5 ms·

I skimmed it and I'm a little confused by a detail. > She contacted her insurance agent and was told her application was denied because something on her medica

I skimmed it and I'm a little confused by a detail. > She contacted her insurance agent and was told her application was denied because something on her medication list indicated that Isela uses drugs. Isela, who works in an addiction treatment program at Boston Medical Center (BMC), scanned her med list. It showed a prescription for the opioid-reversal drug naloxone, brand name Narcan. > Isela had bought naloxone over the counter at a pharmacy, as can anyone in Massachusetts. If Isela bought the narcan OTC and her PCP didn't know about it (aka it wasn't in the medical records), how did the insurance company find out about it?

mwint 4y ago
She listed a drug she (allegedly) doesn’t take in the application field meant for drugs she does take, and it confused the system. (Edit - may not have been her fault, strictly. Sounds like the system needs a “taking” vs “for others” flag, but that also sounds ripe for abuse… I’m sympathetic to insurance companies erring on the side of “you have it, you might be taking it”)
- hedora 4y ago
  The second half of the article explains that she had a "prescription" for it from a doctor she didn't actually know (this drug is only sort of OTC, apparently), and the technicality alerted the computer. The insurance companies then confirmed that their flagging / rejecting of applications like hers is intentional.
  - micromacrofoot 4y ago
    In her case, it may have also been run through medical insurance to cover the cost. There are a few ways this could end up in the hands of a life insurance company, no erroneous form-filing needed.
- deleted 4y ago
  [deleted]
- elliekelly 4y ago
  This happened to me with a prescription drug for seizure medication for my dog. The prescription was written to me and dispensed to me so it showed up in my medical records that I had released to the insurance company. It was fairly easy to clear up though because it was written by a veterinarian and the "patient" name was ellie $dogName kelly. (Thankfully my dog's name is different from my middle name!) Technically the prescription was indeed "mine" it just wasn't ever intended for me to take.
aaaaaaaaaaab 4y ago
Credit card data.
- babypuncher 4y ago
  Since when do point-of-sale terminals send itemized receipts to your bank when using a credit card?
  - jasonjayr 4y ago
    Google "Credit Card Level 3 data" https://paymentdepot.com/blog/level-3-data-processing/ https://paymentdepot.com/blog/level-3-data-processing/
    - edrxty 4y ago
      Holy shit, fuck all of that. I don't want that info being sent to my bank or collected at all.
  - FunnyBadger 4y ago
    Have you ever looked at your CC statement?? It lists every transaction - so apparently this was bought by her prospective insurance company - which is evil.
    - babypuncher 4y ago
      My CC statement shows each transaction, how much it was, and where it took place. But I've never seen it include any information about what was actually purchased. So my question is, how could an insurance company know what prescriptions you picked up at Costco last week based only on data from your bank? I'm pretty sure your pharmacy cannot even share that data with your bank without violating HIPAA. I really appreciate the cynicism here, since most people have no idea how much detailed customer information retailers and banks are gathering and selling, but I think in this particular case it is misplaced.
      - 4y ago
deleted 4y ago
[deleted]
op00to 4y ago
Was it covered by her prescription drug insurance?
deleted 4y ago
[deleted]
Hizonner 4y ago
> If Isela bought the narcan OTC and her PCP didn't know about it (aka it wasn't in the medical records), how did the insurance company find out about it? All pharmacy transactions, including many, many "OTC" sales, are heavily surveilled. I can't buy freakin' dramamine withouth showing ID, even though it's "OTC" here. It wouldn't be very surprising for an insurer to have access to that stuff.
- newfonewhodis 4y ago
  Interesting. Is that specific to your state? Here in WA, I've never shown my ID at a drugstore even for prescriptions much less OTC>
  - alphabettsy 4y ago
    On the federal level pharmacies are required to log purchases for some drugs including those containing Pseudoephedrine, they are required to get ID for this. Same for controlled-substance prescriptions.
kotaKat 4y ago
Because "over the counter" is a bit of a misnomer. You must go to a pharmacy and speak to the pharmacy rep or pharmacist, who has access to the standing order that creates a prescription that's automatically rubber-stamped by an issuing physician. Now you've been "prescribed" Narcan, for all intents and purposes. The pharmacy now fills it via the normal procedures, including submitting to insurance as required to obtain payment for it behind the scenes. So... your insurance knows now you have (at least) once "taken" Narcan. Same thing happens when you go to a pharmacy for a flu or COVID shot or other vaccines: a remote physician "writes" the prescription for the vaccine, to which the pharmacist then draws and administers.

mwint 4y ago

She listed a drug she (allegedly) doesn’t take in the application field meant for drugs she does take, and it confused the system. (Edit - may not have been her fault, strictly. Sounds like the system needs a “taking” vs “for others” flag, but that also sounds ripe for abuse… I’m sympathetic to insurance companies erring on the side of “you have it, you might be taking it”)

hedora 4y ago
The second half of the article explains that she had a "prescription" for it from a doctor she didn't actually know (this drug is only sort of OTC, apparently), and the technicality alerted the computer. The insurance companies then confirmed that their flagging / rejecting of applications like hers is intentional.
- micromacrofoot 4y ago
  In her case, it may have also been run through medical insurance to cover the cost. There are a few ways this could end up in the hands of a life insurance company, no erroneous form-filing needed.
deleted 4y ago
[deleted]
elliekelly 4y ago
This happened to me with a prescription drug for seizure medication for my dog. The prescription was written to me and dispensed to me so it showed up in my medical records that I had released to the insurance company. It was fairly easy to clear up though because it was written by a veterinarian and the "patient" name was ellie $dogName kelly. (Thankfully my dog's name is different from my middle name!) Technically the prescription was indeed "mine" it just wasn't ever intended for me to take.

aaaaaaaaaaab 4y ago

Credit card data.

babypuncher 4y ago
Since when do point-of-sale terminals send itemized receipts to your bank when using a credit card?
- jasonjayr 4y ago
  Google "Credit Card Level 3 data" https://paymentdepot.com/blog/level-3-data-processing/ https://paymentdepot.com/blog/level-3-data-processing/
  - edrxty 4y ago
    Holy shit, fuck all of that. I don't want that info being sent to my bank or collected at all.
- FunnyBadger 4y ago
  Have you ever looked at your CC statement?? It lists every transaction - so apparently this was bought by her prospective insurance company - which is evil.
  - babypuncher 4y ago
    My CC statement shows each transaction, how much it was, and where it took place. But I've never seen it include any information about what was actually purchased. So my question is, how could an insurance company know what prescriptions you picked up at Costco last week based only on data from your bank? I'm pretty sure your pharmacy cannot even share that data with your bank without violating HIPAA. I really appreciate the cynicism here, since most people have no idea how much detailed customer information retailers and banks are gathering and selling, but I think in this particular case it is misplaced.
    - 4y ago

deleted 4y ago

[deleted]

op00to 4y ago

Was it covered by her prescription drug insurance?

deleted 4y ago

[deleted]

Hizonner 4y ago

> If Isela bought the narcan OTC and her PCP didn't know about it (aka it wasn't in the medical records), how did the insurance company find out about it? All pharmacy transactions, including many, many "OTC" sales, are heavily surveilled. I can't buy freakin' dramamine withouth showing ID, even though it's "OTC" here. It wouldn't be very surprising for an insurer to have access to that stuff.

newfonewhodis 4y ago
Interesting. Is that specific to your state? Here in WA, I've never shown my ID at a drugstore even for prescriptions much less OTC>
- alphabettsy 4y ago
  On the federal level pharmacies are required to log purchases for some drugs including those containing Pseudoephedrine, they are required to get ID for this. Same for controlled-substance prescriptions.

kotaKat 4y ago

Because "over the counter" is a bit of a misnomer. You must go to a pharmacy and speak to the pharmacy rep or pharmacist, who has access to the standing order that creates a prescription that's automatically rubber-stamped by an issuing physician. Now you've been "prescribed" Narcan, for all intents and purposes. The pharmacy now fills it via the normal procedures, including submitting to insurance as required to obtain payment for it behind the scenes. So... your insurance knows now you have (at least) once "taken" Narcan. Same thing happens when you go to a pharmacy for a flu or COVID shot or other vaccines: a remote physician "writes" the prescription for the vaccine, to which the pharmacist then draws and administers.