Home Forums Discussions General Discussion Do you give phone refills?

After taking a couple days off for Thanksgiving, I am barraged with the usual refill requests along with some patient upset that their medications were not immediately filled the day they wanted them. I would like to transition into a model whereby meds are reconciled every visit and enough refills are sent to last until the next appointment. The problem is, the patients are used to calling for refills and many seniors do not even understand what they are taking. I have had a sign up requesting them to bring in pill bottles for some time, but it goes ignored.

At this time, it seems the only way to get everyone on board is to just quit doing phone refills, make them come in for med reconciliation, and then they will realize they need to actually get their meds refilled when they are in. This will probably cause all sorts of consternation. However, it will be much better in the future when no one is running out when I'm on vacation.

Can anyone help with ideas on this transition?

Yes we do. I too would like to do less of them. I try to refill a year at a time.

Ideally we should run monthly reports on diabetics, heart patients, etc. who haven't been seen in say > 9m and track follow up that way separately from med refills.

Reconcile med list at least 1-2/year to make sure they are on what we think they are on.

Problem now is pharmacy changes with every new plan year, formulary changes and ridiculous diabetic supply specifications - anyone successfully write "glucometer and strips any brand"? any other time saving prescription tips out there?

Simply charge for phone refills. Or the option to come in for an appointment.
By the way, including a statement that you charge for phone contacts outside of office hours in your answering message has really reduced nuisance calls at night.

Simply.. charge for refills? I'm sure I would need to notify everyone before I implemented that, and it might go over like a lead balloon. Is that a viable option? I have seen some practices that just say they do not do phone refills, and if needed, patients should make an appointment. I am considering sending a portal message for every refill that says to make an appointment.

We first researched our contracts -- none of them (including Medicare) preclude charging for telephone services, but none of them pay either. If you want to try to bill, the code is 99441: "5-10 minutes of medical discussion". It can't be related to any face to face contact within a week.
We dictate an Addendum in AC, stating that the patient called for the refill, chart was reviewed to confirm med dose and currency, and patient notified that their next F2F visit should be within X time period.
We began by notifying everyone who called for a refill or came in for an appointment that effective "this date", we would begin a charge for telephone refills (since at each of our appointments we already provide refills until well past the next visit). Their alternative is to come in for an office visit, with a limited refill provided until that time.
Almost no requests for refills by phone now, except some crisis situations, like lost luggage or different pharmacy. We are flexible in many cases.

I am not sure if these refills are only after hours. When they call to the office after hours, they get three options. One is for refills, which goes right to our MA via email.

As far as when they ask me, I have a slide show on a 48 inch flat screen, which is informative and rather funny. That particular slide just says,

HOW DO WE PROVIDE REFILLS AFTER HOURS?

THATS SIMPLE. WE DON'T.

WE DO NOT REFILL ANY MEDICATION AFTER HOURS.

I don't even answer those pages unless it is for asthma meds.

And, when I do, I simply refill them through eRx and don't call them. I almost NEVER call a patient about refills.

We do no phone refills.
Refill must come as requests from the pharmacy, with current sig., etc.
If someone calls the office for a refill, they are directed to their pharmacy.
If the pharmacy won't send a refill request, the patient has to come in for a visit.
It isn't a request from a pharmacy, then it is a new prescription, and new prescriptions require a visit.
If they change pharmacies, and the new pharmacy can't get the information from the old pharmacy, then the patient has to come in for a new prescription.
We are hard nosed about this (with rare exceptions.)
I'm very tired of facilitating every one else to save money at my expense.

Shortcuts for rx refill

I use keyboard shortcuts
Personally my brain has got attuned to them

Alt F4 closes formulary screen
Alt 1 prepares prescription
Alt 2 sends prescription