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Red Flagged at Pharmacy -does anyone know about ?
  1. #1
    dejeneration is offline Junior Member
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    Default Red Flagged at Pharmacy -does anyone know about ?

    Hi my dad was red flagged at pharmacy for hydrocodone. Does anyone know what this means and how they know. Do Pharmacies share a network, dr's...the dr knew about other dr's he was getting them from. Just his pcp and Oncologist and wasn't getting too many. I was wondering if this is true about red dot or just to scare him and get him to lay off. Just curious.

    Thanks

  2. #2
    RoC1909 is offline Member
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    There is a system that pharmacies use that can determine where a person has gotten previous prescriptions as well as the type (among other info).

    It used to be that they were not linked and you could get a prescription filled at one pharmacy and go right to another and do the same thing.

    I went to one pharmacy not too long ago and they pulled up all of my info from another pharmacy that I used before and they didn't want to give me my meds (due to it being too early).

    Regards,

    J

  3. #3
    dejeneration is offline Junior Member
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    Wow - that is scary. Damn new high tech networks. Thanks for information. His dr. has now refused to refill his pain meds, if he stays off for a while, will they take red flag off or will he forever be flagged at any pharmacy or dr?

  4. #4
    RoC1909 is offline Member
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    I am not too sure if he will be removed from the list. Frankly, I didn't know that there was a list because I definitely would have been "flagged" myself.

    The "main" pharmacy that I went to for my narcotics pretty much knew that I was a addict due to the frequency of my visits. (300 Norco's a month would last me around 9-13 days and I would be right back as soon as I ran out. I ended up having to buy them but at least I was able to get them).

    I have talked to my pharmacist more and more lately (I think he felt sorry for me) and the last few times I have gone back (not for the narcotics though) he always asks how I am doing. I'll make sure and ask him (I imagine someone here might know) if there is such thing as being "red flagged" and find out what it entails.

    One last thing is that you can post this question in the "Pharmacist Forum" on this site and see if any pharmacists that inhabit that forum will be able to answer your question. I browse there quite a bit and there have been some really interesting topics that have sprung up that I have been keeping my eye on.

    Regards,

    J

  5. #5
    dejeneration is offline Junior Member
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    Thanks so much. Yeah this worried me because I used to take alot of pain meds for headaches, tooth problems and would go to different doctors since they are like fast food joints now, any dr. takes your insurance and if they are not fast enough you just go to a walk in one. I would have different scripts from different doctors and had them filled in different pharmacies. I don't do this anymore, until one dr. at ER called me on it. It scared me. I know that ER's are linked by Database and have all your medical information at their fingertips. It just interests me now to find out how these networks work and who all has access to them. It's like hush hush-top secret info. I tried to look it up online and you can't really find any info. This forum is very helpful.

  6. #6
    RoC1909 is offline Member
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    Hi dejeneration,

    I had the original doctor that I went to (occupation doctor since I was injured on the job.) He then referred me to a pain management specialist and I had my first appointment with him last Monday. He took me off of the Norco's (I told him that I have a addiction and that I have a big tolerance to narcotics) and put me on Avinza. Avinza is a sustained release Morphine. It's a one a day tablet that works well for the WD's, but not for the pain. I still have quite a bit of burning in my neck.

    On the first of March, I go in for a epidural and then we will see how I react to that.

    As I mentioned, when I am around my pharmacy (which should be tomorrow. Have to go to DMV which should be a ALL DAY AFFAIR and the pharmacy is not far away) i'll see if I can stop in and ask a few questions. As mentioned, I would bet someone knows about this on the forums but just in case no one does, i'll see if I can get some info.

    Regards,

    J

  7. #7
    xanaxuser is offline New Member
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    I don't know if there is a red flag at the Pharmacies either. But what I definitely do know is that most States' Department of Justice have a database that keeps an eye on doctors and dentists prescriptions as to who they issue drugs to, how much, and what. Basically they looking for doctors/dentists who are over prescribing meds and investigate them for abuse torevoke their license. I know this is a fact for California because I have seen the database myself. and the first thought that came to my head was Wow Big brother is watching!

  8. #8
    theresalee is offline Junior Member
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    Our hippa laws protect a lot of investigation or there suppose to anyway!!!! Yes there is in fact a red flag process at the pharmacies it means you are being watched more carefully and when you get a script they check your records and stuff preety good. There are some phamacys that do not do that.... Most pharmacys are connected, if someone goes to one then trys another with the same med it is usually found.... I took courses for medical billing and know there is also a data base in place for medical records.. Of corse it is not to be used for anything other then insurance purposes or maybe emergencys but none the less it does exist...
    Roc1909, It sounds like we have similar injuries and both work related.. I'm going through hell with mine? What does your MRI say? If you don't mind mme asking? I have one fusion of c4 and 5 also bulging on all the rest except one that appears to be normal.. Its been a while since i had another mri and im getting another, I am almost sure those bulging ones are now ruptured.... I have trouble getting the pain under control b/c I am on subutex which isn't great for bad pain... I also had the burning you mention.. but also have alot of what feels like my nerves are going crazy and hurting with pain in my arms.. Do you get that too??? Thanks Theresa

  9. #9
    xanaxuser is offline New Member
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    Here you go read on and you will see what I am talking about:

    Bureau of Narcotic Enforcement

    CURES PROGRAM

    In 1940, the Department of Justice (DOJ) created the California Triplicate Prescription Program (TRIPS) which became the oldest, longest-running multiple copy prescription program in the nation. Aimed at reducing prescription drug abuse, the program regulated and monitored the distribution of Schedule II controlled substances through the use of state-issued triplicate prescription forms. Other states adopted similar programs including Hawaii, Idaho, Illinois, Indiana, Michigan, New York, Rhode Island and Texas.

    TRIPS issued serially-numbered triplicate prescription forms to eligible practitioners upon request. The prescriptions were reviewed and analyzed for compliance with state laws and to detect possible illegal diversion of Schedule II substances to illicit markets.

    In 1996, the Legislature passed Assembly Bill (AB) 3042, requiring that the California Department of Justice establish the Controlled Substance Utilization Review and Evaluation System (CURES). CURES was established to automate the collection and analysis of all Schedule II controlled substance prescriptions issued in California.

    The Legislature stated that the ability to closely monitor the prescribing and dispensing of Schedule II controlled substances is essential to effectively control the abuse and diversion of these controlled substances. The Schedule II prescription data contained in CURES allows the identification of drug trends or patterns of abuse.

    A drug is rated under the California Uniform Controlled Substances Act, Division 10 of the Health & Safety Code as Schedule II based on the following criteria:

    The drug or other substance has a high potential for abuse
    The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.
    Abuse of the drug or other substance may lead to severe psychological or physical dependence.
    Morphine, Oxycodone, Fentanyl, Secobarbital, amphetamine, methamphetamine, Codeine, Hydrocodone, cocaine, Piperidine, any analog of phencyclidine, methadone and opium are all examples of Schedule II drugs.

    In 2003, Senate Bill (SB) 151, mandated CURES applicable to Schedule III controlled substances if there is adequate funding and provided for the indefinite continuation of the CURES program by deleting its repeal date. Effective January 1, 2005, CURES will begin capturing all prescribed Schedule III substances in addition to Schedule II substances. In addition, all prescriptions for Schedule II-V Controlled Substances shall be written on new tamper-resistant prescription forms which must be obtained from a security vendor approved by the Board of Pharmacy and the Department of Justice. A list of approved security vendors is available on the Board of Pharmacy website at www.pharmacy.ca.gov.

    It is the policy of DOJ to provide medical prescribers, pharmacists, and law enforcement with information maintained in CURES to assist with their authorized duties. The medical prescriber or pharmacist may request a Patient Activity Report (PAR) for a patient under his/her care. A PAR is a printout which contains prescribing history contained in the CURES data system for that patient by medical prescribers in California. Verification by DOJ staff is required to substantiate the validity of the requesting medical prescriber or pharmacist before information on a PAR is released.

    It is also the policy of DOJ to provide CURES information to law enforcement agencies and regulatory boards as a tool for investigations. The availability of the prescription data in one system saves valuable time and resources for investigators trying to track down criminals and others abusing controlled substances.

  10. #10
    zippysgoddess is offline Platinum Member
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    You can definitely be red flagged at a pharmacy if they suspect or see prescription abuse. We had a neighbor who was addicted to pain killers and Xanax, she would take all of hers in a month, then finish off her mothers and her fathers. It got to the point around here that she could only use one pharmacy, none of the others would fill her scrips and when she went to get a refill they would only give it to her the exact day it was due for a refill after calling her doc and verifying she was still supposed to be on the med.

    We get state medical coverage and in Pa, if you haven't had any problems at the pharmacy you can get them filled a week in advance to make sure you don't run out but if they flag you, forget it. Can't even get anything from the hospitals if you go to the emergency room.

    They do have to have valid reasons to do this though, for instance definite instances of drug abuse or addiction. If the person you are talking about was only taking the amount prescribed and never getting them filled any earlier than he was supposed to then you should investigate the matter. There may have been someone else using his name at other docs and pharmacies to get drugs and this has screwed him over or it could be a mistake if the abuser has a similar name or birthdate and someone made an error.

    I had this happen last year with my birthcontrol, someone called the pharmacy for a refill and went and picked it up as me. I went in when I needed one and was told it was too soon for a refill. They checked the records and found the signature wasn't mine and now we have it set up so that only my husband or I can pick up our prescriptions, no one else no matter how much they try or beg. I frequently have narcotic pain meds and my husband has psych meds so if someone could get a hold of our scrips it could create a big mess.



    Chronic Pain sufferer from severe spinal scoliosis with herniated discs and pinched nerves.

  11. #11
    doctor90250 is offline New Member
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    Default My Horror story...

    I am not an addict, but an opioid tolerant patient in constant, agonizing, intractable pain. My normal job is in the medical field, but due to the degenerative nature of whatever is going on with my body, (no one has been able to diagnose the cause), I am now on total disability. The muscles in the back of both legs are beginning to atrophy (shrink), and are becoming so tight it's getting difficult to walk. Problem is...I am on Medi-Cal, (California's medicaid program) which currently is paying only 30 cents on the dollar to healthcare providers, so finding a good doctor who is willing to take it is quite difficult. I will find a doctor who "seems" sympathetic in the beginning, but eventually the either randomly run my name through the department of justice's CURES programs, which tracks every single narcotic prescription you've had filled, or, the decide they are not comfortable prescribing that much narcotic pain medication, and so the search for another doctor begins. I also get frequent kidney stones, which require an ER visit, IV Dilaudid, and a prescription for 12-20 viccodin, or percocet. Each of which are added to my Narcotics record. Then when a doctor runs my name, (which many ERs do automatically on every patient), they see all the prescriptions I've had filled in a 6 month or 1 year period, not taking into consideration that a huge majority of them were for less than 20 tablets. There is one ER physician, and I'm going to throw him under the bus right here and now, named GARY BATTEN, who works at both San Bernardino community hospital, and Parkview Hospital in the city of Riverside. I went into SB community with a kidney stone, and he wanted to do a CT scan. I refused the scan because I have had about 30 of them in my life time, and the cumulative radiation increases my chances of getting cancer in my lifetime to about 60%. He said, "I'm not treating your pain without one", even though I explained my reason. I said fine, take out my IV and I will leave. They removed it, then told me I "HAD" to sign an AMA form, (leaving Against Medical Advice), which I feel I should inform everyone is ONLY to protect THEM, in the event your leaving causes you injury or death...you do NOT, and I repeat DO...NOT, have to sign it!!!!! Well, three nurses came after me saying "SIR, you CANNOT leave without signing this. I said...."shhh, if you listen closely, you can almost hear me not giving a F**K"....and walked out. Needless to say that did not sit well with them...especially him. Five months later, I was on my way to a job interview at Parkview when I began passing a stone. My wife took me into the ER, and guess who was there....yep. Once he realized it was me, he printed out the CURES report, and came to my gurney with, and get this, 2 nurses, the ER coordinator, and head of administration. He then got in my face and began telling me what a miserable drug addict I was, and even said...and I quote..."You're no different than Michael Jackson, and I'd bet money that within a year you will be dead from an overdose just like him!" My wife was in tears, I was so close to punching his lights out, which I realized as we were walking out that he wanted me to do exactly that, because he also had 3 security guards standing outside my curtain.
    Everyone tells me I should write a book about these experiences, to bring it to the public's attention some of the things we are subjected to when we are at the mercy of the system, not to mention the unbelievably intrusive, invasion of privacy by the CURES program. Talk about "Big Brother is Watching" huh?
    I have decided to attempt to write a book on this, so if you have a horror story of your own that you would like to put out there, contact me at doctor90250@yahoo, so we can try to make this a reality. Of course if I am successful in getting it published, you will be compensated, and your privacy will be 100% respected.

  12. #12
    sredrosid is offline New Member
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    Doctor I would love to share mine and my partners personally story with you.

    Hope to hear from you soon.

    To all you others struggling out there, my best goes out to you.keep fighting, if we come together we can make a stand for our privacy.
    Last edited by ddcmod; 05-18-2011 at 05:38 PM.

  13. #13
    BeavisMom62 is offline Member
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    Most states in the country have a state drug database. I only know the basics so some of this maybe wrong. But yes, I dont think it is so much that the pharmacies are linked, but everyone is on this database and all a pharmacist has to do is to check the database. I believe that there are only like 10 states that are not part of this list. I've been watching this because I live in FL, one of the few states that were not on the list. We were supposed to have started last year and it was to have been finalized last Dec but there were problems. Then our governor wouldn't sign it into law, stating that it was an invasion of privacy. But given the fact that FL is the pill mill capital of the country (something like 80% or more of oxy, etc RXs are written here in FL - no joke) and 8 people die of an OD from narcotics every day, he finally had to face the fact that we had a problem. So he recently changed his mind about it and it was signed into law recently. Don't know when it goes into effect though.

    Personally, I dont think it is a bad thing. Maybe being married to an addict I have a different view. I suppose Im addicted/dependent as well. I have chronicpain and get prescriptions for my medications. But hubby gets his on the street, stealing from me and pawning my things to do it. So maybe if the people that he gets his from can't get their pills anymore, he might be forced to quit. Oh, I can dream, can't I?

  14. #14
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    I can see this from all ends. Can see the rising numbers of OD's through out the country, the rising number of rx's that are written, and how many people who have no business getting ahold of rx's they have no business having. Being in the heath care profession, a lot of these people dr. shopping when they could do so, were putting these people in jeopardy of losing their jobs. So many dr's are starting to get onto a system that is provided by the state to see when the rx's expiration dates are, etc. This way they can immediately decide to not give you your rx.

    Again, I understand the reasoning why behind all of these. But it does seem to always, (much like everything else goverment mandated) hurt innocent people as well. Ex: I travel frequently, and have medications that I have to have prescribed on a monthly basis. It is impossible for me to come on the EXACT date of when my Rx's need to be refilled and then take them to the Pharmacy to be filled. My travels take me through out the US, and many times unable to find a Pharmacy to take my RX's into, as I might be in meetings all day, so 80% of the time, unable to refill things while on the road. About a year ago, I was staying in a hotel and when I left, forgot one of my travel bags. Of course, one of which had my medications. When I called the hotel to check to see if they had them, well of course they did not. So I called my dr to explain what had happened. He was unaware of what the guidelines were on things like that, but told me to call the pharmacy and ask what I needed to do if there was anything I could do. I called the pharmacy, and was told that I could have a Dr. write me a rx for them, and all I would have to do is probably pay for them out of my pocket since insurance wise they would not pay for it since it was too early. It was worth it to me, as I was only a week into my month long prescrptions. I called my dr and explained what the pharmacy had said, and went in to have new RX's written up. After leaving the office, took them to the Pharmacy, to which when I went back later to pick up they told me I could not pick them up because they were too early, and they had to call my dr. to check if the RX was valid. I was aggraviated at this point because I just thought they could have told me this originally, so I would not have wasted a trip back up there to pick up too soon. Long story short, the call from the pharamcy scared the ???? out of my dr. when the pharmacy said they had "red flagged" me, because I had picked up prescriptions early a lot. Early...yes, usually 3-7 days early because of my travel schedule, which I was told with in the guidelines of prescriptions..... and if there was a problem with that WHY WAS I NOT INFORMED I COULDN'T DO THAT IN THE PAST?????? Don't tell me there is that said guideline, and then turn around and say that you can't. I finally just didn't push it and went the 3 weeks with out the meds.

    I have since picked up my meds a couple of days early with no problem, but my dr always checks the dates on his data base, to which I then have to explain that I am flying out this day or that day.

    My view is, if you are going to have guidelines, lay them out clear. You can pick up X amount of days early, X amount of times a year. Make it clear and presise on what they want and inforce it.

    Again, I understand why things are in place, and agree there should be to some exstint. But when it violates someones privacy, or makes them feel like a scum because of nothing more than someone's busy work schedules, etc. It gets out of control.

  15. #15
    Makeadeal is offline New Member
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    Default Tracking

    Your insurance is the one doing the tracking. They are the ones that will not allow you to get prescriptions to close together. If this answer does not satisfy you, then call them and ask. I did, and they was tracking, that's the answer I got.

  16. #16
    N0GutsN0Glory is offline New Member
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    Default Red Flagged at Pharmacy -does anyone know about ?

    Most states have an online prescription monitoring system for physicians and pharmacists. They can see what narcotics have been prescribed to you, how many pills the prescription was written for, who prescribed them, when they were prescribed and when/where the prescription was filled. My state, Illinois, was one of the first states to employ the monitoring system.

    The online monitoring system was devised to prevent patients from doctor shopping. If the same doctor prescribes more medication because s/he changed the dosing instructions, it's not a problem.

    Be aware that anything over twelve hydrocodone a day has the potential to cause liver damage because of the acetaminophen. The maximum recommended by the FDA is 4000 milligrams, or 4 grams. The least amount of acetaminophen in a hydrocodone tablet is 325 milligrams.
    Last edited by N0GutsN0Glory; 02-26-2012 at 03:15 PM. Reason: clarify

  17. #17
    Suboxowned is offline Member
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    The pharmacy I use has recently changed their refill requests. You are not allowed to refill your scripts until the DAY before it is due. (ex: 30 day supply can't be filled until the 29th day.) I have insurance and my insurance pays for refills (with a new script or just a refill) every 23 days regardless. So, if I have a 2 refills on my suboxone, I can't have it filled until the 29th day each time. But, if I walk in with a new script for 30 suboxone and its only been 23 days since my last refill, they will fill it. I don't get it. Its from the same dr., same dose, same everything. If they're enforcing "no early refills" then why can I walk in with a new script a week early and have it filled?? Crazy. Maybe I'm missing something.

  18. #18
    pattib1234 is offline New Member
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    In NY I had 2 pharmacies at one point, one would fill a RX when the date was due...which I didn't realize, I go to the second pharm. to get the refill and he SEES in his PC that that Rx is already filled for the month. I believe the Prescription plan approval is approved irregardless of who is filling and that in itself prevents 2 happening in a month. As for my issue... Dr called my home to say he got a memo indicating I was using an ADHD med, Pain killer for constant Migranes and Pain killer for GI/ Irritable Bowel ...wanted to know what was up.... TOLD him to read the list of RX and uses I give him every visit and then discuss. Pain RX was from him, other different and not conflicting becauses issues with pain occur at different times of months...ADHD on the list... He was more concerned about getting a letter from Provider.... he had the facts/discussed and shook his head about my luck and had the audacity to act innocent... facts are facts ...we talked. Dr's don't appreciate being monitored... he said OK and off we went , next visit he'll be updating meds. ...

  19. #19
    rxqueen83 is offline Member
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    The poster who said your insurance is doing the tracking is correct.
    Last edited by ddcmod; 07-12-2012 at 03:46 PM.
    InnerSpirit likes this.

  20. #20
    ARTIST658 is offline Platinum Member
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    I think this response was completely inappropriate for this forum.
    Last edited by ddcmod; 07-12-2012 at 03:47 PM.
    lifewrthlivn likes this.

    You will know the truth - and only the truth can set you free.

  21. #21
    Tobetamy is offline New Member
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    Unhappy Flagged

    Quote Originally Posted by Healthprofessional24 View Post
    I can see this from all ends. Can see the rising numbers of OD's through out the country, the rising number of rx's that are written, and how many people who have no business getting ahold of rx's they have no business having. Being in the heath care profession, a lot of these people dr. shopping when they could do so, were putting these people in jeopardy of losing their jobs. So many dr's are starting to get onto a system that is provided by the state to see when the rx's expiration dates are, etc. This way they can immediately decide to not give you your rx.

    Again, I understand the reasoning why behind all of these. But it does seem to always, (much like everything else goverment mandated) hurt innocent people as well. Ex: I travel frequently, and have medications that I have to have prescribed on a monthly basis. It is impossible for me to come on the EXACT date of when my Rx's need to be refilled and then take them to the Pharmacy to be filled. My travels take me through out the US, and many times unable to find a Pharmacy to take my RX's into, as I might be in meetings all day, so 80% of the time, unable to refill things while on the road. About a year ago, I was staying in a hotel and when I left, forgot one of my travel bags. Of course, one of which had my medications. When I called the hotel to check to see if they had them, well of course they did not. So I called my dr to explain what had happened. He was unaware of what the guidelines were on things like that, but told me to call the pharmacy and ask what I needed to do if there was anything I could do. I called the pharmacy, and was told that I could have a Dr. write me a rx for them, and all I would have to do is probably pay for them out of my pocket since insurance wise they would not pay for it since it was too early. It was worth it to me, as I was only a week into my month long prescrptions. I called my dr and explained what the pharmacy had said, and went in to have new RX's written up. After leaving the office, took them to the Pharmacy, to which when I went back later to pick up they told me I could not pick them up because they were too early, and they had to call my dr. to check if the RX was valid. I was aggraviated at this point because I just thought they could have told me this originally, so I would not have wasted a trip back up there to pick up too soon. Long story short, the call from the pharamcy scared the ???? out of my dr. when the pharmacy said they had "red flagged" me, because I had picked up prescriptions early a lot. Early...yes, usually 3-7 days early because of my travel schedule, which I was told with in the guidelines of prescriptions..... and if there was a problem with that WHY WAS I NOT INFORMED I COULDN'T DO THAT IN THE PAST?????? Don't tell me there is that said guideline, and then turn around and say that you can't. I finally just didn't push it and went the 3 weeks with out the meds.

    I have since picked up my meds a couple of days early with no problem, but my dr always checks the dates on his data base, to which I then have to explain that I am flying out this day or that day.

    My view is, if you are going to have guidelines, lay them out clear. You can pick up X amount of days early, X amount of times a year. Make it clear and presise on what they want and inforce it.



    Again, I understand why things are in place, and agree there should be to some exstint. But when it violates someones privacy, or makes them feel like a scum because of nothing more than someone's busy work schedules, etc. It gets out of control.

    Healthcareprofessional24

    Thanks for your story, it is one that closely fits what I am going through. I went to get my prescriptions filled yesterday and the pharmacist told me that they could not fill my scripts because the Louisiana Board of Pharmacies flagged me for doc shopping and or using different pharmacies. I do not doc shop nor do I write forged scripts. I see one pain management doctor and like you, I have filled my scripts 2 days early depending on the circumstance. Last month I went to visit my parents in MO and my doctor wrote my scripts so I could have them to fill while on my trip, when it was time. I am laying here very confused. Asking myself, is because I filled them in Mo? I have used a couple different pharmacies because when I would go to my pharmacy, they would not have one of my meds in stock, so I would take them to another one. I was very shocked and humiliated yesterday when that happened. I asked the pharmacist what I should do and she said talk to your doctor, but I am thinking that is not the solution to getting this cleared up because my doctor should know that I am only seeing him for my meds because he prints a medication sheet on his patients refills before there visits each month. I know you said that you just waited a few weeks then they filled them again, but I am afraid it's just not going to be that easy. I am patiently waiting for Monday morning to talk to my doctor.. Do you have any more info into being red flagged?

    Thank you,
    Tammy

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