Paying cash for a narcotic prescription

A red flag, says The Angry Pharmacist:

Whenever someone who usually uses insurance comes to you with a narcotic and demands to pay cash, something isnt right. I always do a courtesy run-through to see what the magical insurance company pops up with. 9 times out of 10 they received some narcotics from another doctor and another pharmacy.

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  • Anonymous

    The attitudes shown on the referenced blog also show why there is no confidentiality once a RX is filled.

    I had a doc who needed an antidepressant as a patient. The big clinic/hospital that he worked for also owned the insurance company, and he was in a political struggle within the administration. Given a history of personal destruction as a political tool, he didn’t trust them to not use his medical care history against them.

    So he paid privately in cash for the treatment, and then went to a different pharmacy than his usual one, gave them no insurance information and paid cash for the prescription.

    The pharmacy somehow uploaded the information to the insurance company anyway, where it was tapped by administration.

    His investigation uncovered all this after he was beat over the head and insulted with his “mental disability” as evidenced by taking prozac during a contentious meeting with his medical director.

    Stopping drug addicts is all well and good, but the patient’s right to privacy and need for it is not obviated by the “war on drugs”—and he shouldn’t have to give that up to stop addicts from gleefully killing themsleves. I understand where the pharmacist is comming from. The state puts him in the position of policeman. But it shouldn’t be like that. We shouldn’t have to go to a policeman for our medical care.

    Regarding these databases to catch pill poppers—anyone who doesn’t think that is going to be used sometimes by snoops to personally or politically destroy enemies fell off the turnip truck yesterday. It’s very existence creates a barrier to legitimate medical care for some.

    Anyone thinks that Rush Limbaugh wasn’t a political target? Notice how they used search warrants rather than supoenas to get his records? Remember the viagra incident–cleary a deliberate ploy to use his (non-controled) med use to embarass him.

    Any number of public and not so public characters have legitimate reason to fear filling something so benign as Prozac, viagra, or a properly used opiate RX in the information juggernaut that the pharmacy industry has created.

  • Anonymous

    that should not be pinned on the pharmacy. its not their fault that someone inside of the insurance company violated HIPPA and got a hold of a patient’s info. theres no way to blame a pharmacy to following laws and regulations. the original post by the pharmacist is talking about narcotics anyway. the pharmacist isnt in the position of policeman. its following the law. if they DEA (the real policemen) come into a pharmacy and notice that drugs were paid for in cash when the patient has active insurace (ESPECIALLY if it is a narcotic or ANY rx), massive red flags go up and people get canned. dont say the pharmacy is at fault for billing insurance companies and especially when people at the insurance companies are dicks and leack info. the pharmacy didnt leak the patients. they followed laws and regulations. it totally sucks for that doc but he should be pissed at the people in the insurance biz for ratting on him.

  • Anonymous

    Something does not add up in this story. When a pharmacy fills a Rx, they can no more guess the insurance information than a physicians office could. What are the chances anyone could guess the right plan out of the thousands that are available and then guess the 10 digit ID number and group number. Not likely… So if the pharmacy did already have the insurance information and submitted it like any other claim, the insurance company would then have it on file on their system. However, if the patient filling the Rx says hey this was on my insurance and I don’t want it to be, the pharmacy would simply reverse the claim. If the insurance company keeps this information and it was used inappropriately, it is definitely a violation of HIPPAA. It seems to me there is something more to this story. In short, don’t blame this on the pharmacy.

  • Anonymous

    actually, as a pharmacist i can tell you my staff can figure out anybody’s insurance within an hour. how is complicated but we rarely need a card if the patient has lost it or something. insurance companies offer screening for disease and drug contraindications as well as payment for prescriptions. so yes we will try hard to bill your insurance as our contract with these plans demand we do.

    and yes, any healthcar provider using insurance/medical information for purposes other than providing relevant care is clearly in violation of the law and should be sued.

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