Prescription Refill FAQ
                
What is this about?

• We are charging a $20 administrative fee for refilling prescriptions.
• This started August 1, 2004
• This fee applies does not apply to prescription written when you have a physician or nurse practitioner appointment. You will not be charged the administrative fee if you are given a prescription refills at an appointment with the doctor or nurse.
• The fee is $20 regardless of how many prescriptions are filled.
• It is payable by cash, check, or credit card at the time that you pick up your prescriptions; if you use a credit card an additional processing fee raises the total payment to $22

Why am I being charged an administrative fee for prescription refills?
                
We are doing this to maintain your access to safe and efficient medication management services.  We simply can't do this without your help.  We have developed a system that allows us to provide these services for patients taking tightly regulated opioid and other medications. We want to continue providing these services, but we must ask our patients to bear a portion of the cost now - because health insurance plans often refuse to cover the additional work this service requires. If we do not charge this fee, we could not afford the extra work and we would have to discontinue prescribing medications for hundreds of patients.
                
Why don't Primary Care practices do this, too?
                
They do not have 500 or more patients on medications that require extra work to meet Federal and State guidelines for prescribing these special medications.  IPCA does - it is a pain clinic.  This large number of patients requires IPCA to hire additional staff and use sophistated software to keep the prescribing as safe as possible for the patient and the public, and to meet all the regulations that apply to opioid medications.   Primary Care practices do not need to do this if they only have a few patients taking opioid medications.  And, it turns out that many primary care practices have stopped prescribing opioid medications for pain altogether - in part because it is so much work and is so costly.

Furthermore, a primary care physician can see you every month to manage medications - with the large number of patients being referred to IPCA for medication management we cannot see every patient, every month.  There is not time in the schedule.  Consequently, you will probably be coming in for a prescription fill visit with non-provider staff now and then.
                
I thought my insurance companies payment and my co-pay covered all the costs of prescription refills.
                
The handling of opioid prescriptions according to state and federal guidelines is expensive. Any clinic that does a lot of opioid prescriptions has very high costs associated with this.
                

• Compared to the average primary care office, IPCA is taking care of many more patients who need potent and tightly regulated medication for their difficult pain problems.
• This means that we cannot see every patient receiving narcotic medications once a month. We have far too many patients to do this. We routinely see stable patients every three or four months but we must fill prescriptions monthly in between visits.
•   The administrative fee goes to cover just a part of the cost of all the activity that goes on to fill your prescriptions in between clinic visits. Specifically, we have hired extra staff and purchased additional computer software to do this safely and efficiently, and to comply with state and federal guidelines for prescribing narcotic medications.              

• Your insurance may not cover this unusual and additional service.
• Do not blame your insurance company, there was no way insurance companies could have anticipated the current climate surrounding prescribing narcotic medications for chronic pain.

Does this apply to everyone?

No.  A few insurance companies will cover prescription fill visits without requiring burdensome prior authorization, etc.  Check with your IPCA provider to see if your health plan is one of these.

Also, Medicare and Medicaid (AHCCCS) laws prevent any physician from charging for this service - even though these government health plans Do NOT COVER it themselves.  It is expected to be given free, essentially!  (Remember, the extra work and expense orescribing opioids places o a physician practice is NOT covered by the standard reimbursement formula) 

We are trying to work this out with these plans, and we expect to succeed; but if we cannot do so - opioid prescribing may simply become impossible for those covered under these plans.  Many primary care physicians have given up on prescribing opioid medication, already!