Hospital refuses to allow doctor's prescription to be filled

Hi @aabadi, that is impossible to be answered on a patient forum like this one. I strongly recommend that you discuss this with the prescribing doctor. As your prescribing doctor to contact the hospital pharmacy directly and, if necessary, to also contact the doctor you are seeing at hospital.

@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

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.

Thank you.
The doctor at the hospital is the one that prescribed it. The hospital seems to have disagreed with his decision and overruled him.
Is that normal? There was no mistake or confusion, just a difference of opinion as to the best treatment.
Does the hospital really have such power?

Please speak to your prescribing doctor. Most hospitals have a Patient Relations Department or Office of Patient Experience. You can contact them to help mediate.

Good luck with getting this resolved.

Thank you!

I got a feeling there is more to this situation then you are aware of. The fact that medical director is involved with the filling of a prescription implies to me that there is something happening between the provider and hospital and your caught in the middle. The pharmacy is only following their management orders.

The other thing that is odd is pharmacy's determining if appropriate for specific illness, my pharmacy does not know what my illnesses are. Though based on prescriptions, they have pretty good idea.

I am assuming this is not for a narcotic / pain med. If it is, then there may be other reasons it is not being filled.

As other suggested, you need to go back to provider who wrote prescription.

Laurie

Sometimes this is what happens when politics gets involved in healthcare. Politics messes up everything it touches.

My goodness what did they prescribe!!!