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Kuboluver · 03-07-2008, 07:15 PM

I'm at the end of my rope. I went to see a new doc for pain management last Wednesday, he prescribed 3 different meds for me and I went to see him again today and he prescribed another. The pharmacy that I go to is Walmart, because it is the closest besides Walgreens and my attorney told me to switch from Walgreens because I was having problems with them. The pharmacy is saying they need pre-authorization to fill all of the scripts that the new doc has given me, so they say that they have faxed him 5 times over the past week to please call the IC to straighten it all out. Well, I've spoken to the doc's assistant and she said "We don't get involved in that, that is between the insurance company and your pharmacy." And the pharmacy tells me that it is the docs responsibility to call the IC. The last time there was problems with a pharmacy, my attorney just told me to switch pharmacies, of course his office is closed on Fridays, so I couldn't get a hold of him today. I'm not sure what to do, I'm so frustrated! Do they not understand that I'm in alot of pain and the scripts are for pain meds?! Thanks for listening to me vent a little. Any advice? Thank you all in advance! =)

1171 · 03-07-2008, 07:52 PM

unfortunately not much. you can buy them yourself and request reimbursement.

sparkey · 03-07-2008, 08:56 PM

I go through that EVERY month with my IC. They need the adjuster to approve the meds. So what the pharmacy does is contacts the IC and they send a email to my adjuster and whenever he feels like checking his email, he then gives the okay. I found that i had waited sometimes 2 hours at a pharmacy for my meds to get approved. Only cause the pharmacy was 1 hour away from my home as i live in a small town in the boondocks.

One day I sat there so long waiting, i asked how much they were if i paid for them. It came out to 100.00 for one pres. and 300.00 for another. I used my credit card and the pharmacist said that he would put it back on my card as soon as it is approved. I left the pharmacy and got a call from the pharmacist that he had approved it and it was put back on my card. I was right after i got home.

I do that every time after my appt. now. I just use my credit card and let them put it back on. You can either do that, or pay for it, get the receipt, submit it to the adjuster and wait 30 days. I prefer to use my credit card. It is SUCH a pain in the ----!! Every month. I wish they could just give the okay for 3 months at a time or something. That is your prescription and you can have it filled wherever you want jf you want to pay for it.

Kuboluver · 03-07-2008, 09:42 PM

Thanks for the responses. I would do that, if I had a cc. Smile

I can't afford to pay to get them filled. So, I'll wait, and wait, and wait some more.

backache · 03-08-2008, 04:06 AM

I am a nurse and we make the Dr's office call the IC when something is denied if the pharmacy won't do it. I would call them and tell the receptionist you want to speak to the Dr. or his nurse. I would then explain the situation to them and tell them you are in great pain and cannot afford the meds. Or I would take my WC claim number in to the pharmacy and have them charge it to WC. That was what my lawyer told me to do, he said we may have to take them to court to make them pay, but he will get it done.

sparkey · 03-08-2008, 06:36 AM

Did you get a prescription card from the wc ic? I am just curious as you never said if you did or did not have a prescription card.

Lilly · 03-08-2008, 09:55 AM

The IC is playing the same games with you as they did me. In my case, it was the IC....not the doc's office, that was dragging their feet giving the ok for my meds. I had written scripts from MD turned them in to pharmacy...and pharm had to call IC.....well, IC suddenly halted approving my pain meds that I had taken for almost 2 years! It took 3 months for the "ole bag" to approve them again...only after my lawyer got on her case. By her not letting me have my meds....i fell back into a pain slump, which prompted another 2 doctor visits, cortisone injections etc to get my pain back under control. By her dragging her feet, she actually caused the IC MORE MONEY to be paid out , than if she'd just approved the meds like they always had. This all happened directly after the IC had offered me a settlement amount that we turned down. So lawyer said it was a tactic to force me to accept their settlement....but it didn't work.
Good luck to you, see if pharm will give you the meds and simply bill IC.
Lilly Smile

Kuboluver · 03-08-2008, 09:11 PM

I did get a perscription card, but it was only good until like March 2007, so the adjuster keeps adding more time to it, I have never received another.
I spoke with both the doc and his medical assitant, the doc said that the pharmacy takes care of those kinds of things and his assitant is the one that told me the doc doesn't get involved in that, its between the pharmacy and the IC. I was so aggrevated, I was crying when I left a message on my attorneys voice mail. (he'll probably say "Oh no, not again.")
Thank you all very, very much for your responses!