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  1. #1
    lisa Guest

    Default IC pulling payment for meds ordered by Doctor

    Ok, to be as plain as possible; the games are afoot-
    Friday, my husband got his meds ordered from his Dr ( the orthopedic Surgeon he saw on the 17th , and who released him to work same day). We had asked the IC, for a form 113 so that my husband could obtain another opinion from a different Ortho because this man he went to on Monday did not listen to a word husband said, only spent literally five minutes with him.
    While waiting for the meds to be called in from Orthos office, there suddenly came a problem with husbands card from IC, the pharmacist said the numbers were different, so husband called the IC company, and was told no, number is still good. Finally, when he calls the card company, they say no, the prescription payment was pulled by husbands IC worker! Question is, can she do this? It was five o'clock when we were told this , so calling the state was not a possibility, nor was calling the IC. He is to be at work on Monday, and now he will have to drive all the way to work, 60 miles each way in total pain, work all day, and when he gets off work, he wont be able to call IC, since they will be closed. Can anyone suggest what I need to do or can do for him while he is at work? To explain his injury problem, he fell ~ 14 feet from a modified skytrack forklift to the ground, and one of injuries is a split in his left glut muscle going straight across the muscle. He is also dealing with two bulging disks in his cervial area, also two in lumbar region, with annular tear. The Ortho told him, working with your back will not aggravate your back any more than it is already. (Cant belive that one)
    I realize that we are not the only ones going through all this stuff, and I am sorry this post is so long, but you all are the only people I can ask for help or info from. I am at my wits end, and I am terrified. We have five small children, with no private insurance of our own.I hope this post makes sense,
    thanks for all help and ideas

  2. #2
    sh Guest


    Pay for the meds directly and seek reimbursement; go to the emergency room.

  3. #3
    mac Guest


    Yeah, pay yourself and seek reimbursement later, and/or go to the emergency room. He has an annular tear? If he is in a lot of pain this weekend go to the emergency room anyway, and see if the docs there can do a better diagnostic job than the IC doc did. I'm all for early return to work programs, but if he is as injured as you say, and it's recent, I don't understand the ortho releasing him back quite yet. Also, if the IC doc prescribed meds how can the adjuster 'disapprove' them? It sounds like either a bureaucratic snafu or a dispute regarding liability for the injury in the first place. There's something wrong here.

  4. #4
    aj Guest


    I find in cases involving prescription cards the issue is with the pharmacy and the electronic approval of the prescription. We use a service similar to this and problems like this occur occassionally. I usually takes a call to the provider of the card and giving them authorization for the rx to be filled. If the medication in question is not related to the accident then the adjuster does have the right not to authorize them though that does not sound like the case here. This sounds more like someone did not active a card or add a medication to the card.

  5. #5
    e3mrk Guest


    I had a problem with the W/C paying for my pain med's because they said they were not on their list of approved drugs.
    What I did was contact the Governor of my state and explained the problem and his office contacted the W/C and now they are paying for my med's.
    It may not work for everyone but nothing ventured nothing gained I always say,And with workers comp. A person needs to try everything to get treated fairly.
    Good Luck.

  6. #6
    veryinterested Guest


    Hey e3mrk...what state...I am having so many problems...including meds...Was your Governer really able to help...What did he/she do and how long did it take to see results...

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