Re: Pain pill refill
Hi, this is my first post but I did not join to answer this post I joined for another reason but happened to see this.
In my experience they will always fill (the insurance company). A change in medication even if it is early. Example's given 50 to 75 fentanyl, or 75 to 100, one type of pain med to another type, ambien to ambien er, if it is a change they will almost always approve it.
As for a pain management physician though they may be VERY specific as to an agreement with you (usually in writing) about how/when you refill your medications. If you are on a 30 day schedule with a PMP do not mess around with them. If you received your medication from any other kind of Dr just make sure you follow any rules they gave you.
As far as filling it though once that script is in your hand the pharmacy will usually fill it and as long as it is a different dosage or medication your insurance will usually approve it.
I know some insurance agencies are VERY nit picky but that is to nickel and dime you to death. My insurance agency even approved the change from generic fentanyl suckers to name brand pills that go in your cheek after 1 week and the pills are not cheap.
Also as far as the watching it part... nobody watches it really unless you have an agreement with a PMP that allows them to communicate with the pharmacy which any good PMP that pushes C2s is going to have.
As for any other situation once the script is in hand the only watching is if the pharmacy thinks the script is fake (stolen/forged pad) then they call the cops and ask you to wait while they process it.
The insurance company can't stop you from filling anything they just don't have to pay for it you always have the option of paying full price.
Last edited by murphwi; 02-28-2013 at 10:11 AM.