POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: jpy865 on July 30, 2007, 08:23:03 pm
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I am wondering why my doctor needs to authroize my refills every forth refill. Today I took only three Kaletra's out of my regimin that is one shy of what I am suppossed to take. I visited my pharmacy and they said they are still waiting on him to authorize it. WHY? I understand he probably wants to make sure I am taking it as scheduled, not overdosing, underdosing, giving to others, etc...But I will not have any pills for my morning dose tomorrow.
What should I do?
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it sounds like it is an insurance issue. HIV drugs are not controlled substances as any of the psych drugs.
I had something like that happen, and they told me the doctors authorization was pending...it had nothing to do with the doctor, it was the insurance company who would not cover the meds without talking to my doctor first.
Rich
(who fights with insurance companies at least every other month)
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Call your doctor's office immediately and tell them that it is URGENT that they call the pharmacy right away to authorize the refill. Do not sit back and wait until they call the pharmacy on their own.
In the future, try to build up a reserve for all your medications. Usually you can refill a prescription about five days before the 30-day period. Keep on doing that until you have at least an extra two-week supply on hand. This will tide you over in case there's a delay in getting a new authorization.
Also, tell your pharmacy how important this is and tell them to call your doctor's office (even if they've already done this). Ask them if they will advance you a few days extra supply. If you deal with a pharmacy that knows you, they will sometimes do this for you.
Allan
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Note to Rich (pozattitude)-
This does not sound like an insurance issue at all. Meds are prescribed with a set number of refills. When that number is reached, it is the doctor who must call or fax in a request to the pharmacy for additional refills. Once the initial prescription is filled, the insurance company doesn't usually have to approve additional refills.
Allan
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My refills are done automatically for the HIV meds. My histo meds and done every 6 months by the mfg and my Ritalin has to be done every month because of it being a class II narcotic. Everything else is just based on the number of refills.
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Indeed, I've had different doctors do different things. Currently my fuzeon has many, many more refills on it than all of other HIV meds, but I also get it from a different pharmacy and it was called in initially by a different person in the office of my doctor than is the normal procedure. I think they only do 3 month supplies now due to all the adherence problems of patients -- this allows them to monitor how on time you are calling in for refill authorizations.
I'd not be surprised if this is what your doctor is doing.
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just do what i do, if they don't call your refills in on time, when you have given them a week or at least 3 or 4 days to call it in i call and bug the hell out of them till they call it in, sometimes you gotta be tough with them and get on their case, thankfully i have only had to do it a couple of times, and the pharmacy will give you a few pills as long as it isn't a controlled substance if you need them, at least here in oklahomo they will at walgreens, hope this helps. Ron.