Rx release question

**pseudonym** · 05-02-2014, 07:32 AM

A patient called an outside doc's office and requested them to fax his Rx to my optical. No go. He was required to come into the doc's office where he got his contact lens exam and physically sign an Rx release before the office would send it to my office. All the other docs I've dealt with have faxed the Rx's over even when I did the calling (so long as I have the patient's DOB.)

What gives? Maybe I'm wrong, but I understood that the examining doc had to make the Rx readily accessible to the patient.

**m0002a** · 05-02-2014, 08:06 AM

The FTC requires that an OD must provide a written copy of the Rx to the patient upon completion of the contact lens fitting. Some patients may require follow-up visits after the initial exam before their contact lens fitting is complete. All follow-up exams must be medically necessary, and eye care providers should use sound professional judgment — based on appropriate and objective standards of care — to make that call.

A written copy of the Rx must be provided to the patient without the patient asking for it. Also, the OD must "confirm" the Rx provided by the patient to a third party dispenser when asked to do so by the third party dispenser. A third party dispenser asking for a initial copy of the Rx is a little different, but here is a question and answer from the FTC website that seems to answer that:

The Contact Lens Rule says prescribers must provide or verify contact lens prescription information “as directed” by a third party designated by a patient. But according to HIPAA (Health Insurance Portability and Accountability Act of 1996), don’t I have to get written authorization from a patient before providing or verifying his contact lens prescription to a seller?
No. HIPAA permits covered entities to use or disclose protected health information without patient authorization if the use or disclosure is for “treatment” or “required by law.” Providing, confirming, correcting, or verifying a contact lens prescription to a seller designated by the patient constitutes treatment or is required by the Act and the Rule.

The rules for an eyeglass Rx are a little different since the Rx must be provided to the patient right after the exam is completed and paid for without the patient asking, and there is no fitting requirement.

If the patient faxes a letter of authorization to provide the Rx to a third party dispenser, and the fitting has been completed, and the OD declines to do so, I would have the patient inform the OD that a complaint with the FTC will be initiated within 24 hours unless they comply.

**optical24/7** · 05-02-2014, 08:59 AM

Many OD's hide behind HIPPA to make it tough for patients to get continued care (products) elsewhere. Every office that I and a client have encountered this, the client ceased to use the office and switches over to one I refer to. Bad for business if you have/work in an office that makes patients jump through hoops to acquire a recent Rx of any kind.

**m0002a** · 05-02-2014, 09:07 AM

Originally Posted by optical24/7

Many OD's hide behind HIPPA to make it tough for patients to get continued care (products) elsewhere. Every office that I and a client have encountered this, the client ceased to use the office and switches over to one I refer to. Bad for business if you have/work in an office that makes patients jump through hoops to acquire a recent Rx of any kind.

As the above FTC question and answer says, a HIPPA release form is not legally required. However, it shouldn't be that hard to deliver, fax, email with attachment, or snail mail a HIPPA release form (signed by patient) to the OD office.

**vcom** · 05-02-2014, 09:08 AM

-As far as I understand HIPPA, we should always have the patient sign the acknowledgement/receipt of HIPPA guidelines. And by doing so, they agree to the, "How we may use your private health information" section, which states we can share their information between providers for the purpose of their continued care. So, wouldn't that mean faxing an Rx is ok because it is part of the patient's 'continued care'?

**m0002a** · 05-02-2014, 10:24 AM

Originally Posted by vcom

-As far as I understand HIPPA, we should always have the patient sign the acknowledgement/receipt of HIPPA guidelines. And by doing so, they agree to the, "How we may use your private health information" section, which states we can share their information between providers for the purpose of their continued care. So, wouldn't that mean faxing an Rx is ok because it is part of the patient's 'continued care'?

Maybe I am wrong, but it does not appear necessary for the patient to sign such an acknowledgement in order for an Rx to be provided to a third party. To repeat, here is a question and answer from the US government FTC website:

The Contact Lens Rule says prescribers must provide or verify contact lens prescription information “as directed” by a third party designated by a patient. But according to HIPAA (Health Insurance Portability and Accountability Act of 1996), don’t I have to get written authorization from a patient before providing or verifying his contact lens prescription to a seller?
No. HIPAA permits covered entities to use or disclose protected health information without patient authorization if the use or disclosure is for “treatment” or “required by law.” Providing, confirming, correcting, or verifying a contact lens prescription to a seller designated by the patient constitutes treatment or is required by the Act and the Rule.

**pseudonym** · 05-02-2014, 07:37 PM

Thanks, everyone. The other office is definitely trying to make it difficult for patients' to get their Rx and walk...I just have to figure out how to persuade them differently.

**cocoisland58** · 05-02-2014, 09:13 PM

Originally Posted by pseudonym

The other office is definitely trying to make it difficult for patients' to get their Rx and walk...I just have to figure out how to persuade them differently.

Easy enough to persuade the patient to have his exam at your office next year, one stop shopping.

**ChrisW** · 05-02-2014, 09:52 PM

had the same problem in the past in the UK - new exam for patient f.o.c with us = we look great, other office look petty & we have a very satisfied customer who is more than likely to come back to us next time. Works well for sight test prescriptions, not as straight forward for contact lenses unless they are an established wearer I guess.

**m0002a** · 05-02-2014, 11:07 PM

Originally Posted by pseudonym

Thanks, everyone. The other office is definitely trying to make it difficult for patients' to get their Rx and walk...I just have to figure out how to persuade them differently.

That should be easy. Send them this link from the FTC explaining their responsibilities with specific reference to the question and answer about HIPAA, and inform them that if they don't cooperate you will be filling a complaint with the FTC (a complaint can be filled by opticians or patients). This link pertains to the Contact Lens Rules, but the same rules apply for eyeglass Rx's with regard to HIPAA. I would also inform them that in addition to filing a complaint with the FTC, you will be contacting the local consumer affairs reporters at various local TV stations to see if they would like to run a story about this.
http://www.business.ftc.gov/document...tact-lens-rule

**FL-Opt** · 05-08-2014, 11:21 PM

This is the biggest misconception about HIPAA in the optical industry - Patients are NOT required to sign a release form if it involves their treatment, this goes for medical records, optical Rx's, or anything else regarding their treatment. What I do when I get a request from a patient or another optical is I verify the patient's information (name, DOB, or some other info provided) to make sure I am not releasing the Rx to a non-authorized party. After I verify that, I send it right over. There's no reason patients should have to wait, go to the office, sign an authorization in person, fax it back and all that BS just to get an Rx sent over. Doctors call in Rx's all the time to pharmacies and they don't make patients sign release forms. Use your common sense, don't over-complicate the situation or mislead the public.

**Judy Canty** · 05-09-2014, 09:24 AM

Another "Adventure in Sales Prevention". SMH

**harry888** · 05-09-2014, 04:24 PM

another thought: Might have an open balance at other office.

Harry

**becc971** · 05-10-2014, 08:53 AM

This happened to me with a patient who had moved here from California, and to somewhere out in the willy whacks (2 hours from our most remote office) so it wasn't easy for them to come in and sign it, send it back and wait to get the RX in. The optician told me it was the doctor's policy. I told him it was the most ridiculous thing I had ever heard

I have had to call a lot of other places for prescriptions and that was the first time I'd ever heard that line.

Harry raises a valid point also, but if they had an outstanding balance they should speak to the patient and explain that is why their RX isn't being released, i've had to do that before. It isn't fun, but sometimes it has to happen.

**m0002a** · 05-10-2014, 11:45 AM

Originally Posted by becc971

The optician told me it was the doctor's policy. I told him it was the most ridiculous thing I had ever heard.

Whether it is ridiculous is beside the point. It is a violation of FTC regulations and the offending optician/doctor should have been told that.

**AustinEyewear** · 05-11-2014, 01:30 PM

Originally Posted by harry888

another thought: Might have an open balance at other office.

Harry

My thoughts as well. Pt. may not have completed fitting process either. Pts. are not always angels as many so often express on this msg board. :)

**tigerlilly** · 05-17-2014, 08:29 PM

Originally Posted by harry888

another thought: Might have an open balance at other office.

Harry

I thought the Rx had to be released, period, regardless of any balance owed?

**Speed** · 05-20-2014, 04:35 PM

Buffett said it best "I've seen more than I can recall".

**opty4062** · 05-20-2014, 06:20 PM

Originally Posted by tigerlilly

I thought the Rx had to be released, period, regardless of any balance owed?

EDERAL TRADE COMMISSION
PART 456--OPHTHALMIC PRACTICE RULES--

Sec. 456.2 Separation of examination and dispensing.

It is an unfair act or practice for an ophthalmologist or optometrist to:

(a) Fail to provide to the patient one copy of the patient's prescription immediately after the eye examination is completed.

Provided: An ophthalmologist or optometrist may refuse to give the patient a copy of the patient's prescription until the patient has paid for the eye examination, but only if that ophthalmologist or optometrist would have required immediate payment from that patient had the examination revealed that no ophthalmic goods were required;