I thought that I would share this experience with you good people so that others might benefit.
I suffer from degenerative disc disease. I have several disc locations in my neck and back that cause me great pain. A couple of years ago, I used a direct script service and received three scripts with 2 refills each. I used my insurance card to pay for these (a total of nine fills of hydrocodone 7.5 - 60 count - stretched out over ten months)without even thinking about it. Wow, that was a mistake!
Last week, my wife (God bless her) shut the truck door without realizing my sandle clad foot was sticking out. Ouch!! I don't recommend this! Needless to say, my foot quickly swelled to about three times its normal size and turned an ugly shade of blue. The next day I went to the local er to make sure that it was not broken. Turns out, two of my toes are broken and there is some crush injury also. Imagine my surprise when the er doc came into the room and promptly informed me that he would not be prescribing any type of narcotics! When I asked him what he was talking about he said that my insurance company had flagged my file as a drug abuser. He had the amount, type and prescribing doctors name. Also the date prescribed. I told him why I had been presribed the meds and pointed out it had been long ago. It didn't matter that I had not requested anything for pain (I already have meds for my DDD) and he still was very rude and told me that he would be contacting my primary family doctor to tell him of my now red file condition at the hospital! (Can he do this?) This man had the nerve to say to me and my wife that "addicts will sometimes cause injury to themselves in order to obtain pain meds." In other words, I shut my foot in a car door in order to get pain meds!
I couldn't believe what I was hearing!
I immediatly told him that I was going to file a complaint with the hospital and the insurance company. I had not requested any type of pain meds (that is not why I was there,) my primary already knows my history and why I was purchasing meds on line and he could pack up his attitude, get me another doctor and kiss my a$$!!!!
This is alot of what is wrong with our health care system and the attitude toward chronic pain patients. I doubt if any of things I said to him will make any difference but I did file a complaint with both the hospital and the insurance company. The er did bring in another doctor (after waiting another 90 minutes)and they treated my injuries but did not offer to prescribe anything for pain relief. They told me to take 800 mg Ibuprofen every 6 hours as needed. This morning, my primary doctor had his receptionist call to move up my next appointment. Oh boy!
The lesson? Be careful how you use your insurance in this industry...it could come back to bite you!

Wow, thats insane.

For the first time, I think Im glad I haven't had insurance for the past couple of years....

Oh yeah, insurance companies track prescriptions and if there are a lot of them, they will send the printout to your primary to make sure that your primary knows about them.

I know...it happened to me. I've never used a Direct Script, but my PM doc had me on 5 medicines a month. My insurance company sent my family doctor a print out of all the prescriptions I'd gotten in the last 2 years, but there was nothing on there except what my PM prescribed or my family doctor so I was okay. I would not use my insurance to ever get a DS filled. My sister was caught about 20 years ago for doing just that (she was doctor shopping and filling prescriptions with her insurance in 4 different towns). Her insurance company sent the printout to her OBGYN, who was her primary, and also her boss (no HIPPA back then I guess). She lost her job of many years. It took her a long time to claw out of that hole and get normal again, but I learned from watching her that I would never do the DS thing, so I stayed away from those companies.

what is your insurance company?

My insurance company is Anthem Blue Cross. I hope that I am allowed to give their name without getting my hand slapped.
By the way...does anyone remember the name of the website that lets you rate and comment on doctors? I would very much like to give this doc a rating or two.

www.ratemds.com is one of the sites

Late last year my insurance company sent a letter informing me that they were going to share my private medical history with other medical professionals who subscribed to their service and inquired about my history.

They went on to say it was totally for my benefit because my current doctor would be able to make better decisions on my medical care since he would have access to prior test results, diagnosis, and prescriptions. It sounded to me like they were planning on selling my info. Luckily there was a number to call to "opt-out" of this horsesh!t nonesense. It wasn't exactly easy because I was on the phone for a while being transferred around but I finally made it known I did not want my private info shared with anyone.

Just thought I would share that. Your insurance company may be doing the same thing.

I have noticed in the past 6 mos. drs. will not prescribe any pain meds in the state of NC under any conditions unless you are in a pain management clinic. If you go to an ER 10 pills may be prescribed and they will call the large pharmacies to see if you have had any prescriptions filled previously before they write a script. Prior to this I was getting my meds at 120 with 4 renewals. So I don't think it is just because of insurance, if they are checking with the pharmacies.

I honestly believe this for two reasons: first - many people abuse the ERs to get pain meds. But, if you go in there with an obvious injury - big swelling, broken bones, black and blue, then, to me, there is NO excuse - even if others have abused the system.

Second, the docs are scared $hitless to prescribe - probably due to the DEA and #1.

To me, if you go in with an obvious injury that is clearly painful, to NOT prescribe adequate meds is unethical. I believe things will change, albeit slowly. Even the staunchest "drug war advocates" are recognizing that this war is not working - just as prohibition did not work. But people do not like to admit failure and our very well being hangs in the balance.

I am SO sorry you had to endure that experience in the ER. Until the letters get it, your advice is good. Don't use insurance of DS'. It may come back to bite you. I hope not.

I know this is an old post, but I have always said, from the days of NROP to ROP to DS, NEVER use insurance of any kind. The services were operating in a grey area of the law to begin with (not breaking any, but unconventional to say the least), and using insurance was/is just asking for it. The money saved simply is NOT worth it. Please don't get greedy...use your insurance for your regular doc and meds, and just pay cash for the ROP doc and meds and there will never be any expensive kind of trouble like this.

To me, this includes the new F2F services, unless you are going to use the F2F services *exclusively*, and even then, I'd be hesitant.

Just my opinion, does anyone else agree or disagree?

--J

I agree 100%!

The less paper trail you leave the better. Especially with our new Big Brother style government.

I also agree. Part of the reason I neve went the DS route was I didn't want to fill an out-of-state RX in my small town.

Oh well, it's all moot for most of us now. It will be interesting to see how long the F2F companies are able to keep going. I'm sure the DEA would love to shut them down.

I totally agree. I am forced to pay for all scripts, since my insurance doesn't cover them. So I've found by getting generics and filling at Costco and Wal*mart, it usually costs me around 10 bucks per script. Way cheap, and after reading this, I'm glad I've gotten in this habit!

Has this happened to anyone else? I also would fill my direct scripts thru Blue cross/ Blue shield / Anthem. After the fact, the more I thought about it, the more I began wondering if I ever had an accident would I be flagged? The insurance company never question or denied any of the fills. I never recieved any letters from them and they even allowed me to fill brand, but once I was finished doing this, I began questioning myself. I no longer order thru the internet, but I also have not been in for a regular doctors visit. And I've never used the F2F. But It's always in the back of my mind...that "Big, what if??"

thanks all

They way things are all "connected" now, it is a definite risk that anything you do will become known. Especially with insurance.

So, user beware and use with caution.

This type of situation is exactly why I always used one those free discount cards when I had my direct scripts filled.

They are still tracked by my states PMP but, it keeps the insurance company out of the loop a little. It seems to me that the insurance companies are one of the main contributors to the struggles of CP'ers.

Very sad.

Is it just for narcotics your file is getting flagged? And are insurance companies that bad about it or just the smaller ones?

All scripts are tracked here in Alabama. I used to think it was just narcotics but, it's everything. JMO of course but, I think it's the larger insurance companies that are the biggest pains in the butt.

It's the fact that some insurance companies send a complete list of what you've gotten filled to your pcp, at least mine does. She let me know i was on a lot of sleep meds. Little does she know i rotate them but still get them filled every month since I'm paranoid (I let her know that fact).

Where was this at?

it was all pharms and scripts. the ins. company was aetna. They've been doing it a while now.

The more things become computerized (and we are nearly there), it will be all but impossible,with or without insurance, for it not to be tracked.

The thinking is: this is better for patients and, I think, it may be, but if there is a script you do not want your doc to know about - well, he will. I truly believe it is for coordination of care (and that is a good thing - drug interactions, duplication, etc).

So, being up front with your doctor is pretty important. So, if he sees a script filled, he or she knows - OK this is the one so and so told me about. It could backfire, I know, but I still believe a close, honest, relationship w/ your doc is your best bet.

If I am being someone who doesn't have a clue here, don't hesitate to tell me. It wouldn't be the first time I haven't had a clue, lol. But, please know, my pain issues were not treated for quite tome time.

in my state (WA) all meds get back to your pcp......whether its narcs or maintance. Insurance co's and pharmacies flag. When the dr sends a fax to pharmacy the pharmacy send a fax regarding all of meds taken....even if you pay cash instead of ins. I almost got busted, I can only get my narcs through my pcp at their pharmacy. Another Dr sends my stuff to a different pharmacy. They found out about my benzo but since my dr was already on the list so they said be careful. Whatever you do, dont get script from ER and your pcp. She knew I went but i refused the narcs from the ER either way they got ya and its not worth losing your dr over . JMO

I hate to say it .....But I think even the Free Discount Cards Track your Scripts!

She knew I was getting sleep meds from the psych. She wasn't mad, in fact, she authorizes Sonata anyway. I like her, but Mr Sweetz doesn't, but she's my pcp.

You are right, and that is what I said in my post. I said that the state will still be able to track them on the PMP but, my insurance company ,who is out of NY, shouldn't have access to my states PMP I don't think. I could be wrong.

From my understanding, only physcians, pharmacists, and LE registered in my state have access to that information. Of course the DEA would too.

Someone please correct me if I am wrong.

Yeah, that was what I used to do to. And with those discount cards, there is no way to track the info. It just has your name on it. No S.S#, or address, etc. You are right though. They could track through the doctors.

Sweetz, I saw on another thread that you put a link for RxHope. Can you tell me how that works please??? I would appreciate it very much! I have insurance but still the Seroquel I take at night is very expensive and I would like to change my antidepressant med also; which is expensive! Do you think I should call them? I filled out the form but haven't heard back from them. Any info. would be helpful. Thank You!!!

Sorry Bryan ....But I think you are wrong. For Instance the http://www.yourrxcard.com/ ...You can get a card in your name ....or you can go to a Pharm and use a Generic card with No Name with a different ID# ....But when the Pharmacist goes to use the Card for you ...The Database or that Ins. Card will Automatically convert to You.....Meaning that the ID Number on the card doesn't Matter! ....It is your Name....Address....DOB that gets hooked up in their Database! Now what they do with that Info?....Who Knows. But it does Track your Meds!! and then there is the MIB!! ( http://www.mib.com/ )

We can't win lol. Pretty soon you will have to provide blood and urine for composite DNA testing before you can get your script filled. Sad...

oh god forbid DNA its bad enough my pain management doc does spuractic drug tests...strict too..if you have too much in your system youre in trouble....if you dont have anything they think your selling...so for example if we skip an afternoon pill 2days in a row b4 tests then it looks fishy!! Thankfully ive always come clean but still....its bad.

This whole thing just gets old, doesn't it? The thing is - it doesn't feel like it's for a patient's health. It's the "gotcha" syndrome.

If the attitude was different - drug interactions, etc - well I surely see the value in that. It is all about control issues. Hey, I'm a grown up the last time I looked in the mirror. Just gets old.

Guess we just have to hang in there and hope it will change. And the thing is - it is not only the US.

Legalize, tax, ensure purity, clean up the deficit. Hmmmm. A bunch of idiots.

Yup, using insurance came back to bite me in the a$$ as well so I don't use it for any type of scheduled meds any longer. I was receiving Tramadol from pcp and then had a bad tooth ache so I went to dentist. He prescribed hydro until I could see endodontist for a root canal. Saw endo over a week later and he prescribed more hydro for pain after root canal. They all 3 got a letter notifying them of everyone I was seeing and what was being prescribed. This was from express scripts, a$$holes. So now I only fill blood pressure meds from express scripts and if I get and type og narcotic I go to a different pharmacy that does not have my insurance info. But now I'm afraid I could get in trouble for phamacy shopping. Which I think is bogus anyway because pharmacies are always trying to get you to switch from the competitor by basically giving you gift cards and cash. I just got an offer from target for a $20 target gift card if I bring in a new prescription or switched over an old one. How can they bust you for using multiple pharmacies when pharmacies themselves are begging you to jump from one to another?

Why can't we check our own PMP data. Banks make mistakes, doctors make mistakes - who is to say the state doesn't make mistakes. Anyone have an answer?

With my pcp, I can only get narcs there, I dont even see the script. She faxes downstairs. I have to drive there every 2wks (wont give a months worth) which is a pain in the butt!. And then before the pharmacy fills it they check on the computer (using your SSN) to make sure you havent gotten any narcs or benzo's etc filled somewhere else.....for instance ER etc. I broke my toe and told the ER i couldnt take a script. I had to suffer. She gave me nothing. And I only take Methadone for my back pain.only 10mgs x3 does nothing for acute pain. ALL dr's in the US are coming down to this cuz some people use it to get high. Sooo frustrating to those of us that need it!!

I work in Healthcare. I know Blue Cross definitely tracks your rx's and they go to the PCP. Or even urgent care docs where I work.
Where does HIPPA come in to play? The pharmacies make you fill out a form that you understand your health information is private. Does that only apply to certain meds?? As in not controlled substances and then we lose our rights? Does seem to be hypocritical IMO.

they dont even have us sign those hippa papers anymore. And as far as I know it applies to ALL of our meds. I just know that if I go to a specialist they have ALL your meds already on their laptops. Some meds that you dont even take anymore. So, yes we have zero,nada, zip rights!! They dont even have charts anymore. Im thinking because of all the time, cost etc to get copies of your files is a pain in the butt for them. All they need is the laptop. We are just #'s like press 1 for this option, press 2 for blah blah. BTW I used to be a NAC for many yrs till my back gave out on me lifting those darn patients. Hey missy i live in your neck of the woods...LOL NW I meant

Yup....and press "0" to Euthanize.

Rosie, I'm a Pacific NWer too. Oregon.

We are not YET a PMP state, but I predict soon we will be.

Yes, insurance tracks your scripts. Anything can happen from that point. I never and I mean never, get my scripts (controlled or not) filled anywhere but at the same pharmacy. IMHO, if you go to more than one pharmacy, you get "labeled". Avoid that.

There is a code of conduct - with the doc, with the pharmacy. Adhere to it and the majority of the time you'll be OK. Yes, there are Ahole docs and pharmacists, but most are caring people who want to help. We, as patients, must do our part. In my wee mind, a contract with the doc should be on both ends. The patient agrees and signs and the DOC has a contract too. No, I live in the same world as y'all, lol.

Good to "meet" another PNWer.

Remind me what PMP stands for. My brain is useless these days!

LOL old hand.......PMP? Search me your guess is as good as mine and your an "old timer" LOL sorry couldnt resist!! Go ahead wet noodle for that one.

Rain. Im the same way about pharmacy's. I go to my pcp pharmacy for the narc....then the mom and pop for all my maintance meds (they deliver). Been going to the same mom and pop for 10yrs. They all know me by name lol. I refuse to go to the ER unless forced to by my pcp. I dont want to be "flagged". I know someone who used to go 1x a week for shots, scripts etc. She is flagged now. Er cannot refuse to see you but the very least they give out Ibuprofins. If I have to go for my chf they treat me like gold cuz Ive often refused scripts. So they drug me up via IV write in the chart I refused script. And the ER gets so excited about it LOL......oh why do I always go off topic!!!!

PMP stands for prescription monitoring program.

Somehow though our info has been being kept track of for a long time even before pmps. I have a friend who's parents just applied for private health insurance because they are self employed and they were questioned about prescriptions they took 25 years ago. I guess at one point they thought my friend's mother had lupus and she was taking a bunch of differnt meds for it, but like I said this was like 25 years ago and the insurance company had all of this info handy to decide wether or not they were going to provide them with health insurance. I was floored by this information.

I can only see this getting worse if the government is in charge of our health care. Although, I did hear Obama say that maybe taking the pain medication was a better option than surgery because of costs, so who knows!!!

MIB Group, Inc. ("MIB") is a membership corporation owned by approximately 470 member insurance companies in the US and Canada. Organized in 1902, MIB's core fraud protection services protect insurers, policyholders and applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability income, critical illness and long-term care insurance.

This is where the Info came from!!!!

Jeez, How does this MIB get our info? I would assume the way they get it is because all of the different insurance companies conspire and share information with eachother so they know about everything we have ever used our insurance for. So this goes back to the question of if we don't use our insurance to fill a script, is there any way this mib would know about the prescription? Or can they access the pmp data as well? Thanks for the info Stevo!

jakeyr....I don't know how they get all their info....But you can request your MIB report! ...Or so I thought I saw that on their Web Site!!

That would be a nice report to have. MIB! Anyone else immediately think of Men In Black?

LOL old hand.....yes I loved that movie.....especially Will Smith!!!! Stevo! Explain in English please Im being a dumb redhead here LOL j/k. I dont know about the MIB thing but I do know that with modern technology all pharmasist and dr and ins co have their ways of find out stuff. Gvt issues. About 5yrs ago I went to Cali to visit my parents and one of my scripts was due while I was there. It was a pain in the butt cuz the pharmacy had to call the pharmacy here in WA (I had re-fills for Soma) plus have to pay cash, ins wont cover. They were trying to re-fill a script from my reg pharmacy and it was a HUGE orderdeal. They had to wait for the pharmacy to fax over info........then they had to wait for the OK from the the state of CA for me to get it filled there instead of WA. It took 2 days for all that to happen.

Finally got that done. When I got back home I still had 1 more re-fill left and went to my mom and pop pharm asked if they can transfer it back. Nope once transfered re-fill was null and void here. Luckily my pcp understood and re-filled for here.


So, is that what MIB refers to? I dont know.

what are HIPPA laws for this is a crock of bull. I am from alabama too and I do not think it is right that an insurance company can give your pcp all your info. Can they give it to your job too?

I though we were protected through HIPPA looks like it just gives them more permission to screw with us! It is said for people with CP issues to have to go through all this bull just to get the treatment we need and DESERVE.

THANKS FOR LETTING ME VENT.

There is no more hippa law. Its all about the DEA ever since the Ryan thingy. I dont believe they can give your personal info to your job cuz you could claim a major law-suit. Unfortunatly the Gvmt knows EVERYTHING about us!! Even spying on the boards. Mums the word unless you want to get an LL. LOL....Oh no they are tapping our phones too!! LOL send me to the looney bin for a vacay. LOL J/K couldnt resist. Vent all you want, well maybe not on this thread tho. Im still learning the ins and outs too.

Insurance companies can get information from your doctor, because you, or more likely, your doctor is charging them money to take care of you. Insurance companies will send letters to doctors under the guise of "caring about you" and ask the doctor to change medications (like from a brand to a generic), take you off of medications, and send lists with all the medications you have had filled in the last 6 months and all the makes of prescribing doctors. They say this is to help the patient. Not really, it is to let the doctor know if you are doctor shopping or going to the ER often. It is also intended to reduce the number of medications people take so they spend less money. After all, most insurance companies are out to make a profit.

[quote=91791627. After all, most insurance companies are out to make a profit. [/quote]

ha...yet another reason why i should be glad i've never gone with a "mailed script" and used my Rx card.

given some of my other conditions (HBP, asthma, migraines), i'd be soooo in trouble if my dr. got letters because i'd filled stuff from someone else for the same condition.

at least my insurance (and Rx card) is through my husband; my job won't ever see that. but my dr....that's a really scary thought.

Now this is insane - just like the book 1984. Big brother is indeed watching.

Here's a scenerio I wonder if they ever thought about....

You are out of town and get injured. Instead of going to the ER, you go to an urgent care center or a doctor that was referred to you by a friend, relative, etc. After the doctor examines you, writes the script, etc you come to find out that he does not accept your insurance. So you pay him cash.

When you get the script filled, the pharmacy accepts your insurance so you use it.

Would that flag you as a "drug abuser"??

Insurance companies can get info from the big pharmas directly. 3 years ago when I applied for health insurance with a new company they called to let me know about all the perscriptions that I had filled during the course of several years. They were at Walmart, walgreens, ect. I had not used insurance and paid cash. When I asked how they got this information they said that it is common practice to run your name through the big name pharmacies to see what meds you have been taking. And the pharmacies give out this information. Like I said, No insurance, primary care Dr had no record of these meds, got them direct script, paid cash and the insurance company knew, they knew everything.

That's not good news that insurance can do that.

Your doctor may very well see it and think that. I had to call the after hours call line once and the partner of my doc called in a small script for me. My doc saw it on the letter sent and almost dismissed me. Apparently the partner never told my pcp she called in an emergency script for me. This was over 5 yrs ago.

My doc now gets a letter too. I know because she mentions meds my psych gives me. I never act freaked out about it, just act like it's nothing, but it pisses the hell outta me!

I hear ya Sweetz!

I also used my insurance for a direct script a long time ago but I have been in a ER since then and not had a problem.

I live in the great state of TN.