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A Word from the Owner 

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Island Psychiatry 'Outside of Appointment RX Request'

We appreciate the questions that some of our patients have had about our policy regarding prescription requests made outside of regularly scheduled appointments. We'd like to provide you with information which may help clarify the reasons for this fee.


Before implementing this fee, our office received a great number of daily requests for this service. The sheer volume began to interfere with our team's ability to provide personalized and attentive care for other administrative matters.


These fees were designed to alter certain behaviors that reduced our ability to service all of our patients' administrative needs in the most efficient and equitable manner possible. These behaviors included, but are not limited to, the following:

➤ Failure to schedule appointments according to your clinician's recommended treatment plan (***Most common.)

➤ Lost or misplaced prescriptions.

➤ Multiple requests to change pharmacies after the Rx was sent for purposes of cost or convenience.

➤ Failure to check for refills on prescriptions already sent.

➤ Taking quantities greater than our clinician’s recommended dosage.


Issue of Controlled Medications


A common question we receive regarding this Rx fee includes, "The reason I am requesting a refill is because my medication can only be prescribed for a month. It isn't because I lost my medication or didn't schedule an appointment in time. Why am I paying for this?"


We understand this question, however we must abide by all federal (DEA, Drug Enforcement Agency) and New York State regulations and guidelines. These regulations severely limit the clinician's discretion regarding the amount of medication dispensed and the ability to authorize refills.


Additionally, when prescribing controlled medications, the law mandates thorough review and documentation including an examination of the patient's online records of controlled medications (PMP - Prescription Monitoring Program.) This process requires more time and we appreciate your understanding.


Pharmacy Related Issues


In addition to these patient centered issues and legal requirements for controlled medication there has been a rise in the following pharmacy and insurance issues:

➤ Pharmacy stock or pricing problems.

➤ Insurance company demands for having prescriptions written to their exacting (and often unreasonable requirements.)


While we share your frustration regarding these obstacles, they are outside the control of Island Psychiatry.


Expedited/Rush Fee


If an expedited/rushed prescription is requested, an additional $15 fee will be added to the existing prescription refill fee. Expedited prescriptions necessitate the additional work of 'bumping' a particular request ahead of other patients who are waiting for their prescriptions. In addition, prescribers are often urgently messaged in the middle of their full clinical days or over the weekend.


We want to reiterate that this fee was instituted in order to encourage patients to keep track of the quantity of medication they have remaining in advance of their next scheduled appointment. As expedited requests are often associated with missed appointments or late cancellations, we hope that this fee diminishes the frequency of these events.


All of these policies are ultimately designed to ensure the highest quality and most cost effective care possible. As always, we encourage you to express your feelings about this and other policies directly with your clinicians.


We appreciate your understanding regarding these matters.

Randall Solomon, MD

CEO and Founder


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