Prescription Refill Protocol

Currently our office receives a large volume of calls and faxes daily for medication refill requests.  Our office staff can no longer safely manage this volume of phone and fax requests (see what is involved in refilling a prescription).

Therefore, as of July 1, 2009, we have a new prescription refill protocol. We understand that this is a change for both you and us. We hope to work together to ensure safe and high quality medical care.

1) Before you come to your regular appointment, you should look over your medications, diabetes supplies, inhalers, etc. to determine if you need to request any new prescriptions at your appointment.

2) We do require office visits on a regular basis for all of our patients taking prescription medication. The interval will vary depending on the condition being treated and the type of medication prescribed. Please be sure you have enough medication to last until your next scheduled visit.

3) It is very important to request your prescriptions during your office visit. As of August 1, 2009, we will begin charging a fee for prescription refills that are not requested during an office visit.

4) Please bring all your prescription bottles (or an updated medication list) with you to your appointment. This is important to make sure that:  a) you are taking the correct medications and the correct doses; and b) we have an up-to-date list of your medications. We will carefully review your medications and write refills at your office visit. We will also ask you to review the new prescriptions to make sure that they are written correctly.

5) As part of our new policy, we will offer the following options for prescription refills:

a) We can provide written prescriptions.

b) We can fax prescriptions in to a mail-order pharmacy. You will need to provide us with completed forms provided by your mail order pharmacy.

6 Our new policy will be to call in appropriate requests for prescription refills within 3 business days (not including weekends and holidays). We will have written prescriptions available within 3 business days.

7 Please let our staff know if your request is urgent or if you are out of medication.  Urgent prescription refills will require a $20 processing fee paid in advance by credit card or cash (SEE WHY HERE).  Urgent refills will be processed within six business hours; we can call the prescription in to your pharmacy or you can pick up a written prescription. 

8 If you call to request a refill but are overdue for a follow-up visit and/or blood work (necessary for monitoring the safety or effectiveness of a medication), the provider may agree to call in enough medication to a local pharmacy to last until we are able to schedule an office visit (two weeks maximum). It is your responsibility to schedule an appointment before you run out of medication. You should schedule your next visit before you leave our office.

We understand that there might be a situation when you do have to call us for a prescription. Please look at the list below and see what you can do to avoid incurring a prescription refill fee.

Are you changing to a new local pharmacy? You should call your new pharmacy and request that your prescriptions be transferred from your old pharmacy. We sometimes do not have to write new prescriptions.

Are you going on an extended vacation and need to use an out-of-town pharmacy? You need to call the NEW pharmacy that you will be using and have them contact your hometown pharmacy to have your prescriptions transferred. When you return home, you have to reverse the process.

Are you changing to a new mail order pharmacy? Some pharmacies will transfer your prescriptions to the new pharmacy. If you still have refills on your current prescriptions, please check with your current mail order pharmacy to see if your prescriptions can be transferred.

Notes

REFILLING A PRESCRIPTION

Every request for a refill requires the following steps:

1. Phone message transcribed or fax printed;
2. Phone message or fax is brought to medical records;
3. Patient’s chart is pulled from medical records and verified;
4. Request is attached to chart;
5. Chart is brought to nurse;
6. Nurse reviews chart for pertinent information
1. Verifies chart and request;
2. Is medication a controlled substance;
3. When were last labs done;
4. When was patient last seen;
7. Chart brought to doctor;
8. Doctor reviews chart
1. Verifies chart and request;
2. Reviews patient’s labs and medical history;
3. Does medication itself require labs or levels to be checked;
4. Does medication have risk for dependency or abuse;
5. Is medication scheduled (use and distribution restricted);
6. Is there a risk for interaction with other medications;
7. Does medication have new FDA guidelines or recommendations;
8. Does the benefit of continuing medications outweigh risks;
9. Doctor makes decisions
1. Whether or not to fill prescription request;
2. Whether or not to give subsequent refills;
3. Does patient need follow-up appointment;
10. Doctor documents decision in chart;
11. Chart returned to nurse;
12. Nurse calls or faxes in prescription;
13. Nurse documents prescription and pharmacy in chart;
14. Chart returned to medical records.