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Hospital refuses to allow doctor's prescription to be filled

Visiting Mayo Clinic | Last Active: Jan 6, 2023 | Replies (9)
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@sueinmn

@aabadi That is an interesting question. Welcome to Mayo Connect, let me see if I can help you from both a patient and caregiver perspective.

First, are you sure the hospital is refusing, or is the insurance company? Often meds may be required to be tried in a certain order before they are covered. (Step therapy) This is especially true for newer, high cost drugs and many opioids.

Second, is the doctor on their staff, or does he just have "privileges " to provide care there?

And finally, hospitals are often working from an incomplete patient history, and the prescribing doc may need to better explain the specific reasons.

Two places to start with questions are the prescribing doc and the Patient Advocate.
Sue

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Replies to "@aabadi That is an interesting question. Welcome to Mayo Connect, let me see if I can..."
aabadi | @aabadi | Dec 26, 2022

Thank you
The doctor is an outside contractor.
The Hospital themselves provided him to us.
The doctor is here every day and sees the patient
He determined that a certain medicine should be prescribed.
He prescribed it to the hospital pharmacy.
The hospital medical director intervened and told the pharmacy not to fill it.

Can a hospital do that? Get in the middle between doctor and patient, when there is no data showing the doctor is wrong?
That's the issue.

Thank you so much.

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