Creams- % getting approved by insurance

Discussion in 'Independent Medical Contractors' started by Anonymous, Mar 14, 2014 at 1:34 PM.

Tags: Add Tags
  1. Anonymous

    Anonymous Guest

    New to the pain/scar creams but I have a handful of doctors writing them for me. The issue at hand is I've been seeing so many being denied by insurances that the docs are getting frustrated and beginning to question wether it's worth their time. Is this just the name of the game? Any advice? Is it the compounding pharmacy? I see this as a big opportunity to make $$$ but at some point these docs are going to pull the plug if they aren't seeing more patients being approved. Thanks everyone for their honest thoughts.
     

  2. Anonymous

    Anonymous Guest

    Medicare has spent $172 million on penis pumps over the last five years. Sell penis pumps instead.
     
  3. Anonymous

    Anonymous Guest

    It's the pharmacy, they aren't helping you
     
  4. Anonymous

    Anonymous Guest

    thats because you are late to the game. The pain/scar cream game is late in the 4th quarter and you just got your uniform on and walked into the gym. The insurance companies aren't covering it anymore because even they have realized they've been getting raped for the last 3 years for creams that don't do jack shit. Very soon you will see surgeons going down for their involvement in "studies" and they reps who are paying them as well. Be thankful that you were late to this one, yes you missed the boat and didn't make any money but you also don't have to worry that the FBI is calling you every time a blocked # comes up on your cell phone.
     
  5. Anonymous

    Anonymous Guest

    Agree that the OP is very late to the game, but disagree that the insurers are not covering creams anymore. Instead, it is that they are finally tightening up the indications necessary for reimbursement of pain creams --- after getting raped without any KY jelly for far longer than 3 years.

    Regarding scar creams, it's generally a one-time hit, at the most twice, with no ongoing residuals. Payments will be dropping for scar creams as well, then eliminated down the road, once the insurers pick which low-cost contracted compounding pharmacy they choose to fill those scripts --- and eliminate payment to any other pharmacy, leaving the insured patient 100% financially responsible.

    OP: It's been a great ride. Sorry to hear you were at the airport when that ship set sail.
     
  6. Anonymous

    Anonymous Guest


    Why do you say that? What more can a pharmacy do if insurance carriers aren't covering?
     
  7. Anonymous

    Anonymous Guest

    A good pharmacy will have a qualified staff that have plans B, C, and D at the ready. If the doc writes for 240 and its denied, the pharmacy should cut back on the dosage to see if that gets approved and so on. Some pharmacies have a cash option for the patient for a generic watered down cream so they still get some benefit. Therefore, your doc will have a higher success rate for his or her patients. Again, this all depends on the state and the quality of the pharmacy. Hope that helps! One last thing, I hope everyone keeps poo pooing the pain/scar cream market..... It only discourages folks from jumping in on this gravy train!
     
  8. Anonymous

    Anonymous Guest

    Do yourself a favor and put some of that money away. You are going to need it for bail and to pay your lawyers.
     
  9. Anonymous

    Anonymous Guest

    i don't think its legal for the pharmacy to "cut back the dosage" because it was denied by the insurance company. If you are working with a pharmacy that does this I would seek other legit pharmacies to work with. This is the exact reason why everyone keeps on "poo pooping" on the pain/scar cream market. Theres no legitimacy behind the entire "gravy train". Those that hopped on when it was the new thing to do have moved on, if you are still here or just getting on board, I hate to tell you but you missed the real train.

    are the pharmacies still suggesting that you swap out your script pads for new ones every other week with different formulations? new fax #'s, etc? Or have the insurance companies caught on to that game?

    Just don't answer any blocked calls to your cell phone. Tell your doctors to do the same
     
  10. Anonymous

    Anonymous Guest

    I have to agree with quoted poster. My docs tell me that they have more cream reps trying to see them then pharma reps. It's soooooooo whored out. Time to move on.
     
  11. Anonymous

    Anonymous Guest

    So what is the names of a legitimate compound pharmacy?
     
  12. Anonymous

    Anonymous Guest

    why would I move on when I am making 17k/month? some of my friends make up to 50k/month with 2 guys I know making over 100k/month.
     
  13. Anonymous

    Anonymous Guest

    There are still legitimate pharmacies helping patients with high quality compounds. However, it is not the EASY money that it once was, which is better long term anyway, b/c it will deter thousands more reps from trying to get some EASY money. For those who are still working the market, helping physicians treat patients, and seeing a fair amount of approvals, the business is still legit and if you're willing to work for it, then it can be a good opportunity.
    more info upon request: thrivemedinc@gmail.com