How do you navigate C-2 refills in patients who are stable in their treatment and do not otherwise need to be clinically seen monthly?
This practice is routine in child psychiatry. We fill stimulant prescriptions electronically at the phone request of the family as long as they are keeping quarterly appointments. We do not charge for that service. We do document it in the medical record.
Your question begs another question, however...
My practice is all adults, yet I have a fair number of patients who are taking controlled medications. In the case of stimulants, I will proactively send three 30-day prescriptions, one for each of the next three months, and then see the patient(s) quarterly. I have had no issues with local pharmaci...
The DEA allows up to 90 days for a C-II drug to be prescribed on any given day (this applies mostly to stimulants and not opioids, which have other restrictions). It can be prescribed all at once or in smaller increments like 30, 45, or 60 days, etc. with a current date. If for a future month, an ad...
I always see patients monthly in the beginning to make sure they are stable. After a few months, I’ll go every other then every 3 months. I’ll bring them in if we need to change something before the 3 months, and I am available to patients to meet sooner if needed for other reasons. I’m pretty stric...
- Yes, absolutely. To my knowledge, the only thing that is relevant is the doctor-patient relationship.
- Insurance companies' 30-day imposition is not based on care, compassionate medicine, nor science or evidence-based beyond shaping clinician behavior.
- See 1 above. The 30-day limit appeared de novo ...
Addendum: I just saw 'part 2' of the question, would I consider charging a small fee for refills in between visits? Yes, I am seriously considering doing so. This is because refilling stimulants, with the never-ending supply chain shortage, insurance denials, and extra time required for controlled R...
I now have a small practice (past retirement age!) and have 5 patients on stimulants. I see them all at least monthly by their choice. But when I worked in a large health care system, I saw everyone every 90 days, and that felt right. It gave me a chance to assess the efficacy of the meds.