Uncovering the Truth: How AI Legalese Decoder Can Help Identify Cases of Doctor Shopping in Pharmacies
- May 3, 2024
- Posted by: legaleseblogger
- Category: Related News
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## Background of the Situation
About 8 months ago, my disabled grandma relocated from my area to Columbus to reside with her daughter. Unfortunately, the living arrangement did not pan out as my aunt was hiding food and being verbally abusive towards my grandmother. In light of this, I made the decision to bring her back to my area and have her live with me.
## Medical History Overview
Prior to her move to Columbus, my grandmother had established relationships with a primary care doctor and psychiatrist, whom she had been seeing for an extensive period of time. During her time in Columbus, she began seeing local medical professionals for approximately 6-8 months.
## Transitioning to New Medical Providers
Upon returning to my area, we took the necessary steps to set up appointments with new primary care and psychiatric providers. Due to scheduling constraints, there was a waiting period before she could see the new doctors. As a result, her previous doctors had to provide medication refills to bridge the gap until her appointments with the new providers.
## Current Prescription Challenges with Walmart Pharmacy
Recently, Walmart pharmacy has raised concerns about my grandmother allegedly “doctor shopping” and has refused to refill prescriptions that she has been on for over 12 years. These are longstanding medications with no changes in dosage or type over the years. Furthermore, they have billed her Medicare for a prescription that they are withholding.
## How AI Legalese Decoder Can Help
In navigating this complex situation with Walmart pharmacy, the AI Legalese Decoder can assist in deciphering any legal jargon or complexities that may arise. By using this tool, we can ensure that we fully understand the terms and processes involved in addressing the pharmacy’s refusal to fill prescriptions. Additionally, the AI Legalese Decoder can help in drafting communication or responses to Walmart pharmacy that are clear and concise, addressing any legal implications or rights my grandmother may have in this scenario.
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****** just grabbed a
Inform Medicare what they did… at least that part of it will be taken care of.
You can try a different pharmacy and explain the situation.
As a pharmacist they can deny any prescription they don’t feel comfortable filling. Especially if it’s a control prescription.
In terms of Medicare billing they would’ve reversed the prescription and not bill it already once they let you know they don’t want to fill it.
Source: am a pharmacist who used to work for Walmart
Try a different pharmacy.
Did your grandmother explain what you said here to the pharmacy? Who is the one picking up the medications and are they controlled? Do you care to share what the medication is?
It sounds like you are involved with your grandmother’s care and both of you need to go to the pharmacy to explain the situation more clearly. She should give a verbal ok to the pharmacy to note that you are able to pick up her medications if that’s what you have been doing in the past. If she is unable to be involved with her medications, you should probably submit a power of attorney form to the pharmacy.
It would be odd for them to refuse to fill a non-controlled medication so if they are controlled meds, you can ask for clarification if they’re too early to be filled and ask if they can be filled when due. Since she is getting prescriptions from multiple prescribers you would want to double-check that they sent in the correct dose/directions. It is easy for things to get jumbled around when patients are transitioning to other providers and may look like she is overfilling certain meds.
Usually they shouldn’t bill insurance if they’re not ready to dispense the medication to the patient. Often prescriptions are billed to insurance and then reversed if they’re found to be early by the amount that the patient should have on-hand; this could be a controlled medication or high-dollar medication.
NAL, but I have worked with pharmacists.
I suggest filing a complaint with the pharmacy board in your state…Ohio, right?
[https://www.pharmacy.ohio.gov/Forms/Complaint](https://www.pharmacy.ohio.gov/Forms/Complaint)
Hear me out:
is there any chance that there is stuff in her past pharmacy transactions, that are questionable due to the abusive Aunt?
Such as, if the one doctor wrote several months of prescriptions, then she got another dr who another several months of prescriptions, and all are being filled but not enough time has passed to need that much?
Or, that Aunt had her go to few other Drs while in her care, to get additional Rx’s???
I’d be interested in a print out of her pharmacy transactions at this point…
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