Wiki Prescription w/o Visit???

[erickalm]

Are providers allowed to prescribe prescription medication to a patient without initially seeing a patient for a new problem?

Patient called her doctors office to make an appointment after experiencing flu like symptoms (which also seemed to be going around at the time). The doctor instead called patient back, asked a few questions and sent a prescription to a nearby pharmacy w/o the patient even stepping in the office.

So are they allowed to prescribe a medication without having seen the patient first?
Don't they need the patient to be present to properly diagnose them & prescribe the correct medication and select correct treatment plan?
Do they charge a visit for this?
And if so how?

 

[cheermom68]

No visit

Happens all the time. There is no visit charged for this.

 

[mitchellde]

Happens all the time. There is no visit charged for this.

It does happen all the time and this is why the AMA create codes specifically for non face to face visits, for this type of occurrence and it can be charged. as 99441, 99442, 99443, or even e-mail 99444. Some payers do pay these codes but if not the patient should be charged. There are other parameters that must be met and are explained in the code book.

 

[cheermom68]

no charge

Most offices that I have ever worked for or with do not charge for these, because the code is usually not paid and patients tend to react negatively to this type of charge. If your office wants to develop a policy to charge the patient for these types of phone calls, I would suggest posting the policy and informing your present and new patients so that there are no surprises.

 

[ajs]

Are providers allowed to prescribe prescription medication to a patient without initially seeing a patient for a new problem?

Patient called her doctors office to make an appointment after experiencing flu like symptoms (which also seemed to be going around at the time). The doctor instead called patient back, asked a few questions and sent a prescription to a nearby pharmacy w/o the patient even stepping in the office.

So are they allowed to prescribe a medication without having seen the patient first?
Don't they need the patient to be present to properly diagnose them & prescribe the correct medication and select correct treatment plan?
Do they charge a visit for this?
And if so how?

Many physicians have enough knowledge about their patients history to be able to prescribe certain medications without physically seeing the patient. They do tend to have their own guidelines around these situations.

The gynecology practice I worked for had some providers who would prescribe antibiotics automatically over the phone for an established patient calling in with UTI symptoms, but other providers in the same office would choose to have the patient come in to the office, or go to the lab, to have a urine sample tested first. Most providers I have worked with do not charge for a phone call that results in a prescription.

Are they able to charge a fee? Yes. Do they have to? No. And if they have the same policy across the board for all patients it does violate Medicare regulations.

 

[mitchellde]

Most offices that I have ever worked for or with do not charge for these, because the code is usually not paid and patients tend to react negatively to this type of charge. If your office wants to develop a policy to charge the patient for these types of phone calls, I would suggest posting the policy and informing your present and new patients so that there are no surprises.

I understand that the patients will be reluctant to pay for this BUT.... we are a society of cell phones, and most patients would rather visit via phone rather than in person or txt or email for that matter. If we continue to allow the patients to access our providers for free, the provider will eventually be out of business and the community will lose a valuable resource. It takes time on the part of the provider to address patient issues and you have no problem submitting a bill when they are in the office, so I fail to see why you would have a problem submitting a bill for the phone call, the same information was collected and communicated. I think we need to retrain our patients that the providers are valued professionals and deserve to be compensated.