My clinic refuses to fax to mail order pharmacies. Instead, I give the paper prescription to the patient and tell them to mail it.
I started this policy over a year ago, when five different patients called in the same week, about two mail order pharmacies.
Patient: "I called my pharmacy. They say that they don't have the prescription and the doctor just needs to call."
I check. Each of the prescriptions had been faxed. I called the two companies a total of five times that week. Each time they would ask for my identifying information, the patient's identifying information, transfer me and then say, "Oh, yes, we have the prescription."
Ah. This is a nice example of triangulation. The patient calls the pharmacy for their refill. The mail order company faxes me a request. I check the chart, see if the person is due for labs or a visit, and fax the prescription. Then the company sits on it. The patient calls them and the company says they don't have it. They delay. Finally the patient calls me to call the company and then the company admits, oh, yes, actually we do have it.
So we refuse to fax to these companies.
Last week I saw a patient who had mailed her prescriptions. She did not get her medicine.
"I called the company five times. They told me they didn't have it. They said to call you to send a "hard copy". I said, "I mailed it to you myself on this date." Then they said, "Oh, yes, we have it." However, she was out of her medicine for three weeks.
I said, "They saved the cost of three weeks of medicine. That is fraud." I explained the scam.
Comprehension dawned on her face. "They do it on purpose?"
I shrug. "Five in one week seems like a business operation to me. I recommend that you write to the state insurance commissioner."
She said, "Next time I will mail it certified. And yes, I will call the insurance commissioner if they do it again."
The patient's main insurance sends information that getting the prescriptions mail order will be cheaper, and so people want to use the mail order: but the mail order pharmacies in our area are saving costs by ripping people off and delaying prescribed medicine. I do hope they end up in jail: if we can't jail the corporation, let's at least jail the CEO and the top 4 officers.
WA State Office of the Insurance Commissioner: http://www.insurance.wa.gov/
OptumRx is one of the big offenders.https://www.optumrx.com/RxSolWeb/mvc/home.do
Expressscripts is the other big offender.https://www.express-scripts.com/index.html