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Question about insurance and prescriptions
  1. #1
    beancounter is offline New Member
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    Default Question about insurance and prescriptions

    Hello,
    I am a new member and I hope I am posting this query in the proper sub forum. If I have posted in the wrong place, my apologies.
    Yesterday, I had a rather heated discussion with my primary care dr.'s office manager and staff. I am a chronic pain sufferer (degenerative disc disease and severe osteoporosis) . I live in the Tampa area of FL, which unfortunately is the "epicenter" of the pill mill problem.
    I go to a pain clinic that I do not feel is a pill mill. I am examined each visit (monthly) very carefully and my pain doctor is very good about documenting my condition. Unfortunately, they do not take any insurance, so they are grouped in with the pill mills. I get my scripts for the pain meds I require and have them filled using my insurance at the same pharmacy each month. The primary doc's office told me that I was breaking FL law by paying cash for a doctor visit and then using insurance to fill the scripts.
    Does anyone know if this is true? I certainly do not want break any laws. I have been seeing my current pain doc for over 5 years now and the pain doc my primary wants me to see of course takes the same insurance as my primary, but I do not care for his attitude nor his bedside manner. I do not want to change docs because I have a very good relationship with my current pain doc and see no reason I should have to change just because the clinic does not take insurance.
    I hope this post makes sense. Bottom line.... If I pay cash to a doc and use insurance to fill the scripts, am I breaking FL law?
    Thank you for any and all replies or advice. beancounter

  2. #2
    shybaybe2003 is offline Senior Member
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    i would call your insurance cusotmer service center and ask them. if your place is considered a pill mill, then you may be breaking the law, especially if they dont take insurance which i find kind of suspicious, but i dont live in florida and i dont know how your doctors work. I just know here in Fort Wayne, Indiana, as far as i know all docs office and definitley pain management clinics take insurance. good luck to you.

  3. #3
    shybaybe2003 is offline Senior Member
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    i also wanted to add i seen something on the national news last night about the DEA cracking down on some pill milll docs and it was in florida. im talking getting arrested and losing there license. I didnt know if you heard that or not but it was on the national news last night

  4. #4
    newyorkgal is offline Platinum Member
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    I don't know about Fla. laws but that sounds wrong to me. I am on subutex and I have always paid cash to my doctor who won't take insurance for sub and I've also always used insurance to fill the scripts. One should have nothing to do with the other. I live in NYC.

  5. #5
    beancounter is offline New Member
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    Thank you for the replies. Yes, I have heard about the problem in my area with "pill mills", but I do not believe my pain doctor is not one of them. I actually get a more thorough physical exam every month from my pain doc than I do from my primary care doc. And she will spend the time I need to discuss my condition. The primary is standing in the exam room with his hand on the doorknob as if he can't wait to get out of the room and on to the next patient. You can not buy medicines at the pain doc's office nor are they affiliated with any pharmacy. You are free to fill your script where you want.
    It just did not make any sense to me that I could not pay cash for an office visit and then use insurance to fill the scripts. I actually feel this is a sneaky way to start coming down on the illegal clinics. That's fine, but it does not help a legit pt. like me.
    It seems that most doctors down here have such a strong disdain for any doctor who does not take insurance and they use that fact to "prove" that they are a "pill mill". I thought it was a doctor's choice to take insurance or not. Sure, they are probably losing income by not taking insurance, but think of the much lower overhead they have not needing coders and specialists to deal with insurance.
    FL. is truly a mess when it comes to medical care. Doctors are so focused on narcotic abuse that I feel they do not properly care for their patients. Why do you go to the doctor in the first place? Usually something hurts. And to have your doctor say "I do not write for ANY narcotics", to me is a pretty sad thing. What ever happened to "first do no harm"? I wonder how many people are down here suffering because their doctors are afraid of the DEA or having a patient become addicted. If a person is stupid enough to abuse their drugs, it should not affect those of us who take our meds as agreed. I have been on strong meds for over 10 years now and have never abused them.
    I rue the day I crossed the GA / FL border. I was under the mistaken notion that medical care down here would be top notch. Now I have learned that is not the case. I am so tired of being demeaned for going to a pain clinic by my primary. It's probably time for a change. Maybe if they were to suffer some serious pain they would have a different outlook on pain management. It really is time for a paradigm shift. (Sorry for ranting)
    Thanks again for your replies..I truly appreciated them....
    Last edited by beancounter; 02-28-2011 at 03:02 PM.

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