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Question on Refill Protocol

jeauxbertjjeauxbert Posts: 953
edited 06/11/2012 - 8:27 AM in Pain Medications
Last month, when I called my doctor's office for my refill, I heard a message stating I had to call an 866 number to get the refill.

So, I did. And the gent took all my information down, including insurance information, etc. He said he would contact my doctor and gave me the name of a pharmacy that would fill it. I thought okay, this is where I get my parents' meds; they will actually mail the medication to your home, but someone has to be there to sign for the package. We are never home, so I told the gent to let them know I would pick up my medication (I pick up my mom/dad's as well).

Later that day, I got a call; it was a recorded message stating that my refill had been approved and to follow normal refill instructions.

According to the PM office, this is what everyone is doing so the nurses can spend time attending to issues patients have and not so much on medication refills.

I have began having problems with this pharmacy not filling on time; I called last Wednesday so my MSContin could be picked up yesterday; the refill was approved on Wednesday. Thursday, the pharmacy still had not received the written script and told me it would not be ready until Monday. Well, Monday (yesterday) at 4:45 they STILL did not receive the written script. This happened to my mother in January with the same medication.

I am contacting my doctor's office (and hers) to find out what I need to do to have everything transferred to my little neighborhood pharmacy. I can't have this happening every month. My MSContin should have been filled yesterday; today I am not a happy camper as I have not had my morphine.

I was just wondering if anyone else has had to go through this change with their PM refills?

Thanks - hope you all have a great day!

Jeaux
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1

Comments

  • HI Jeaux, I don't get refills at my clinic, I always turn in new scripts once a month to the pharmacy. I guess it's their way of not having to man the phones for refill requests. I hope you get the refills today and not have to wait any longer.
  • My comp insurance wanted me to use a mail order pharmacy and it was a pain in the a** they took three days for it to get to my house but they wouldn't fill it three days early so I didn't run out , now I just use the local CVS they never give me a hard time .
  • dilaurodilauro ConnecticutPosts: 9,736
    Jeaux, a couple of years ago, my insurance company did something very similar. It was a call in refill to a center that processed the request. Sometimes I would get it and sometimes I would not.
    I do prefer the personal touch in having in my hand a prescription refill.
    I hope that you get your refill as soon as possible so that you will not have to be in unneeded discomfort.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I called the "Pharmacy" and of course they have not received the written script yet. :SS

    I called my doctor's office. Don't you know - they have had the script in my chart since 1/30. THEY are always on time. I told them I didn't like the new set up one bit. So, we compromised. I still have to call in to the "refill line' but can pick up my script at the doctor's office. #:S

    I just needed to vent while I was getting answers, and as usual, you guys stepped up to the plate. Thank you all for your input. I truly appreciate you.

    Jeaux
  • BotzBotz Central FloridaPosts: 223
    How do you get to call in refills for MS Contin? I'm required to see the Doc, $40 offfice visit to get my prescriptions refilled. Then handed a hard copy of the script to take to my pharmacy.

    Art
  • Normally, I go in every month. However, my mother was diagnosed with cancer and I have had to take off a good bit of time to bring her to her various appointments; she also has back issues requiring heavy medication and doctor visits. My dad is also elderly (84) and can't drive; since my mom can't drive, I have to bring HIM to his appts as well. My PM office is aware of my dilema and that I am trying to take off as little as possible. Before April of last year (when Mom was diagnosed), I never missed an appointment (I started treatment at this clinic in 2004), never failed a pee test (they do these every visit). They understood the stress and pressure I was under and did not want to add to it - that can't be good for chronic pain. So, they allow me to phone in and request my refills; just as long as I see them at least every 2 - 3 months. I have an appointment February 27, so I guess it was not an issue with them.

    I've said it before, and still can't say it enough, I have found an awesome Pain Management Clinic who works with me (well except for the Psych guy... man, don't get me started on THAT one, grrrr) and I could not ask for anything better than that!

    Hmm... now that you mention it, Art, maybe they started that refill line BECAUSE of me, and not FOR me? #o

    Thanks for asking!

    Have a great day.

    Jeaux
  • My Dr. writes on the prescription how many refills. So I call the pharmacy and they have automatic notification already from her first prescription I bring to them. But usually I have to go in every month for narcotic refills. I hope you get your meds soon Jeaux. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • It was very sweet of you to comment.. How are you doing these days?

    My other meds (ambien an zanaflex - hey I just realized I am taking meds from A to Z - LITERALLY!) have the refills on them and I just call the pharmacy when it's time for refilling. It was the narcotics (oxy and MSContin) that I had to call the office for.

    Usually, my refill date is around the 3rd, 4th or 5th (depending on how the previous month fell). So, around the 25th, 26 or 27th of each month, I'd call for the refill (they say they need at least 72 hrs notice for refills, and they don't refill on Fridays). HOWEvER, they wuold usuallly call me the same day or the next day to tell me the prescriptions were ready to be picked up. Really quick turn around. I'd bring it to my pharmacist around the 27 or 28th (or 29th or 30th) to fill so there would be no lag in dosing.

    so, things ran pretty smoothly all this time until WHAM! In January I got hit with the Refill Line. Which, I felt the way the pharmacy I was referred to handled things in a totally unacceptable manner. Like my Daddy always said "If it ain't broke, don't fix it.."

    But, it's all straight now and life is good again.
    :D

    Again, Charry - thanks for asking! Have a good day!

    Jeaux

  • You can't call-in a refill for C-II medications. You have to pick up the hard copy from your doctor's office and hand it to the pharmacy. Retail pharmacies do not fill Controlled substances drugs if there is no hard copy.
  • Bea, I thought this was true as well, but it turns out this is completely state-by-state, not a Federal law. Some states allow call-ins. Of course, we're talking about calling in to go pick up your prescription- not calling in a refill.

    Some states only allow a doctor to write a refill for one month for each visit. Many states have no such restriction.

    I am glad someone resurrected this ancient thread so I could share this recently acquired knowledge :)

  • Do you have a list of the states that allow call ins? I would also assume some of this depends on how the Doctor wants to do it also.

    Dave
  • in my state of nc, i have to have a paper rx every month, however if it's hydrocodone, that can be called in and have one refill.
  • Obviously it depends on how the doctor wants to do it as well. I could never find a state-by state thing. That would be nice to have, wouldn't it?

    The no-refills thing and the no call-ins to the pharmacy thing are federal laws. But there is no Federal law requiring a visit for each prescription.
  • Not sure if this applies to the narcotic drugs but I just found out my doctor can send the prescription to my pharmacy by what he calls e-script. I'm in the process of changing meds so I call him each week. We talk about what to do and he orders the meds from him IPad. When he did this last week I went to CVS to see if they had it. It was less than 15 mins and they had it so it works great for me.

    Now if the rest of the medical world would do this. Wasn't there something a few years back where the government was going to standardize medical records?
  • That's not because it's hydrocodone, that's because it's hydrocodone/tylenol, and it's schedule III. If it was pure hydrocodone it would still be schedule II.

  • Yeah, I don't know. Definitely not the Schedule II meds, no idea on the others. My doctor has also developed new paperwork for their testing, no more hand written stuff! I really like all of this new technology stuff ;)
  • Florida also allows it - on an existing prescription - to extend it. New ones, they have to have the original "initial" prescription. So Florida is a state that is cool. :)

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I live in Louisiana and I think you have to have a written prescription in hand for anything stronger than Lortabs. My pain management contract requires me to come in every month and pick up my prescriptions. I am still on Norco and still every month. It is usually a visit with the Docs' PA-RPN unless something new is happening then I see the Doc. It is OK I guess, except their office is 75 miles from me. Guess that what I get for living in the boonies. : )
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
  • I'm pretty lucky in that I get to call in my refills, my doc gives me 2 or 3 months worth on the script, but the pharmacy can only dispense so many a month. Once the refills are done, I have to see the doc and get another hard copy to take to the pharmacist. I'm not sure if it's just because it's all within the military med system, because we have our own pharmacies on the bases, or if it's allowed on civi street as well here in Canada. Makes it easier, cuts down on my doc appts!
    Kelly
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Here in the state of Pennsylvania anything stronger then Tylenol has to be on paper and hand delivered to the pharmacist directly. No e-scripts, no refills, not allowed to be filled until the very DAY you run out of the needed pain med.

    It can be rather nerve racking - my pain contract says I will get all these type of meds at x drug store ONLY. However X drug store only get these meds delivered on Tuesdays. So yesterday ( a Friday ) I hand in my script and ask if they have enough and they do - but only by 20 pills!! So had my script been for 20+ more pills I could not have gotten any of them - as we are also not allowed to get part fills on pain meds.


    I have ran into it where they have not had enough and I have to call and get permission to go to a different pharmacy.

    Being as we can only get the pain meds the same day we are due to run out this can be a "tad" stressful..

    ALL the drug stores in my area get these type of meds delivered on Tuesday - so if one store is out or low most of the other 3 in town are too ~X(

    Sorry a little off subject rant here ;)
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • But the FDA allows a Dr. to write you 3 months of scripts at a time but you have to hold on to all the scripts until month stated. My Dr.writes my meds for 3 months at a time put the same date on all scripts but states what month to fill each med and can be taken to any state as long as the script says the exact month to fill scripts. I found this out while traveling for 4 months this summer. NO pharmacy is able to fill anything stringer than Vicodin or Narco stuff like that with out a written script. I do know of a lot of pain clinics that mail their scripts to the pharmacy. I like this Idea
  • MsHumptyDumpty..

    Just want to let you know that the info you posted is not correct for the state of PA. You can get refills on schedule 3 medications. Also, doctors can call in schedule 3 meds. Finally, everyone in PA does not have to wait until the day they run out to get their medication refilled.

    It's the way your doctor does things, but it's not statewide.

    :)

    Flower
  • Yes, remember, schedule 3 includes the lower doses of opiates mixed with something, and usually has lower requirements. This would be things like vicodin, norco, lortab, oxycodone/tylenol, etc.

    Schedule II would be anything uncombined, and that's when you hit the requirement for hard copy prescription. This would be ms-contin, oxycontin, oxycodone without tylenol, morphine IR, etc.

    And above and beyond legal requirements, a doctor can have a policy more stringent. For example, a lot of PM doctors here don't do refills on schedule III meds. That's policy, not law, but still within their rights.
  • According to the US Drug Enforcement Administration Drug Scheduling site list vicoden (hydrocodone), lortab (acetaminophen/hydrocodone), oxycodone/tylenol (percoset) as Schedule II drugs, The presence of acetaminophen (tylenol) does not change which schedule a drug falls in.

    Dave
  • Sigh. Sorry, I should not have been trying to mess with numbers today. Of course you're right.

    I will try to find the articles that discuss how the meds are placed in the different schedules. Mixing them with other medications is considered to make a difference in their abuse potential, as "pure" narcotics have higher value to some people. This is a subject under a lot of debate lately!
  • HB,

    Having recently retired, part of my day to day job was of course drug interdiction, and too at times working as partners with the DEA. What is as you know becoming a HUGE news item is "abuse of prescription drugs", but more so from teens in a household.

    In some of our briefings, that topic was raised as 'said neighborhood' was flooded with drug issues among the youth. Pill popper party's were and are still sadly, common. For a lot of that, *we* who behave with our medications are scrutinized like hawks. Some formulas we are seeing changed too such that the medication can't be "modified" into another lethal drug! I am all for that as long as the purpose and ability of the drug for those who need it is maintained.

    I guess in the end, time will tell how tight some of this will become. When we've had our god kids over, my stuff was in our safe - even some of the NSAIDS, as these guys (not saying my GK's are) are pretty darn creative - look at allergy meds. Can only get a 30 day supply anymore for the OTC - which is now behind the pharmacy counter!

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • It's not just that, I have been reading articles on Medscape regarding new regulations on doctors, whether to re- classify some of these drugs, how they classify them, etc. There are new rules being rolled out for pain management doctors, new prescription registries, etc. They even discussed taking vicodin off the market.

    But it's interesting to note that just like everything else in the world, there's substantial disagreement on these issues :) And in the end, hopefully little will change for us.

    Anyway, the new DEA program is called REMS if anyone wants to google it before I find the articles.

  • I hear ya, and agree fully HB. What's that phrase? "Them rules be a changin!" In some ways, I am glad that they are cracking down on the physicians a little. We've all heard of the "pain clinics" that prescribe without even really "seeing" the patient - big down here in Florida.

    Down here now, a straight Pain Clinic can only supply like 3 days worth, and do a full exam. Then the patient has to go to a GP or specialist. A lot of them are closing down now - I am kind of glad about that too. As long as we are still treated as we are, chronic pain sufferers thank you spine - grrrrr... :)

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Well, I go to a board certified pain management physician, and hopefully they will continue to certify to prescribe REMS drugs. The problem is that it won't do anything about the schedule II drugs that are still an issue, as they've already decided not to add vicodin or percoset.

  • I presently get my meds via my GP and my NS. I am in process of moving them all over to my GP, or at least giving a copy of the prescriptions to my GP so she has it all in one spot. I haven't had any real changes to my medications except for 8 days when I reherninated. So, so far so good as they say. I hear ya on the rest.

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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