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J_Rene
Regular Member


Date Joined Oct 2005
Total Posts : 279
   Posted 3/31/2008 5:45 PM (GMT -7)   
This has just been a trying day for me...
 
It all started when my PM doctor just disappeared from his office (last week this was )and I didnt get to get my meds refilled {{{ scratches head}}} ok.. Jessica don't panic... I called my PC dr and he was nice enough to give me 30 perc's which is a miracle from God himself that he did that. So Im making the best of my situation... cause I normally take oxy and percs... but hey ..Im making it work. So todays monday and my PM doc's back in his office. HARRAY!! Im saved...  So I go and get my scripts and go to the pharmacy... and this is where it all begins... they won't refill either... the oxy they want prior auth for and the percs they won't fill cause I just got some ... now common sense would tell a person {{{ or at least I think it would}}} that if a person is on oxy and perc and doenst have but the lesser of the 2 ..they'd need more to compensate.  Thats where I am in all this mess. I have 2 left and who knows when they'll approve my medicine. Im soooooooo sick of dr's , pharmacys and insurance companies controling my freakin life!!
 
Some days.. I swear... you wonder how you got thru the last one.
 
What should I do? No one wants to help me...
 

Major car accident 07/02

On going back and leg problems

DX with fibromyalgia 10/05

Goal in life:

To go bra less as much as I can!


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/31/2008 6:59 PM (GMT -7)   
The authorization issue is probably insurance. If it had been authorized in the past, one would think it shouldn't be a problem, but that never stopped an insurance company before! I'd suggest either calling your insurance company and ask why they didn't authorize the oxy and what they need from your doc now. Then you'll likely need to call your doctor's office to have them run through whatever hoops the insurance company has - but it shouldn't be more than a phone call from them if it's been authorized in the past.

Each insurance company makes its own rules, basically, (along with laws, of course) and they can decide how many of what they'll approve. This isn't my area of expertise, but I'm kind of surprised they've authorized oxy and perc together in the past, but that may depend on dosing, etc. The perc you'll probably have to wait to fill until you've used up the newest refill, but with your doc's prescription you should be able to get the remainder once you run out. The insurance companies do call the shots, I agree. And the legal authorities, of course. Your insurance ought to be able to tell you exactly what you need to do to get your meds. Try and see what they tell you.


Yea, it does make you want to pull your hair out, but as chronic pain patients I think it's something we have to accept will always be part of our lives. Maybe it will improve, but it probably won't ever be simple. good luck!

p.s. love your goal!!

pps. a thought: could anything be related to your doc's sudden disappearance? Legal authorities watch PM docs like hawks these days.

Post Edited (PAlady) : 3/31/2008 8:02:22 PM (GMT-6)


BigLucy
Regular Member


Date Joined Mar 2007
Total Posts : 413
   Posted 3/31/2008 7:15 PM (GMT -7)   
Maybe someone who has worked in a pharmacy can answer this, but your post just struck me--how can pharmacies dictate when a person gets a RX or not. I take perc. for BT pain and the MD writes that I can take up to so many a day and if he decides I need to increase my BT pain med and writes another script to compensate for the shortage I may experience in the near future, who is the pharmacy/staff to decide that I can only have what was written on my previous RX. Does what I just wrote make sense? And I've never heard of calling in the Oxy ahead of time b/c you need a hard copy; what's prior autho. mean? the fact that your MD wrote out a hard copy isn't autho enough?, furthermore, if you have gotten your meds at that pharmacy before, don't they have a record that you take pain meds (which doesn't count for the new RX but shows a MD has and probably will autho. again).

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 4/1/2008 6:43 AM (GMT -7)   
Hi Jessica,
What day did you fill the percocet prescription? What does it say the maximum daily dosage is for the one you got from your PCP?
That may be why they will not fill the Percocet. Even if the script said, take 2 every 4-6 hours, it also has a maximum daily dosage, which is usually 4, so if you took two every 6 hours, you would be well over the maximum daily dosage of 4.....
If that is the case, you won't be able to get the Percocet filled until the number of days that the script for 30 would have run out on .......
As far as the Oxycontin goes, have you had to get prior authorization previously? Or it may be because they are using the brand name to fill now because of the lack of a generic formulation.
It should be just a matter of them contacting your insurance company to get that authorization though. Good luck, I hope that you get this straightened out.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


J_Rene
Regular Member


Date Joined Oct 2005
Total Posts : 279
   Posted 4/1/2008 6:30 PM (GMT -7)   
Thanks for all the advice
. Well today I didn't get anywhere. The pharmacy totally confused my dr's office. So I had to drive an hour (I dropped off at the pharmacy but my work) They did let me buy a 3 day supply. So now I have to get a whole new script. The whole system is screwed up. They come out smelling like a rose in the situation and we suffer. Im really pist off that the dr didnt call my insurance company to straighten this mess out. They just went by what the pharmacy was saying. So now I have to get a new script... its soo not fair to us.
 
I just want to get off these drugs. I feel like my whole life revolves around them, I hate that. I mess those days where you could hop out of bed and feel fresh as a daisy.
 
At least Im getting some relief.. Thank you God!
 
 
 

Major car accident 07/02

On going back and leg problems

DX with fibromyalgia 10/05

Goal in life:

To go bra less as much as I can!

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