Family MD charging office fees for renewing RXs

Ms Kylee · Feb 26, 2008

I'm enough of a (B word) to tell the receptionist that not only would they not charge me this extra dough, and if they did, I'll be asking for my medical records and finding another doctor. But.. that's just me...

hikernurse · Feb 26, 2008

That's awful. That should be a service the office provides. I agree with Kylee; if they insist on charging you for that, I would find a new MD and make sure the office knows why. Those fees will really add up.

Ms Kylee · Feb 26, 2008

Especially when you're on multiple meds.. that's just plain ignorant... another way to make more money.... nope.. not paying... and can you have my records ready in half an hour? I'm going to be picking them up and finding myself a new doctor... thank you very much.. Goodbye. *Hang up*

Altra, BSN, RN · Feb 26, 2008

Just pointing out ... a physician office practice is a business. And the goal of business is to make money.

One alternative available to your MD would be to make it a practice not to call in Rxs but to require an office visit.

If you find this objectionable then I absolutely encourage you to vote with your feet and find a new provider.

KLKRN, RN · Feb 26, 2008

Obviously your provider does not have your best interests at heart.

Get your records and move on.

EmmaG, RN · Feb 26, 2008

Five dollars per med is a bit steep; I can understand charging per call.

Any office nurses who can give us an idea on the time spent calling pharmacies for refills? My doc wants the pharmacy to call when refills are needed; there is a line reserved just for that purpose, and the nurses give him the requests along with the patients' records for him to approve or deny the requests.

I'm sure this takes up time for both the doc and the office staff, so I have no issue with them charging a fee, but I think a flat fee per call would be more reasonable.

meownsmile, BSN, RN · Feb 26, 2008

Most of the docs in my area require a office visit to renew scripts. Especially if they are meds that you need monitoring for, which most are. 5 bucks a script sounds pretty good rather than 85 for a office visit to have them take your blood pressure and tell you they will call them in. How long between scripts does your doctor require before he sees you in the office? Most dr.s will give you either a 3 month or 1 year script depending on the drug.

If we happen to run out of something the pharmacy usually will call dr and he will refill x1 with the understanding we call and make an appointment before it needs refilled again.

Kymmi · Feb 26, 2008

Obviously your provider does not have your best interests at heart.
Get your records and move on.

I do not see where charging a fee for refills is out of line....it takes time for the MD to review the chart and for the office staff to phone the script in.

As far as not having your best interests at heart I'd have to disagree...most MD's that I've ever seen have written my scripts with enough refills on them until it was time for my next set of labwork and follow up office visit....usually every 6 months. Im surprised that MD's would refill scripts routinely without seeing their patients and the MD's that do refill with just a phone call and not seeing the patient on a regular basis would be the MD's I'd think didnt have my best interest at heart.

My physican will refill without a charge on occasion if there is a reason I cannot make it in before my meds run out however that is few and far between because my appointment is usually scheduled about a month before I need to have new scripts written however if I was in the habit of calling for more meds without following up with bloodwork and a visit she'd not refill them and if she did that on a regular basis then I'd have concerns with how well she cared about follow thru.

dream'n, BSN, RN · Feb 26, 2008

Right or wrong, some offices are now writing refills for a years supply on all maintanence meds at the annual physical, and charging fees for "in-between" refills. This is for several reasons. One is that some patients will continually ask to refill meds while refusing to come in for an office visit or blood work (I know the refills can be denied but it puts the Dr. in a hard place when it is an important med. that needs monitoring; thyroid, coumadin, hypertension med., etc. Do you deny a very important med to a patient, or risk continuing to refill?) Secondly the amount of refills coming through the average family practice office can be unbelievable; 35-60 per Dr. a day, and all of them need individually researched/charts pulled, etc. Third, again you would not believe the amount of refills requested when the patient was just given a prescription for a years worth, because it was lost, it is not convienent for them to drive the script to the pharmacy and wait, they prefer it to be called in and waiting for them, or they want to move to a new pharmacy and it's easier to have the Dr. call it in than have the pharmacy transfer the script.

I am not agreeing or disagreeing with the practice of charging a fee for refills, but these may be some of the reasons why certain Drs. are now doing it.

santhony44, MSN, RN, NP · Feb 26, 2008

You can spend an amazing amount of time dealing with things like refills.

Someone has to take the message, pull the chart, get those to the provider; the provider has to review the message and the chart, decide what to do, then write or authorize the script; someone has to call or fax the script, probably then call the patient- and that's if it's all pretty straightforward. If the script requires preauthorization, that's a whole 'nother issue. (I have seen literally hours being spent on one script preauthorization!)

Of course if the patient is calling the office every few minutes to see if it's been done yet, that takes up that much more time.

And, as someone else pointed out, there's a good chance that the folks wanting refills are ones who haven't done what they were supposed to do in the first place, like have labs done or make an appointment to come in.

Then there are the people who "just need an antibiotic called in" because they have whatever. And the people who just need a refill, they don't need to be seen, but when you pull the chart, haven't been seen in 3 years!

I don't know that I'd charge $5 per prescription, but $5 per call doesn't sound unreasonable. If I charged for the amount of aggravation, some people would be charged $500, not $5!

I think if you were to find out why this doctor's office instituted this policy, greed would be near the bottom of the list.

caliotter3 · Feb 26, 2008

I agree with the people who say a fee for per call rather than per prescription is justified. MD offices are businesses and the amount of time and effort taken for this service certainly justifies compensation, but not at the rate of per prescription. As we age, most of us gather more and more maintenance drugs and really can't afford fees based on the number of pills we have to take every day.