patient wants a copy of neutralized prescription

**jpsgirl5899** · 04-29-2017, 08:28 PM

Had a customer 2 years ago get glasses from us in which he was unhappy with the new Rx. So at his request, we duplicated his 2012 prescription. He loves them so much that he recently contacted us to get a copy of that duplicated prescription. We told him that because it was a duplication, we are unable to provide him with a written prescription. That didn't go over well. I'm curious, if he pushed the issue and requested a copy of his medical records, we'd have to give him a written copy of the eyeglass order with the Rx on it. Obviously, it wouldn't be the signed Rx from a doctor but it would just be the numbers and would satisfy the customer's request. I'm just requesting any suggestions you might have. Thank you!

**peyes** · 04-29-2017, 09:17 PM

I would give the Rx and write across it: Duplicated from old glasses 2012.

**drk** · 04-29-2017, 10:14 PM

I would NOT give the Rx because it's not an Rx. You don't have the authority to write an Rx.

Now, if in your state he has the right to his "optical records" as "medical records" (only a state board would know that one), then you'd be obligated to give a photocopy of your paperwork.

My opinion, only.

However, what's wrong with him requesting the records from the original prescriber? It would be more germane. That's what I'd have told the guy.

**Chris Ryser** · 04-30-2017, 12:51 AM

Originally Posted by jpsgirl5899

Had a customer 2 years ago get glasses from us in which he was unhappy with the new Rx. So at his request, we duplicated his 2012 prescription. He loves them so much that he recently contacted us to get a copy of that duplicated prescription.

Now he found out that he could purchase online, at a price that would be much less than the retailer charges, but needed an Rx that would work for him.

It is as simple as that. In every European Country the optician would hand the patient a copy of his Rx, already a 100 years ago, so he could have the glasses repaired if he would break a lens, when on holidays at an Italian or Spanish beach.

These days with the new competition of online opticals where the price difference can be monumental between the two identities, that the goosebumps of some professionals become clearly visible, when asked such questions.

**Kujiradesu** · 04-30-2017, 10:13 AM

With a little google-fu I found this: https://www.legitscript.com/wp-conte...egulations.pdf

Its state by state, but the way I have always played it is: When I do a neutral. I make the glasses. If they're doing the work somewhere else that place can do their own neutral.

**Quince** · 04-30-2017, 06:41 PM

We often give out copies of the work orders we write up that include PD and whatever Rx was used. It is specified who wrote the Rx or whether is was a duplication. We do not offer to tell people how to use any of the information. Mostly this is given out only for insurance reimbursement.

**Robert Martellaro** · 05-01-2017, 09:00 AM

Originally Posted by jpsgirl5899

Had a customer 2 years ago get glasses from us in which he was unhappy with the new Rx. So at his request, we duplicated his 2012 prescription. He loves them so much that he recently contacted us to get a copy of that duplicated prescription. We told him that because it was a duplication, we are unable to provide him with a written prescription. That didn't go over well. I'm curious, if he pushed the issue and requested a copy of his medical records, we'd have to give him a written copy of the eyeglass order with the Rx on it. Obviously, it wouldn't be the signed Rx from a doctor but it would just be the numbers and would satisfy the customer's request. I'm just requesting any suggestions you might have. Thank you!

Refer your client to the doctor who wrote the Rx in 2012. Recommend (strongly, if their medical history requires it) a comprehensive exam from an MD or OD.

Hope this helps,

Robert Martellaro

**Barry Santini** · 05-02-2017, 02:46 PM

Heck, I would oblige and write it out.

Not on an Rx form
Not on a legal Dr.'s prescription pad
Not signed by a "doctor"

Just what they wanted...the auto lensmeters readings, toggled to a precision of their preference.

B

**DanLiv** · 05-03-2017, 10:30 AM

Originally Posted by Barry Santini

Heck, I would oblige and write it out.

Not on an Rx form
Not on a legal Dr.'s prescription pad
Not signed by a "doctor"

Just what they wanted...the auto lensmeters readings, toggled to a precision of their preference.

Me too. We don't need to gatekeep the Rx, it's up to the one filling the Rx to respect an unsigned and non-legal Rx. Plus since it was a previous customer, in my mind they paid for the work that went into that job and they are welcome to all the information on it. I do the same when my existing customers ask for PD, I will happily supply from a previous job they paid for.

**Barry Santini** · 05-03-2017, 11:43 AM

Q: What defines a 'legal' Rx?
Proper form?
Doc's signature?
Valid expiration date?
Valid date?

If any of the above is missing, is it still legal?
If none of the above is present, is it really a non legal Rx, or just a set of focal numbers?

B

**DanLiv** · 05-03-2017, 01:16 PM

A license state like NY probably standard rules about what's required on a legal Rx, but out here in the lawless wild west of CO I think a date and signature is it. Least that's all I would require. Yes without that it's just numbers, like if a nurse scrawls "take two vicodin every 8 hours", it's just words, not an Rx.

Originally Posted by drk

I would NOT give the Rx because it's not an Rx. You don't have the authority to write an Rx.

I'm pretty sure anyone can write whatever they want, but it is true our authority cannot make what we write an Rx. Without the doc's signature it's just information.

**drk** · 05-03-2017, 02:04 PM

I don't know about your board, but if you literally "write down" anything that has numbers on it, I think there's a pretty good case that you're writing what will be taken as a prescription BY THE PATIENT. Why would you do that?

If some jackass makes glasses off it, then they're guilty, too.

I suppose that jackass would be better off just "re-neutralizing" the specs.

Which brings me to this point: Why would some guy who likes his glasses duplicated all the time need anything written down at all? He's going to clone his lens powers until the end of time. He has the DNA on his nose-cheesy face.

Now, photocopies of medical records are another thing, and I think you're safer there. But it's still pointless. And counterproductive to good health, BTW.

**drk** · 05-03-2017, 02:10 PM

Originally Posted by Barry Santini

Q: What defines a 'legal' Rx?
Proper form?
Doc's signature?
Valid expiration date?
Valid date?

If any of the above is missing, is it still legal?
If none of the above is present, is it really a non legal Rx, or just a set of focal numbers?

B

A prescription is a Dr's. orders. Only Dr.s can write a "Dr's orders." It's part of a treatment plan for a disorder.

A prescription can only be filled by licensed dispensers. Any Tom, Dick, or Harry CANNOT FILL a prescription. "Some guy on the internet" cannot fill your prescription. Only someone with a license can fill the prescription (in any state that gives a darn about their citizens).

**Quince** · 05-03-2017, 03:19 PM

Originally Posted by drk

Which brings me to this point: Why would some guy who likes his glasses duplicated all the time need anything written down at all? He's going to clone his lens powers until the end of time. He has the DNA on his nose-cheesy face.

So he can order online, of course!

**drk** · 05-03-2017, 09:11 PM

Well, something we'd all like to facilitate.

**lensmanmd** · 05-03-2017, 09:43 PM

Originally Posted by drk

A prescription can only be filled by licensed dispensers. Any Tom, Dick, or Harry CANNOT FILL a prescription. "Some guy on the internet" cannot fill your prescription. Only someone with a license can fill the prescription (in any state that gives a darn about their citizens).

Unfortunately, not every state is a licensed state. And many licensed states only care about the fees they collect. Many will allow an unlicensed salesperson to fill an RX as long as there is an OD or "licensed" optician on duty.

I work in Maryland, an unlicensed state, yet I support our centers in Virginia, a licensed state. I am constantly amazed at the questions (and lack of knowledge) that I get from these so called licensed opticians.

Going back to Barry's article about ANSI standards and the optical lab. An RX is filled, and within standards. The said RX is neutralized, written down and given to the patient. That neutralized RX is then filled and fabricated within ANSI standards. The patient requests the RX be neutralized again. The optician gives the patient a copy of the neutralized RX. Patient orders the glasses on line and so on and so on. At what point has the RX deviated so far from the original RX? Isn't it our duty to have a conversation with the patient? Isn't it a duty for the OD to at least check the VA before blessing the neutralization? When I worked for the 7-11 of the optical industry, the policy was for the DONL to test VA before signing off on a neutralization. Period. But that was once upon a time in a galaxy far and away.

I, for one, completely disagree with providing the patient with a neutralization, even on an unsigned piece of standard paper.