Calif RX multiples Rx's within 2 yrs
Always a big issue again came up here in this office. If Patient presents a new Rx and we have another within 2 yrs yet they request to use older one.......doesn't the newer one supercede?
Is there a rile or law for us to state ? I have worked in a lot of offices who make us say a dialog that by law we have to fill the most current RX.
Help???.,
Are they both within their respective expiry date. If not, go with most recent, or get on your phone and speak with the refracting Doctor and see about extending the expiry date or find out exactly what CA State Law requires from you.
I didn't attend the funeral, but I sent a nice letter saying I approved of it. Mark Twain
It's really not a "big issue" unless you chose to make it so. What's wrong with using some common sense and doing what the customer asks.
This got me thinking of situations when you shouldn't use an older prescription... So... What if the customer failed a vision screening (let's say for driving a school bus, since the requirements are more stringent), then was sent to have an exam and prescription update. The doctor fills out the paperwork saying they pass with correction (but it's the newer rx). The optician makes the lenses according to the customer's request. They have an accident. Is the optician at any fault when they knew the patient had a newer rx but still filled the older one?
Yes, in this hypothetical, their prescription changed enough in a short period of time to fail them for school bus driving. And yes, vision was assessed after the accident and found inadequate. And yes, I completely manufactured this scenario. As a rule, I'd just do what the customer asks when presented with two legal Rx's. Just saying, there could be a situation you maybe shouldn't if you don't know the whole story.
Originally Posted by Eyesee333
I'm also not familiar with the California statutes, but common sense dictates that we should use the latest Rx. That should be enough to protect everyone's best interests. However, I have used an older Rx for a variety of reasons, but as Paul said, only after explaining the circumstances to the prescriber, both seeking their approval, and to update their client's history.
Hope this helps,
Robert Martellaro
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
I'd first ask the patient why. Everything flows from there. More likely than not I'd honor the request.
Because...he's not a "customer" and you aren't selling shoes?
I say the new one trumps the old one. ALWAYS ask why. If the pt already got the new one and was having problems, I would recommend a recheck. When you call the Dr's office, they are always going to give you the new Rx. If all you do is tell them the pt wants the old and not the new, at least it is documented. Nothing wrong with that. I tell the patient that if there was a problem with the newer Rx, then you need to have that problem addressed or else that can happen again. The Dr can't fix it if he doesn't know you're having a problem.
point well seen but in our office he is a customer, we are a retail shop with no Dr
yes the whole thing is the verbage that all offices I have worked in here in the S.F. Bay area. "By law we need to fill the most current, if you would like me to call ver to the Dr and request a re check or see f they will rewrite the Rx for the old one I am happy to assist you". This owner hasn't ever used that verbage or worked anyplace but his own shop...so he is scetchy on this " law" word. Plus he likes to play Dr........just wanted to know if a California Dr here knows where to resource this for a once and for all answer to put this topic to bed. Thank you.
again, I always ask why. Sometimes it could be simple misunderstanding. If he still insists on using the older Rx, I would tell him, no problem, I just need to get it approved by the Dr and give them a call. I never say by law I can't do it. I just say I can't. I'm not a Dr...I didn't examine the pt. I don't know the reason behind an Rx change... that's the Dr's job.
Right on Uncle!
This is not an issue of laws or regulations. The customer knows best. Ask him and do what he tells you to do. This could very well be one of those many cases where the newer Rx is bogus. The customer is the arbiter of his own vision, not the doctor, not the optician and surely not some "regulatory" agency in the State House.
Look at Rxs with medications at the pharmacy... I can get a refill of the old one but the Dr wrote out the new stuff... Pharmacist will fill what I request. I'm just saying I don't recommend doing it without getting all the information. Plus I think it is always good to have it all documented. Like Uncle Fester said " I'd first ask the patient why. Everything flows from there."
Well, maybe in CA., not in NC or NY ( last rules from when I was there, 16 years ago) the 2 states I am licensed in. NC law says I can duplicate an existing pair of specs, no expiration. Heck, there is no real law in NC regarding an Rx with no expiration date written , that it is something legally preventing me from filling that for as long as the patient wants me to.. I can't find a "law" in NC that says even that an expiration date is valid, and anymore binding then writing "varilux Crizal" on the Rx is binding on me, beyond a recommendation.
As was said above, think people (unless you were flipping burgers last month, or layed of from Aeropostale ) ask questions. You may just get the answer somewhere in the rant you get. Listen, ask, learn, trust what you know.
PS. Sorry about the bus driver, just not my fault.
Yes. This. +1
There were kids on that bus.
contrary to what most consider "not my fault, always someone else's fault for what I did", I followed state LAW giving patient the choice the law provides them. I don't play Kreskin as to what people see or don't see, nor am I responsible for the kids or the little spca rescue puppy on the bus. Doesn't mean I don't feel bad, just not my fault. I followed the law.
Please move on if your desire is to turn this into a blame someone else for being stupid thread, thought this was about what we CAN and CAN'T do, period. Most of us do the very best we can everyday, and hope it's right. Can never please all the people all the time.
Someone convince me that a .25D change in one lens or 5 degree axis change on a .50D cyl (or less) from that previous script means squat. I'll bet if John Q. Public goes to 3 different refractionists he's walking out with three different Rx's!!!
PS- Only drk's is spot on!
A prescription expires on the expiration date. Use some common sense and fill the most recent.
My customers are not sick, so they aren't patients.
Sickness is only one category of patients.
There are people with vision disorders.
There are people who are on high risk medications.
There are people who have chronic, controlled health conditions.
Either you're in healthcare or you're not.
I would say the fact that vision correcting devices are physician-prescribed only is a big clue.
You guys have to get clear on that, IMHO.
Nevertheless, the Rx regs and our industry are a screwed up mess.
Just follow my advice! :)
[QUOTE=CME4SPECS;526942
My customers are not sick, so they aren't patients.[/QUOTE]
Mine are. Some are sick with personality disorders. Jerkies.
It is a fact that progressive lenses produce unprescribed astigmatism in various locations on the lenses surface depending on design.
Shouldn't they be banned from wear while driving? Especially bus drivers?
Patients do not need to lay out hundreds of dollars for new glasses if changes are minor. Would I recommend it? Absolutely! Would I lose sleep over filling the previous rx as I am allowed to do--Absolutely not!!!
I don't think the words "common sense" belong in the same paragraph as "California laws".
We've done that on very rare occasions where for whatever reason the customer was unhappy with the newest RX. Maybe the dr made a mistake, maybe the patient's blood pressure was up that day, maybe they are used to the old rx and unwilling to take the time to acclimate, etc...
You'd have to contact a CA attorney to know what the law is, but in many states you can legally use an expired rx so I wouldn't worry about them plowing into a bus full of children. The same thing could happen if they keep their old pair and refuse to purchase glasses with the updated rx.
In CA an expiration date is required on an rx. If you bring me 2 rx's that are both current, I am going to recommend you fill the most recent. Nothing is stopping me from filling either one if they are both within the expiration date. Some people have their eyes examined yearly and the rx will be given an expiration date of 2 years, so they actually have 2 valid rx's. Our laws state that you can't fill beyond the expiration date.
I can easily see the differences as little as ±.25 D. But the power error when a .50 DC is five degrees off axis is less then .1 D, which I can't see.
Here's the math and details of the ANSI cylinder axis tolerances.
http://www.dickwhitney.net/ANSI%20Cy...ter%20Memo.pdf
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
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