believe the quantity or dose is excessive or they feel the patient doesn't need the med.
Pharmacists have a tremendous amount of control over whether you get your prescribed meds or not. So once you find a good RpH, develop a relationship so that you will get your scripts filled regardless of what kind of day the RpH is having.
Take care, Shore
[This message has been edited by Shoreline (edited 10-30-2003).]