Some points:Janknitz wrote:write "dispense as written" on the RX.
1) "Dispense as written" is the correct magic words only in certain jurisdictions. Others have different magic words, or magic checkboxes, or magic signature lines. In those other jurisdictions "dispense as written," even though everyone knows what it means, doesn't accomplish anything.
2) Specifying this doesn't mean they have to fill the prescription. It just means they can't fill it with anything else (including an Autoset). Pharmacies and DME's reject such prescriptions all the time. One example would be if they don't have something in stock or it isn't in their ordering system.
3) It's easy to get a prescription filled. The point here is to get it paid for. In my own case, I knew there was no way my insurance would pay for the machine I wanted so I got it at CPAP.com and paid for it out of pocket. Many people can't do that. You can write DAW on prescriptions all day long. That has nothing at all to do with whether insurance will pay for it.
4) Insurance companies are completely unimpressed with what doctors think or write. We cost them money. They write the insurance laws, so all they have to do is say something is "non-covered" and that's pretty much that. They know we'd rather our patients get the fancy meds or machines. They just think of us as a proxy for the patient and reject our prior authorization requests without a second thought.
A recent example was 2 weeks and many forms spent trying to get a slightly higher-than-usual dose of a common drug approved. The typical dose costs $4 a month. The dose I wanted would have cost $6 per month. They wanted me to provide literature searches, expert testimony, etc. I finally just told the patient he'd have to cough up the extra $2 a month. If they'll do that over that amount of money (which, I'm sure, ended up costing them more in time than they saved), they're sure to do it over the amount of an upgraded CPAP.
Remember, your job as a health insurance subscriber is to send the insurance company money. Their job as an insurance company is to take that money and give most of it to corporate management. The rest is earmarked for a new company jet to take company officers to their management retreats. They have vast numbers of employees whose jobs are to avoid spending any of that money on wasteful things such as healthcare.
