When does a RX expire????????

[Oedema]

Ahhh yes......the venerable, inexplicable "contact lens exam fees". I know how to handle this question when it comes up with my own fittings, and how to coach existing fits in handling the situation. How does one explain, when asked "Why was I charged more for my routine eye exam, just because I wear/wore contact lenses?".

I don't know about you, but I certainly appreciate being paid for my time and expertise when dealing with contacts. Even if I'm not making changes there is extra work and thinking that goes into the exam for a contact lens patient.

But thats part of the problem with contacts, so many practitioners (fitters and OD's alike) giving away their service and knowledge that many people will balk at CL related service fees. For this reason I personally don't feel inclined to try and build this part of my practice. Pittance for fees, whiny patients that return endlessly; no thank you!

[chip anderson]

Oedema:
The point is: A contact lens exam is strictly a routine eye exam with the words "OK for contacts on the Rx". This is the doctor saying: The eye is healthy enough for contact lenses. Something that any routine eye exam should reveal, no extra time, or whatever required.
Now many practioners, if they will release Rx at all charge an extra $80.00-$150.00 for the same exam allowing the patient to belive that some sort of additional services have been performed. Now all this assumes that the patient will be referred to a competent optician contact lens fitter who will do his on K readings, fitting, follow-up and evaluations.
The only addittional effort the doctor need expend is putting "OK for contacts" on the Rx.
Chip

[Oedema]

That is not my idea of a "CL exam," if they can get away with charging $80 for write "ok for contacts," all the power to them. I'm guessing this is an ophthalmologist? But why is that even necessary for you to fit contacts?

[chip anderson]

I know how, which is more than I can say for all but a handfull of the hundreds of prescribers I have known. Also there are still a rare few eye doctors that feel thier talents should be used exclusively practicing medicine and surgery. I do realize that most of them are now businessmen, but there are still a rare few that are ethical left out there.
Some even feel that the time they would spend selling contacts could possibly save or restore and eye that they would not have seen if they were wasting thier time in the optical business.

Chip

[sugarpopspete]

In ontario when does a RX prescription expire???

The reason i ask because each doctor writes their own expiry date. Some state 6 months, 1 year or 2 years. They make life difficult when trying to get a rx faxed over from their office. Obviously they want to bring the client back in their office.

So again according to the college of physicians and surgeons of otnario when does a rx prescripton expire????

Our office doesn't write expiry dates. We have, however, been refused the rx from other offices that DO write expiry dates. Annoying for the patient, who just wants to purchase glasses, and finds no problem with their 3-yr-old rx.

[Oedema]

Our office doesn't write expiry dates. We have, however, been refused the rx from other offices that DO write expiry dates. Annoying for the patient, who just wants to purchase glasses, and finds no problem with their 3-yr-old rx.

They should not refuse to release the Rx to you, even if it has expired. According to the college of optometrists they should release the Rx with "expired" written or printed on it. I don't really feel like its the OD's job to police the enforcement of expirations, release it, and if there ends up being a problem, well then, told you so.

[eye2]

1 year is reasonable....

Very easy to accommodate. Just have Doc. Put right on rx expiration date, problem solved. Unfortunately you have places that will disregard that and still fill it. I know of one right here in NY!

[Barry Santini]

Very easy to accommodate. Just have Doc. Put right on rx expiration date, problem solved. Unfortunately you have places that will disregard that and still fill it. I know of one right here in NY!

yeah...me!

B

[chip anderson]

I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it. Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.

Chip

[DragonLensmanWV]

I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it. Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.

Chip

That's high security paper. Like this:
http://www.highsecuritypaper.com/fea...enmessage.html

[eye2]

yeah...me!

B

Sorry Barry you guessed wrong!

[eye2]

I have one group of OMD's that does not have this on the Rx they give this to the patient but if copied, duplicated or sent by Fax or E. Mail (even from them to the optician) it comes out with EXPIRED written all over it. Created a problem when one is trying to get a duplicate to send to the insureance or other third party payers.

Chip

Funny how insurance companies review expired and other optical places will just disregard it and use it.

[chip anderson]

The problem with this "high security paper" is it shows expired the day it's written if copied, faxed or e.mailed. Where I have a problem is with Rx's for prosthetic eyes. The only reason we ever need an Rx for a prosthetic eye is to collect from the insureance or other third party. Don't really need Rx to provide one to the patient, just to get money out of third parties.

Chip

[Barry Santini]

Rx Expirations dates for eyewear "formulas" are just another blatant example of attempts to *control* the client. Plain and simple.

In my mind, this can be lumped in with the industry-wide advice to engage in the intra-office prescription "hand-off."

CL expirations are another thing altogether.

OMO

B

[optical maven]

If there is no expiry date on an Rx, then who is responsible to the patient when they claim they were unaware their 3 year old Rx may not be accurate. Does it become my liability to replace the lenses when the person says they should have been informed? I had this happen before I included a disclaimer on the Rx as to the potential inaccuracy of an old Rx. Sorry, but it is in the patients, prescibers, and dispensers best interest to include at least a disclaimer as to the potential inaccuracy after a certain period of time.

[chip anderson]

If one goes in and asked to have a dress made at size 4 and refuses to have measurements or fitting done. Then picks up same an comes back later when she finds out she has gained weight and needs size 6. Is the dressmaker responsible? If so how much? Does she need to take it back and refund? Does she need to completely re-make the dress? Does she need to provide free alteration?
How far is one required to go? Is one required to do anything at all? If one is supplying a product at the customer's specifcation and the customer's direction against the advise of the seller, who's responsible?

Chip

[Barry Santini]

Whose to say a 1 hour old RX is accurate?

Just what is "accurate'?

Better is what the person finds as "satisfactory"

B

[optical maven]

Last time I checked making glasses was a medical act. That is why a license is required to prescibe and dispense. By your comments I am assuming you are advocating a complete deregulation of dispensing and requiring the same educational standards as required to fit a dress. Have you been lobbying you state regulators to require no licensure to dispense glasses?

If one goes in and asked to have a dress made at size 4 and refuses to have measurements or fitting done. Then picks up same an comes back later when she finds out she has gained weight and needs size 6. Is the dressmaker responsible? If so how much? Does she need to take it back and refund? Does she need to completely re-make the dress? Does she need to provide free alteration?
How far is one required to go? Is one required to do anything at all? If one is supplying a product at the customer's specifcation and the customer's direction against the advise of the seller, who's responsible?

Chip

[chip anderson]

Maven:
I actually lobbied in my state for licenseing for about 40 years. The few times we approched this with something acceptable (this was back when OMD's for the most part didn't dispense and we had thier support, which we don't have now that OD's are qualified to provide follow-up care on post-surgical patients, we no longer have this) the OD's (they actually had thier members on the legislative commitees) would tack something unacceptable (like we couldn't take PD's or seg.hts.) on it. Gave up on fighting that windmill years ago.

Chip

[Barry Santini]

To do eyewear well takes skill and training. To do it adequately takes almost nothing in the way of skill or knowledge. Hence, the growth of online.

And the risk of long-term sustained harm when it is done less-than well is very low.

So I'm against any position that trumpets a risk of harm greater than reality backs up. And so we'll just have to acknowledge that good enough is in fact good enough..not the best or near excellence, and not hide behind our license that, being done without, presents a great risk to the public.

As far as eyewear is concerned. OMO

B

[eye2]

[QUOTE=Barry Santini;381825]Whose to say a 1 hour old RX is accurate?
Just what is "accurate'?
Better is what the person finds as "satisfactory"


B thats all true, but if its written on the rx expired how is it your right to circumvent what the Doc wrote and use the rx? Same could be said for contacts also, do you also circumvent that issue as well? Can't have it both ways B. :hammer:

[Barry Santini]

Contacts no. Eyewear Yes. That doesn't mean that I would and routinely do ignore exp dates. It's just that no person is *obligated* to return the the dr. who writes the expiration date. So I'm thinking it is more about "control" than health. So if the date is all about eye health\, then make the exam the determining factor...not the eyewear. Duplicating eyewear has nothing to do with health. Not having an eye exam when you should does.

There's a distinction here that also applies to contacts, since they are medical and in the eye

B

[optical maven]

So to some extent we are talking apples and oranges. In Ontario presribing and dispensing glasses are only allowed by license. In the US these laws appear to be different between states. I have always and will always give a prescription, no matter how old to the retail store or patient. But, I am still responsible to make the patient aware that the Rx may not be accurate after 1 year. Should I say the Rx is good for life? Will you redo the glasses, ad infinitum, if the customer cannot see? If you advocate for no expiry date, then there should be no date on the Rx at all?

If it is different after 1 hour as you blogged above, then there is a medical problem (eg unstable blood sugar), and for sure they shouldn't have that filled.

Contacts no. Eyewear Yes. That doesn't mean that I would and routinely do ignore exp dates. It's just that no person is *obligated* to return the the dr. who writes the expiration date. So I'm thinking it is more about "control" than health. So if the date is all about eye health\, then make the exam the determining factor...not the eyewear. Duplicating eyewear has nothing to do with health. Not having an eye exam when you should does.

There's a distinction here that also applies to contacts, since they are medical and in the eye

B

[Barry Santini]

In NY State, I can duplicate/copy a person's own Rx glasses. If we agree this is no good, then we MUST ban all OTC and internet eyewear.

Either....or.

B

[eye2]

In NY State, I can duplicate/copy a person's own Rx glasses. If we agree this is no good, then we MUST ban all OTC and internet eyewear.

Either....or.

B

B what we were talking about was using an expired rx not neutralizing a persons specs to duplicate them. If the rx says expired I don't care what you do you can't use it. Now if you say you neutralized the persons glasses then yes that is allowed under NY law. But what if there is a case where you notice that said rx has expired and you ask doc to ok it even though it was not the original doc do you use it or not?