Comments on: My PCP told me he received a letter from my insurance stating concern over the amount of narcotics I consume? http://www.aubenades.org/recovery-narcotics/my-pcp-told-me-he-received-a-letter-from-my-insurance-stating-concern-over-the-amount-of-narcotics-i-consume Wed, 03 Feb 2010 01:18:59 -0600 http://wordpress.org/?v=2.8.2 hourly 1 By: sarah314 http://www.aubenades.org/recovery-narcotics/my-pcp-told-me-he-received-a-letter-from-my-insurance-stating-concern-over-the-amount-of-narcotics-i-consume/comment-page-1#comment-4624 sarah314 Sun, 13 Dec 2009 03:02:59 +0000 http://www.aubenades.org/recovery-narcotics/my-pcp-told-me-he-received-a-letter-from-my-insurance-stating-concern-over-the-amount-of-narcotics-i-consume#comment-4624 They may have sent a letter to your doctor questioning his prescribing habits, checking for documentation to ensure that he isn't over-prescribing narcotics to people. A letter like that would come out of a medical or utilization review type department, and any file copy regarding it would be referenced under your physician's name in the UR department. (Its not something that would be tied to your file, because they'd be questioning his prescribing habits...not your consumption habits.) One other thing...did you call your health insurance company or your pharmacy benefits manager (PBM)? If you called your health insurance company, they wouldn't have any information related to what your PBM sent out anyhow. Technically, your PBM is your "insurance" for prescriptions, and it would be *their* utilization review department that such a letter might have come from. (Common PBMs include Medco, ExpressScripts, Caremark, etc...check the insurance card you use for prescriptions. Quite likely, it mentions one of those companies or another PBM.) Honestly, I wouldn't worry about it TOO much if I were you. If such a letter actually was sent, it quite likely was just asking your doctor for justification as to his prescribing habits. If he has a pattern of prescribing lots of narcotics to patients, they might just want him to justify that. But again, its not something that should affect you personally - again, its likely the doctor's judgment they were questioning yours. P.S. It doesn't meant there's anything "wrong" about your doctor either. If he treats a lot of patients with severe pain, he justifiably could be prescribing higher than typical amounts of narcotic meds.<br><b>References : </b><br>15 years working for medical providers and health insurance companies They may have sent a letter to your doctor questioning his prescribing habits, checking for documentation to ensure that he isn’t over-prescribing narcotics to people.

A letter like that would come out of a medical or utilization review type department, and any file copy regarding it would be referenced under your physician’s name in the UR department. (Its not something that would be tied to your file, because they’d be questioning his prescribing habits…not your consumption habits.)

One other thing…did you call your health insurance company or your pharmacy benefits manager (PBM)? If you called your health insurance company, they wouldn’t have any information related to what your PBM sent out anyhow. Technically, your PBM is your "insurance" for prescriptions, and it would be *their* utilization review department that such a letter might have come from.

(Common PBMs include Medco, ExpressScripts, Caremark, etc…check the insurance card you use for prescriptions. Quite likely, it mentions one of those companies or another PBM.)

Honestly, I wouldn’t worry about it TOO much if I were you. If such a letter actually was sent, it quite likely was just asking your doctor for justification as to his prescribing habits. If he has a pattern of prescribing lots of narcotics to patients, they might just want him to justify that. But again, its not something that should affect you personally – again, its likely the doctor’s judgment they were questioning yours.

P.S. It doesn’t meant there’s anything "wrong" about your doctor either. If he treats a lot of patients with severe pain, he justifiably could be prescribing higher than typical amounts of narcotic meds.
References :
15 years working for medical providers and health insurance companies

]]> By: tim g http://www.aubenades.org/recovery-narcotics/my-pcp-told-me-he-received-a-letter-from-my-insurance-stating-concern-over-the-amount-of-narcotics-i-consume/comment-page-1#comment-4623 tim g Sun, 13 Dec 2009 02:37:59 +0000 http://www.aubenades.org/recovery-narcotics/my-pcp-told-me-he-received-a-letter-from-my-insurance-stating-concern-over-the-amount-of-narcotics-i-consume#comment-4623 maybe it was a remark made in passing.<br><b>References : </b><br> maybe it was a remark made in passing.
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