Insulin pen, box: open box or not? Rite Aid Old Memo of 2013?

[Apotheker2015]

And that's the insulin 1 month supply - open vs not open box- discussion for our first quarter of 2018. I believe Quillivant XR is next. Any takers? or are we going to save it for the next quarter?

*so if pharmacy A does not open the box and dispenses 1 box as a 1 month supply, then patient gets the prescription transferred to pharmacy B which then dispenses just 1 pen for a 1 month supply. Patient throws a fit. Then what?

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[zelman]

And that's the insulin 1 month supply - open vs not open box- discussion for our first quarter of 2018. I believe Quillivant XR is next. Any takers? or are we going to save it for the next quarter?

*so if pharmacy A does not open the box and dispenses 1 box as a 1 month supply, then patient gets the prescription transferred to pharmacy B which then dispenses just 1 pen for a 1 month supply. Patient throws a fit. Then what?

Patients throw fits all the time. If you don’t know how to deal with a temper tantrum, you must not work in retail.

 

[maria1oh]

Quillivant xr has been on back order for months now and everyone has been switching to other meds. (Chewable ritalin, ritalin, concerta, adzenys xr odt, etc )

 

[ifillrxs]

And that's the insulin 1 month supply - open vs not open box- discussion for our first quarter of 2018. I believe Quillivant XR is next. Any takers? or are we going to save it for the next quarter?

*so if pharmacy A does not open the box and dispenses 1 box as a 1 month supply, then patient gets the prescription transferred to pharmacy B which then dispenses just 1 pen for a 1 month supply. Patient throws a fit. Then what?

Every FAQ answer from WAG starts off with something like, "Due to insurance regulations..." Refer the patient to their insurance member services since they are the ones restricting the patient from getting a whole box. Pharmacy A WILL get audited and WILL pay for the entire cost of the prescription. Apparently now, from the perspective of the ins company, that is a misfilled prescription.

I have had many people complain to me about their lack of a 90 day supply pen prescription. Sometimes it would calculate to a 70 day supply or something similar where another box would exceed the 90 day max. They felt I was shorting them which led into an entire math lesson. Exhausting.

Before this started, I was against the practice of splitting boxes because of the missing single patient instructions that are included in each box. Since WAG is now providing a printout of those instructions with each prescription, I'm all for it.

 

[Apotheker2015]

Patients throw fits all the time. If you don’t know how to deal with a temper tantrum, you must not work in retail.

You missed the point @zelman. I was making a joke.

 

[Apotheker2015]

Quillivant xr has been on back order for months now and everyone has been switching to other meds. (Chewable ritalin, ritalin, concerta, adzenys xr odt, etc )

There was a never ending discussion about Quillivant XR a year or two ago. It started with the insulin boxes issue which also took a while to die. Not quite like the "DEA controlled substance forwarding/transfer issue". Blood was spilled on those discussions.

 

[npage148]

*so if pharmacy A does not open the box and dispenses 1 box as a 1 month supply, then patient gets the prescription transferred to pharmacy B which then dispenses just 1 pen for a 1 month supply. Patient throws a fit. Then what?

You tell the patient they were billing it incorrectly and giving them extra and it was a lucky bonus you should not have been getting

 

[CetiAlphaFive]

If there's no video evidence of a pharmacy dispensing a whole box, how does the insurance prove it happened?

Every FAQ answer from WAG starts off with something like, "Due to insurance regulations..." Refer the patient to their insurance member services since they are the ones restricting the patient from getting a whole box. Pharmacy A WILL get audited and WILL pay for the entire cost of the prescription. Apparently now, from the perspective of the ins company, that is a misfilled prescription.
I have had many people complain to me about their lack of a 90 day supply pen prescription. Sometimes it would calculate to a 70 day supply or something similar where another box would exceed the 90 day max. They felt I was shorting them which led into an entire math lesson. Exhausting.
Before this started, I was against the practice of splitting boxes because of the missing single patient instructions that are included in each box. Since WAG is now providing a printout of those instructions with each prescription, I'm all for it.

"WILL"
[Citation Needed]

This is a matter of scale.

Walgreens probably realized they're getting nailed often enough by an insurance company they care about to change a policy in a way that will hurt metrics.

There was a never ending discussion about Quillivant XR a year or two ago. It started with the insulin boxes issue which also took a while to die. Not quite like the "DEA controlled substance forwarding/transfer issue". Blood was spilled on those discussions.

Truly a Pyrrhic thread

 

[ifillrxs]

If there's no video evidence of a pharmacy dispensing a whole box, how does the insurance prove it happened?

It happened because the pharmacy's insurance claim will reflect 15 ml with a 30 day supply.

 

[CetiAlphaFive]

It happened because the pharmacy's insurance claim will reflect 15 ml with a 30 day supply.

Yeah but how do they proof it

 

[ifillrxs]

Yeah but how do they proof it

During an insurance audit, a representative of the PBM will physically be in your pharmacy to see the actual prescription. The auditor will read the prescription and calculate if 15 ml is correct for a 30 day supply.

Or more commonly, a desktop audit is performed and the pharmacy has to provide the electronic image of the prescription to the auditor.

 

[owlegrad]

No video=no proof.

 

[Lnsean]

No video=no proof.

Who hurt you?

 

[Lnsean]

This isn't hard. If the industry practice is to open these boxes now then so be it.

 

[maria1oh]

If you document actual day supply and refill accordingly then I heard you can survive insurance audit. One time filling 15 ml as 30 day supply will not hurt you if you document actual day supply. The problem starts when you excessively refill it every month and the actual day supply is 3 months. They get 12 boxes of insulin over a 1 year period when they really only needed 3 or 4 boxes.

Also anyone getting busted for not documenting affected area on topicals? Maybe it's time we get out the ointment jars and start breaking topicals.

 

[BidingMyTime]

I still have never heard of any pharmacy actually being audited for not breaking an insulin box....but it seems like I may be the last hold-out on not breaking insulin boxes.