HELP - On Q Pump!!!

[nyt]

Looking for some suggestions. In the past Dr. Hibner always sent home your extra On Q Pump filled with Marcaine for when the first one was empty. Well, now they are sending home a script for a refill. I questioned the NP Lisa about the script and she told me any local pharmacy would fill it. That is absolutely NOT true. I knew this was going to be a problem when they gave me the script.

1. I've called a bunch of local pharmacies plus the one local compounding pharmacy and none of them can fill this specaility script.
2. I called two of the local hospitals and both pharmacists said they can't fill it because I'm not an in-patient plus they were concerned because their patients in hospital never keep their pain pumps in that long. For them I raised a "red flag." I told them I knew that most On Q Pumps did not stay in that long but this was a special situation.
3. I called one of the local infusion pharmacies. The pharmacist said that a) the prescription had to come from an in-state doctor, b) they had to approve the medication, c) they had to order the medication in, and d) I would need a home health nurse set up to come in for the change.

ARGH , ARGH , ARGH !!

I'll call Dr. Hibner's office in the morning and let them know of my difficulties. At this point I'll have to pull the pain pump in 2-3 days when it is empty unless Dr. Hibner's office can fill the script and FedEx it to me. They just started to send home scripts for the On Q Pump so I know I'm not the only patient who can't the refill. I don't know if I'm the first they did this with or how many before me but if I'm not the first I know that other's couldn't have gotten their scripts refilled.

Any suggestions?

[nyt]

Sent an email to Dr. Hibner. He said I was suppose to have it filled at the 222 building pharmacy as St. Joseph's. If Lisa said that to me I totally missed it and the nurse who gave me the scripts didn't tell me either. Oh well, thanks for listening to my rant.

However, for anyone else out there, make sure you get your script filled at the 222 building pharmacy at St. Joseph's.

[HerMajesty]

When I saw Dr. Weiss in California, he prescribed me a topical concoction and sent the order to the compounding pharmacy he uses in California, and they shipped the med to me preserved in cold packs using 1-day shipping. I am not in California, they shipped it to my home in Nevada. Are you sure you cannot get the 222 building pharmacy to ship another pump to you before this ones runs out? From my experience, it is apparently legal to ship across state lines.

[nyt]

I had already decided I would ask Lisa if they could contact the pharmacy and then see if they could ship it over night. Thanks for the suggestion! Just annoyed that this shouldn't have happened.

[nyt]

On Q Pain Pump Marcaine refill will be FedExed to me by Wednesday.

Any of Hibner's patients out there. Make sure you get your On Q Pain Pump script filled at the 222 Outpatient Pharmacy on Thomas Road in Phoenix, AZ before you leave. The cost is $291.00 and the pharmacy tech on the phone was totally unwilling to contact my insurance company even after I told her that my insurance would pay for it. So you might need to plan on paying for this upfront and then submitting for reimbursement. Maybe you will get lucky and get someone much more helpful than the pharmacy tech I had to deal with on the phone.

Has been an extremely frustrating few days .

[helenlegs 11]

Glad you did get that sorted nyt, worrying to say the least (and that was just me!!)
You shouldn't have too much trouble getting a reimbursement should you? just a time consuming operation ?
((((hugs))))
Helen

[nyt]

Just wanted to update anyone looking for information on how to deal with insurance companies for reimbursement of your On Q Pump.

1. The 222 Outpatient Pharmacy that you must get your prescription filled at will tell you that "No insurance company will pay for this prescription." That is absolutely not true as I have a partial reimbursement sitting right in front me.

2. The 222 Outpatient Pharmacy can not submit this prescription to your insurance company for you. The reason is as follows: The medication (Marcaine) goes into a medical device (On Q Pump) and in order to bill for medical devices you have to special authorization/codes which the pharmacy does not have.

3. All medications are given what is called a NDC (National Drug Code) by the FDA. This is a 11 digit identification number that is unique to each medication. The NDC number that is on the paperwork from the 222 Outpatient Pharmacy is an invalid NDC because in order to enter a medical device that is filled with a medication into their current system they have to use an invalid code. In order to submit for reimbursement for the medication in the On Q Pump you have to ask for the correct NDC before you submit to the insurance company. I have spoken with the pharmacy manager and they are going to work on providing the correct NDC when they dispense the On Q Pump.

4. The major cost of this almost $300.00 prescription is the On Q Pump itself. The pharmacy manager is going to send me all the details I need to submit to my insurance company to see if they will reimburse for this medical device. He was extremely helpful and said they will work on providing Dr. Hibner's patients with all the appropriate documentation they need to be able to submit for reimbursement.

This is a work in progress but the pharmacy manager was really helpful and wants to get all the kinks worked out. If any of you are having surgery with Dr. Hibner please advocate for yourself at the pharmacy to get all the information you need so you can try to get reimbursed for your On Q Pump. Like I stated above, so far my insurance has reimbursed for the Marcaine (minus my copay) and now I'm going to figure out how to submit for a medical device.