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#651378 - 02/16/08 06:03 PM
Questions to Consults Direct
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Sweetz
Diamond Mind 
GRAND Pooh-Bah
Registered: 05/11/02
Posts: 1919
Loc: Texas!
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I already posted this, but I guess they didn't read it or selectively didn't answer.
Here's the questions I saw that had no answer on the board. How about it CD??
If someone were to use your service and your Dr. works for 6-7 services how does the Drs. office manage to get the script verification straight, as you cannot tell the local pharmicist which OCS you are using? Also, they talk about the DEA sending out letters of Drs, on watch lists. To me this seems impossible as there are millions of pharmacies nationwide. How would they begin to go about this? And, if you Dr. was put on one of these type lists, at some point, would you be made aware of this quickly, in ehough time to alert the patients? Perhaps, if you can better explain these to a few of us, who are no doubt considering D-S, maybe that would help to make us less apprehansive. Thanks Much
Also, what about the fact a pharmacist told someone trying to fill a script that your doctor was on the DEA watchlist? I know he just got his license renewed, but I betcha without any formal charges docs can do that.
I got watcher12's permission to repost their questions. The only thing I did was edit out a statement.
http://www.drugbuyers.com/freeboard/ubbthreads.php/ubb/showflat/Main/39899/Number/646100#Post646100
Hopefully some answers will be forthcoming.
_________________________
Commit a random act of kindness today!!!
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#651408 - 02/16/08 07:21 PM
Re: Questions to Consults Direct
[Re: Sweetz]
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glasser
Enthusiast
Registered: 05/19/06
Posts: 230
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I'll try. As far as script verification goes, the Dr. that approved you is the verification. Because that dr. may have other OCS's he consults with, your name is associated with 1 doctor only, so CD has in place a number the pharmacist can call to verify your script as legit, calling only the Dr. that prescribed for you.
As far as a watch list, I'd think if a dr. was on it, they would of had to of been charges first against him then cleared of those charges, and cleared by the dea to continue writing scripts, or they wouldn't of been hired in the first place, maybe im off here, so I think Jeff or Debbie can answer that, just an educated guess.
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#651438 - 02/16/08 08:46 PM
Re: Questions to Consults Direct
[Re: glasser]
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ConsultsDirect
ConsultsDirect.net
Threadhead
Registered: 09/05/07
Posts: 824
Loc: 90 Days Supply
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glasser,
You are basically correct in regards to verification. About 14% of all Prescritions are verified. This in an Industry average. If you call your local Pharmacy and ask, they will say they probably verify about 14 out of 100 for one reason or another. Our Pa Service and Doctor verify Prescriptions without any problems.
I simply don't know anything about a watch list, but that doesn't mean, there could be one or there couldn't be one.
I thought I had sent a PM to watcher12 regarding these answers.
Hopefully, this may answer watcher12's questions. You should be able to ask these same questions to any Company that offers Direct Scripts.
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#651441 - 02/16/08 08:55 PM
Re: Questions to Consults Direct
[Re: Sweetz]
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ConsultsDirect
ConsultsDirect.net
Threadhead
Registered: 09/05/07
Posts: 824
Loc: 90 Days Supply
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Dear Sweetz,
Our Doctor isn't in trouble, so this isn't a concern. If he was "in trouble", we would either switch to a different Doctor, or not send out the Prescription.
I have posted our policy on refunds on several occasions. You can not loose money with Consults Direct.
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#651465 - 02/16/08 10:10 PM
Re: Questions to Consults Direct
[Re: ConsultsDirect]
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ConsultsDirect
ConsultsDirect.net
Threadhead
Registered: 09/05/07
Posts: 824
Loc: 90 Days Supply
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Question: What if a pharmacy confiscates a prescription hard copy, do you offer a refund for that?
Answer: We are not sure why a pharmacy would confiscate a prescription. Why would they?
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#651534 - 02/17/08 07:42 AM
Re: Questions to Consults Direct
[Re: Bryan72577]
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ConsultsDirect
ConsultsDirect.net
Threadhead
Registered: 09/05/07
Posts: 824
Loc: 90 Days Supply
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Scruf & Sweetz,
Very good questions.
Sweetz: I hope I answered your questions. I also sent you a PM.
Scruf:I would like to see the post about one of our clients indicating that the pharmacist kept the script, called police, because it was illegal. If you could find that for me I would appreciate it. I couldn't find it.
In the event that a Pharmacist wouldn't want to fill a Precription, you could simply go to another Pharmacy. I would think the Pharmacist would call to verify the Prescription. This is one of the reasons we ask all our clients to call first and simply ask: Will you fill an out-of-state Prescription.
We have successfully completed over 2,010 Consultations thru Thursday of this week, that have been filled at Pharmacies.
We have only had 1 person that has asked for a refund. We simply sent a refund after we received the Prescription back. I think any good company would refund a person's money.
A few people are simply looking for the "bad" things about Direct Scripts for one reason or another. Most haven't used them, or they had bad luck with the company they used. Maybe Direct Scripts aren't for these people.
We are very happy with our 2,010 Clients (not including those that have received Prescriptions or will within the next few days).
If all of our clients re-consult every 90 days, which almost everyone is, we will stay in business for years to come, just with re-consults. Of our first 500 clients-498 of them have re-consulted with us. Most of our new clients are referrals from other clients. Almost all our re-consults take their next Prescriptions (the one at re-consult) back to the same Pharmacy.
It's a very easy process, once you get started with Direct Scripts.
Whether you use our service or one of the others here at Drug Buyers, I would recommend that you look into the entire process. Gather as much information as you can, from reliable sources. I would think the best sources for information would be a Direct Script Company, a PA Service, a Doctor that writes Prescriptions for a DS Company, or the Hundreds of satisfied customers and clients that use Direct Scripts on a daily basis. Many of them post on Drug Buyers about their great experiences and how much money they are saving.
We have been on Drug Buyers for about 6 Months. The first month we had 10 Consultations, the second month we did 33 Consultations, then things started to happen. We just completed our 2,010 Consultation the other day (we count the clients that have successfully completed a consultation and have the Prescription filled). If you break down the 2,010 by the 6 months we have been open......we're completing about 335 a month. (about 10 per day). However, we are completing more consultations now then we were three months ago-as more of our new clients continue to re-consult after 90 days, our client base will continue to grow.
We are planning on only taking new clients up until June. We will probably only accept referrals from current clients after that.
Jeff
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#651619 - 02/17/08 11:36 AM
Re: Questions to Consults Direct
[Re: ConsultsDirect]
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FrankienJonnie
Banned by popular demand. Looks like another ID of Boltin1
Member
Registered: 02/04/08
Posts: 182
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Good answer, but a few of my posts seem to have not been answered. First, I just wanted to say/ask, or have CD answer to comment on the issue that many of us have posed (not just be, be older and wiser members), about the issues with all these DS's getting added into your state's PMP (Prescription Monitoring System), and while many people can use, legitimally a defense of "My records are valid, not forged and up to date",..and that "My records speak for themselves and since I have a valid condition, I would be excempt from any denial or any negative issues/consquences regarding the scripts I'be been getting".
The issue stil is, if your state uses a PMP (over 30 states do), and this same, consisten prescription gets logged into this state database, month after month, year after year; and then perhaps one day you are in an accident or have a more immediate emergency, go into an ER and while they may even give you a shot for a painkiller, if the dr. consults your PMP, comes back to your room, says here is a referral to a local doctor for you to follow up on, but says, based on your state's PMP records on you, we can't help you further than we're already done with the care we're provided to you during your stay to the ER...basically sayind that since you're PMP in 3 inches thick, and the fishy look of an out of state script, consistently being logged for, ..lets says two years, that a heck a lot of local scrutiny and "close to home", "in your backyard, sorta speak", proof of what you've been doing and why after this long, you can't get or switch to a local dr. or pain clinic..then there's something else going on. Sure there are tons of excuses from having an accient during a vacation, and or to the extreme that I see a pain specialist that's "out of state", the ability, when you say you have excellent records, then the topic comes down to why can't you get a local pain doctor/specialist to come to the same "conclusion" as this "far away, out of state, doctor", as the one has come to, that continues to write out the same script(s), time after time, year after year for.
I just can't see that being a coninual, on-going route for someone to use, and I think even my example of using a DS for two years is way too long not to raise the issues I have.
And then we can even go the route of if you are using your insurance, because your co-pay, lets say is $3 to $10, once your insurance starts to question it, WOW, since they can make up their own polices and procedures, imagine what could happen if they do their own invesigation regarding the "doctor" you're using for these DS's and link that back to "who" he/she works for and the nature of that operation. Am I the only one that sees these issues EXPLODING in people's faces?....literally their back yards. I would be scared as heck, if this would happen to be, locally. I would effectively ruin it for myself, locally, which really does leave no other viable alternative, that is when I'm told locally, by a pharmacy and or a follow up dr. I go and see, that, "I'm sorry, based on your DEA file, we can't help you."
JMO.
_________________________
Hillary For President!!! If you had peace, serenity and remember the Clinton years with content and joy, lets have that again America! Trust it's Hilliary, not Bill.
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#651640 - 02/17/08 12:13 PM
Re: Questions to Consults Direct
[Re: FrankienJonnie]
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rkjones
Veteran
Registered: 02/13/04
Posts: 560
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Sure there are tons of excuses from having an accient during a vacation, and or to the extreme that I see a pain specialist that's "out of state", the ability, when you say you have excellent records, then the topic comes down to why can't you get a local pain doctor/specialist to come to the same "conclusion" as this "far away, out of state, doctor", as the one has come to, that continues to write out the same script(s), time after time, year after year for.
This is the reason many use direct scripts or OCS in the first place. whether direct script or OCS, there is no local pcp, specialst or etc. that will treat them adequately for their pain that they have found yet in teir local community.I have a great pcp in florida but can't afford to fly down there every month or any month right now and I have a good doc here but if I leave here and move to Washington, I may not be able to find a doctor that agrees with my last 2 doctors that my condition warrents pain treatment. Arkansas, i moved to betweeen florida and michigan and not one doctor there with all my records would treat me thus I came back to MIchigan (should have went where it was warm , Florida) and be forced to fly unless washington has an OCS or direct script that can be used there. Now you are, I guess, basing this argument on direct scripts are filled at local pharmacies so are reported to the pmp but OCS don't report to the pmp. In my opinion it won't be long before the OCS does report to your pmp to stay within the guidelines as well.
Just because you happen to fly out to your favorite doctor for treatment is not that unusal, I don't think and if you became disabled or finances were not as well off as before then certainly you would look for a local doc so that doesn't seem to be a big deal either, you just have to remember if he wanted to he can see when you had your last fill and if it was for the exact same drug he may not want to prescribe it until 30 days from last prescription but he can always prescribe a stronger or lower dose of a different or same medication and no laws are broken. You also have to remember a doctor locally can prescribe tylenol 3, 1 po q 4h prn pain #90 and if it is not strong enough he can turn around the next day and write you a script for say loratab 10/325 1 q 4h prn pain #90 and they would fill it and assume well the other medicine wasn't strong enough.
If I move 3 hours from where I am now , I will continue to drive back to see my good doctors, however if i relocate to Washington,I will have to seek 3 new doctors now, a pcp. urologist and a nephrologist however all my doctors have agreed to have them call for info.
Direct scripts can't be used in my location anyway, and i would probably be afraid of it written from out of state as when I used to fly back to my pcp in Florida, I filled it there as well cause of the laws here.
I probably posted to much to make sense but I think direct scripts are great for those that can use them at least their pain is being managed as these troubled times are casuing more and more to suffer.
_________________________
Watch your THOUGHTS for They become your words
Watch your WORDS for They become your actions
Watch your ACTIONS for They become your habits
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#651673 - 02/17/08 01:02 PM
Re: Questions to Consults Direct
[Re: ]
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glasser
Enthusiast
Registered: 05/19/06
Posts: 230
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that sounds like you are with an hmo type. My insurance, I can go see who I want anytime I want, and they pay for it.I don't have to go to a pre-approved Dr. of their choosing, which is what all HMO's require.
They do have the right to not approve a test or procedure they don't feel is necessary.
Insurance companies don't just make things up as you go, thats outlined in the policy. And mine is private.
If I get pain meds every month for example, nobodys going to question it if my Dr. wrote the script, not my insurance, nor anyone from a PMP as long as I don't overlap scripts. Take a DS to the pharmacy in the alloted time frame, and everything should be fine. Its when you yourself do something that sends red flags up, like trying to fill sooner than you should, using multiple pharmacies.
Once you have a DS filled, take it back once a month like any other script.
I've had out of state scripts filled before and said Im a part time resident of that state, and see a physician in that state, but Im back here now, and didn't have it filled before I left because I had some left, what are they going to start an investigation on you because you have 2 homes in different states?
You have to do something real stupid to bring attention to yourself.
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#651706 - 02/17/08 01:55 PM
Re: Questions to Consults Direct
[Re: FrankienJonnie]
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patient2all
GRAND Pooh-Bah
Registered: 05/16/02
Posts: 3473
Loc: usa
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FrankienJohnnie,
while many people can use, legitimally a defense of "My records are valid, not forged and up to date",..and that "My records speak for themselves and since I have a valid condition, I would be excempt from any denial or any negative issues/consquences regarding the scripts I'be been getting".
That sounds good and I always thought I could take comfort in that "defense" myself. However, it turns out that if the DEA deems the doctor-patient insufficient or invalid, pain, conditions, don't mean a darn to the DEA.
The DEA doesn't understand why you just don't go to a reasonably local Doctor. We know the reason, local doctors are either suspicious of us from the get-go, simply scared themselves or a little of both.
And that's straight from the horse's mouth, so to speak.
---
Nonetheless, that doesn't stop me from using an OCS. Doctors here are immensely opiophobic. NSAIDs, the newer the better are the preferred solution. They like the often riskier Ultram based medications too, despite their stong addiction potential and other medical risks.
Whatever route we take, we're all taking our chances to some degree or another without that "face-to-face".
patient2all
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#651727 - 02/17/08 02:41 PM
Re: Questions to Consults Direct
[Re: glasser]
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patient2all
GRAND Pooh-Bah
Registered: 05/16/02
Posts: 3473
Loc: usa
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Everyone is asking great questions here, the type we need answered before even considering this route.
Glasser raises a point that perhaps unintentionally gets at the inherent problem behind "direct scripts":
I've had out of state scripts filled before and said Im a part time resident of that state, and see a physician in that state, but Im back here now, and didn't have it filled before I left because I had some left, what are they going to start an investigation on you because you have 2 homes in different states?
(emphasis mine)
However, chances are we don't have a second residence in the same state as the doctor writing the "direct script", we're not a part time resident there, we did not see a physician there.
By making those assertions, either to a pharmacist or, worst case at some point to a DEA investigator, you've compounded your problems. I'm not quoting Glasser to make the point the s/he is lying, it's just that the above quote contains many of the reasons I've seen folks give to "cover" themselves with "direct scripts".
I've seen some people use the excuse that they were injured in Florida and returned home. Obviously, if that happens more than once, the person must be foolish to keep going to Florida to get injured 
The questions may be innocent at fill time, but should this 'hit the fan', the way a lot of OCS usage has, you don't want a small town pharmacist with a good memory recalling your encounters.
That's the biggest issue - you may be called upon to come up with some elaborate story to explain the distant Rx.
-----
I posted my citations on the VIP side, but the DEA is hip to "direct scripts" and the NABP pharmacist's journal just described a BOLO for exactly this sort of activity.
----
It's also not so far-fetched that more of us may become part of investigations into this activity. Patients of ROPS/NROPS have been questioned so far, we know that for a fact. The ROP patient may not be the "target", but at least they have a consistent story if questioned.
The ROP patient hasn't done anything wrong or lied in any way.
The NROP/IOP user may have committed one offense by ordering.
However, the "direct script" patient with all the fake reasons may be in more trouble. And it may start right at the pharmacy counter. Some smaller towns' LE may be completely unaware of the "direct script" phenomenon and the more prevaricating involved, the bigger a hole one is potentially digging. You may be perceived as attempting to commit a crime whether this is legal or not.
---
I'd love to see "direct scripts" work long term for folks. I don't want to see anyone suffering in pain. I'd take a chance if even a little forethought was put into the relative geographic local of Doctor vs. patient.
Just when I see that it appears that the same Doctor is writing an untold amount of these Rxs for an indeterminate # of services, I think folks have to be forewarned of the possible long-term consequences. Because this time, the "direct script" patient is right in the middle of things.
I wish it weren't so. I wish the "direct script" thing could have been done a little differently, but sadly it made it to the DEA's radar in record time.
Sorry to be the bearer of what could be bad news....
patient2all
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#651731 - 02/17/08 02:43 PM
Re: Questions to Consults Direct
[Re: kserah]
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hillgirl
Member
Registered: 11/06/06
Posts: 121
Loc: DC
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Hi All - These are the same questions I have. As I understand it, in order to be in compliance with applicable fed AND state laws, that all pharmacies (including OCS out-of-state pharmacies) do have to report the covered meds they dispense for residents of PMP states to the PMP systems of those states. If you live in a PMP state, any covered meds Rx'd to you are supposed to be reported to your state's PMP system. Whether this is happening systematically yet, I don't know. But there is also a nation-wide PMP being put in place (NASPAR?) -- not sure if it is fully operational yet, or when it will be... Anyway, these are good questions, and any insights are most appreciated. Thanks!
Best, - HG
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#651780 - 02/17/08 03:53 PM
Re: Questions to Consults Direct
[Re: hillgirl]
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glasser
Enthusiast
Registered: 05/19/06
Posts: 230
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Just to answer patients question, no I currently don't own a second home. I have however lived in florida for 4 months out of the year for several years, and now I visit their 2 times a year for up to a month at a time, staying with friends. I have had my primary from here call a script for pain meds to a pharmacy in Florida, and they filled it at a grocery store pharmacy close to the house I was staying at.
I've also had a Florida Dr. give me a script down their, and had Walgreens fill it because it was next door to the Dr's office. Neither asked for identification. The grocery store, I took an empty bottle in and asked them to call it in to my Dr. for a refill.
My above post I was just saying...if I got asked by a pharmacist, that would be the answer I'd give, as I have proof that I do business in Florida, and do go their for an extended period of time. I have not been asked, but then, my local pharmacy knows me, knows I travel their every year, and wouldn't suspect anything wrong. Now we have a walgreens here (I don't use them) but I'm in their system now since I had a fill in florida with them, so If I did the direct route, I could take it to either, as Walgreens has the info that I had indeed been scripted in Florida before with their chain of pharmacies.
I understand peoples concerns, the injury probably wouldn't work time after time, but the part time residency would.
Im also in a state with no prescription monotoring program
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#651911 - 02/17/08 06:41 PM
Re: Questions to Consults Direct
[Re: ]
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FrankienJonnie
Banned by popular demand. Looks like another ID of Boltin1
Member
Registered: 02/04/08
Posts: 182
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[quote=FrankienJonnie] No,you are not.I would be terrified to use insurance on Ds scripts.I'll just pay the full amount, its cheaper than whatI'm used to paying thru OCS pharms.. Maybe private insurance is more lenient,but because i have a pre existing serious condition,I have no choice but to accept state funded insurance.With the new laws being passed here,EVERYTHING is checked.I was just turned down for an MRI,they dont want to cover anything that they feel isnt neccesary.My fear is that they will get the bill for the meds,look and see the Dr that prescribed is not one of their providers,and then they start digging.And they probably have every right to terminate my policy if they see Im ordering online.
You see, I think you're very, very correct here. Exactly, and yes you better belive that more than likely, your state does use a PMP, impliments it and here is a secret I'll share w/you folks.
I'm not writing this is order to help people "allude" any type of law enforement, but I feel I can share it because my dr. told me this. One time I aksed my doctor for a refill early becuase I truely did loose one of my bags on a place trip. It actually did find it's way back to me, like two months later and the airline was so "proud" that they claimed they found it, and actually delivered it right to my phone. BUT, here's the point, and this med was even a sch.II, very strict, and the actually paper script cannot have refills written on it (yes, I know that now federal law allows a dr. to write up to 3 consecutive script, for three months out, and hand you three indiv. written scripts, but that wasn't the case w/me; and when I went to a different pharmacy, based on the dr.'s advice, so I wouldn't have a problem. I got denied from TWO places, based on these two things, one I could control and one I could not (sorta of);
1. The place I went to, looked my history up in my state's PMP, and said that I'm not due for a refill for another two weeks.
2. The second, having had a government discount card on file which does save a TON of money, little did I know, "acts" like an insurance card and the excuse was "your insurance is not covering it becuase you're not due for this refill yet", so here is the SECOND time in one day I was denied for this refill becuase of big brother and the pharmacy running my "insurace", LOL - "discount" card.
Moral - BE WARE of government discount card, while they do work in your favor on price, they are setting it up on a monitor type of system that "runs" each script and will kick it BACK to you if it's not time.
So, this would be the same scenario by using your works insurance or private insurance. This is one way they "police" what you're getting and how often and I personally think pharmacists just LOVE to say, "sorry it's too early, your insurance won't clear it. Yes you can offer to just pay it, but then it's up to the pharmacist to make a judgement call, and typically it's not in your favor.
Now, guess what, each time, I didn't have the nerve to say, but on my last and 3rd attempt, I went to Target, where I did have one of these sch.II scripts done/filled about 3 months ago, and luckily, they based their decision on THEIR own history, they obviously didn't check my state's PMP, and I did not have my governmental insurance card on file; when I turned it in, I just said, "can I get a price please, no insurance - I don't have any".
So while just like my daddy told me, "you may be able to outrun a cop, but you can't outrun a CB radio!" LOL
_________________________
Hillary For President!!! If you had peace, serenity and remember the Clinton years with content and joy, lets have that again America! Trust it's Hilliary, not Bill.
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#651914 - 02/17/08 06:51 PM
Re: Questions to Consults Direct
[Re: glasser]
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FrankienJonnie
Banned by popular demand. Looks like another ID of Boltin1
Member
Registered: 02/04/08
Posts: 182
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Just to answer patients question, no I currently don't own a second home. I have however lived in florida for 4 months out of the year for several years, and now I visit their 2 times a year for up to a month at a time, staying with friends. I have had my primary from here call a script for pain meds to a pharmacy in Florida, and they filled it at a grocery store pharmacy close to the house I was staying at.
I've also had a Florida Dr. give me a script down their, and had Walgreens fill it because it was next door to the Dr's office. Neither asked for identification. The grocery store, I took an empty bottle in and asked them to call it in to my Dr. for a refill.
My above post I was just saying...if I got asked by a pharmacist, that would be the answer I'd give, as I have proof that I do business in Florida, and do go their for an extended period of time. I have not been asked, but then, my local pharmacy knows me, knows I travel their every year, and wouldn't suspect anything wrong. Now we have a walgreens here (I don't use them) but I'm in their system now since I had a fill in florida with them, so If I did the direct route, I could take it to either, as Walgreens has the info that I had indeed been scripted in Florida before with their chain of pharmacies.
I understand peoples concerns, the injury probably wouldn't work time after time, but the part time residency would.
Im also in a state with no prescription monotoring program
True true, and you have a special circumstance; actually, many people do have residence in another state, and if that works out like you said, that is pretty cool, and works!!
HEre is the stinger!! LOL And I thought this is not a law for you (since you're state has nothing against a controlled med to be transferred), BUT, sometimes a pharmacy chain, develops their own policies and procedures and I found out, that while, one time, I argued with a pharmacist at a CVS(which too are mostly all over the US), about transferring a controlled med (in a similiar circumstance), and I almost offered to the pharmacist as proof, to get the state law, for the state I was in, that said that it's okay to allow a controlled med to be trasnferred from another state, to the one I was in. He said, "Yes, that may be true, I'm not trying to argue w/you and you are probably correct on that, however, when CVS put together their Rules/regulations and so forth, that either complied with state and federal laws, based on scheduled or "controlled" medication, some of our polices go a bit "stronger" than what a state allows, and it is not a discretion issue, but I must follow the Rules of "CVS" and obviously a rule that may sound like it goes against a state law (meaning that if things were opposite and my state had a law concerning a controlled med and we at CVS said that no, we can allow it - NO, we can't, in that case the state or feredal law supercedes, meaning we can't over rule their law, but "can" decide to be more sringent. And becuase MOST of the CVS locations around the country, have adopted the rule/policy/regulation that we have in place regarding a transfer of a controlled med, in order to keep things easy to know from state to state, we just went across the board and said "no" or whatever the case may be, for ALL CVS stores.
I have had that instance come up before and from having had jobs in the retail sector, in the past, working for/at a chain store that has retail locations across the US, they are allowed to make policies and regulations based on the law, and sometimes they can exceed or be "tougher" than the state or federal law. That sucks, but oh well, ya know.
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Hillary For President!!! If you had peace, serenity and remember the Clinton years with content and joy, lets have that again America! Trust it's Hilliary, not Bill.
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