nythng4mygrl
Member
What is the name of your state (only U.S. law)? Louisiana
Good afternoon. I am in the process of obtaining reimbursement for prescriptions from insurance company and am running into a speed bump. I mailed ALL required information which included a printout from the pharmacy that listed all prescriptions, dates of service, dr that prescribed meds, amt dispensed, RX number, and the total charges, as well as what I paid out of pocket. The printout was signed by the pharmacy, and now the insurance company mailed me a letter requesting DEA numbers for the physicians that prescribed the medication. I just spoke to the physicians office and they have informed me that this information is private, and that the pharmacy had the information required when they filled the prescription. They stated that the insurance company should not be allowed to withhold my reimbursement since i do not have access to the DEA number, and if the pharmacy did not have the DEA number, then the prescription would have never been filled. Basically i was told that the printout from pharmacy should suffice.
The instructions read verbatim:
1. Print Patients Name
2. Identify Relationship to cardholder, date of birth, and number of prescriptions submitted for each patient.
3. Print Pharmacy nmae and address and the prescribing Doctor and DEA number used by each patient.
(please note that Claims receiving any of the missing information will be returned or payment ma be denied)
Is there any privacy law that i can recite in my letter to the insurance company, or is it really mandatory to obtain the DEA numbers for these physicians? I have never heard anything like this, and this is an independent plan that my daughter's father provides for her that is in her name as the member. Express Scripts is the company that reimburses for prescriptions but the plan is under Blue Cross Blue Shield.
Any advise would be helpful. Thanks!!
Good afternoon. I am in the process of obtaining reimbursement for prescriptions from insurance company and am running into a speed bump. I mailed ALL required information which included a printout from the pharmacy that listed all prescriptions, dates of service, dr that prescribed meds, amt dispensed, RX number, and the total charges, as well as what I paid out of pocket. The printout was signed by the pharmacy, and now the insurance company mailed me a letter requesting DEA numbers for the physicians that prescribed the medication. I just spoke to the physicians office and they have informed me that this information is private, and that the pharmacy had the information required when they filled the prescription. They stated that the insurance company should not be allowed to withhold my reimbursement since i do not have access to the DEA number, and if the pharmacy did not have the DEA number, then the prescription would have never been filled. Basically i was told that the printout from pharmacy should suffice.
The instructions read verbatim:
1. Print Patients Name
2. Identify Relationship to cardholder, date of birth, and number of prescriptions submitted for each patient.
3. Print Pharmacy nmae and address and the prescribing Doctor and DEA number used by each patient.
(please note that Claims receiving any of the missing information will be returned or payment ma be denied)
Is there any privacy law that i can recite in my letter to the insurance company, or is it really mandatory to obtain the DEA numbers for these physicians? I have never heard anything like this, and this is an independent plan that my daughter's father provides for her that is in her name as the member. Express Scripts is the company that reimburses for prescriptions but the plan is under Blue Cross Blue Shield.
Any advise would be helpful. Thanks!!
