Do doctors know if a prescription has been used?

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  • Thread starter Thread starter leroyjenkens
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Discussion Overview

The discussion revolves around the implications of obtaining a prescription for compression hose prior to a vein procedure, particularly whether a doctor or insurance company can determine if the prescription was used. The scope includes practical concerns regarding insurance reimbursement and the necessity of the prescription.

Discussion Character

  • Debate/contested
  • Conceptual clarification

Main Points Raised

  • One participant questions whether the doctor will know if the prescription for compression hose was used before the scheduled procedure.
  • Another participant suggests that a prescribing doctor could potentially call the pharmacy to check on the prescription, but doubts that this is a common practice.
  • A different viewpoint emphasizes the benefits of using compression hose for vein health, particularly for those who stand for long periods, and mentions that the prescription may also include medications affecting blood flow.
  • Further clarification is provided regarding the role of the insurance company, indicating that they may not care if the prescription was filled, but require documentation that a doctor deemed it necessary for reimbursement purposes.
  • One participant advises filling the prescription to ensure reimbursement for both the vein procedure and the hose, suggesting that the actual use of the hose may not need to be disclosed.

Areas of Agreement / Disagreement

Participants express differing views on whether the doctor or insurance company will check if the prescription was filled, indicating a lack of consensus on the matter.

Contextual Notes

The discussion includes assumptions about the practices of doctors and insurance companies regarding prescription verification and reimbursement processes, which may not be universally applicable.

leroyjenkens
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I got a prescription for compression hose for varicose veins. I'm going to have the procedure that will take care of it, but for insurance to pay for the procedure, the doctor first needs to prescribe compression hose 3 months in advance. I have no need for it, because the vein isn't causing pain or discomfort, it's just for aesthetics and because it will get worse over time. So will they know if I show up to the office in November without having used the prescription?
 
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A prescribing doctor could call a pharmacy, if he knows which one you use, and ask, but I can't imagine that they ever do.
 
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The hose is helpful in lessening your veins enlargement. You should use it if you have to stand on your feet while working in a long duration everyday. It will get worse if you are pregnant, for example. The prescription includes also drugs that help modulate your blood flow. Your veins would appear almost indifferent in November if you follow the procedure.
 
leroyjenkens said:
So will they know if I show up to the office in November without having used the prescription?

It's not clear who 'they' is referred to here, the doctor or the insurance company?

It seems like if you want to get reimbursed by the insurance company for the vein procedure, you need to show that a doctor's prescription for compression hose was obtained so many days before the procedure took place. The insurance co. may not particularly care if you ever filled the prescription (and from personal experience, these things require careful fitting and are expensive w/o insurance), but at least they have on file some
sort of an indication that the problem was serious enough that your physician thought compression hose necessary. With all of the different schedules for reimbursement that insurance companies have, it could be that an insurance claim for vein procedure which did not require a prescription won't be paid at the same amount (or any amount) as one which does.

Fill the prescription for the hose. There's a record it was filled if anyone checks. You get reimbursed for the vein procedure (and the hose) by your insurance. No one has to know if you ever wore the hose unless you want to tell them.
 

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