Average Wholesale Price (AWP) is often referred to as the wholesale price of medications.
That said, I do not use this platform to complain. It is just not right to do. I have always been of the thought that complaining does not do anything to help the situation and if you do not do anything to fix it, you are just complaining. I’m here to state the facts. Here’s the deal, sometimes a person needs medication and medications have a purpose but due to the changing environment of the insurance world medications are getting more and more difficult to obtain because of cost. This is the old “which came first, the chicken or the egg?” dilemma. Some might say that pharmaceutical companies are raising their prices but for everyone that says that some are also blaming the insurance companies for increasing deductibles and formulary tiers. That’s just one side that you, the patient, sees and we are very empathetic about it. I’m here to shed some light on what we are going through in the office when I prescribe a medication.
When I choose to prescribe a medication it is because it is what is indicated by the condition presented in front of me. We have electronic prescribing so it is immediately transmitted to the pharmacy to help get efficient fulfillment of your medication. During this transaction, your insurance (if applicable) will be verified and if it is covered you are told what your copay will be depending on what tier it falls. However, if you have an deductible that has not been met then, just like any insurance, you are subjected to whatever the cost will be out of pocket. We usually get a phone for this and I am usually asked to change the medication, of course, to my second choice (which is called my ‘second choice’ for a reason). If your insurance decides it needs further justification they may ask for us to complete a prior authorization (PA) –which is simply another hoop to jump through, that we do because we want you to get your medications. Often times it is unnecessary, it will come back with a statement that the medication I thought was best for you initially is now being requested by the insurance company (who has not evaluated you–but asked for your diagnosis) thinks that the other medication would be better for you. In the end who wins? The better question is who loses?
Just to recap:
- the patient does not have their medication OR the patient has decided to just pay for it
- the doctor has now had to succumb to the forces of the insurance company to save the patient from the above happening
- time has now passed that may have allowed the condition to exacerbate
- resources have been used, office staff, patient time in called both pharmacy and office, sometimes the insurance
What if you knew the AWP??? What if the AWP was less or minimally more than your copay? What if you were able to obtain the medication I prescribed, what I thought was best for you, immediately without having to deal with the difficulties described above?
We will never stop supporting those that support us! It’s an honor and a responsibility to be part of the community–more that, serving the community! #SiennaEyeDoc #CommunityMatters
We changed the way we send out our birthday wishes. Unfortunately, you won’t be receiving our videos any longer but we will be texting you on your birthday. In place, hopefully this cute card will suffice! (credit TokyoMilk) #SiennaEyeDoc
Almost there! The millwork has started to come in! Winter Cabinets (Scott Winter) is responsible for them and Claypoole Group (Chase Claypoole) is responsible for the overall construction. The design group Twenty20Studio (Ramon Gisbert) is responsible for the creative design. #SiennaEyeDoc #WeAreMoving #8800Hwy6 #FlooringNext
I received a pretty interesting email this weekend regarding an online contact lens company that many of you have probably seen pop up on your Facebook feed (according to their email you will soon see them in mainstream media as well) they are called Hubble. I found it interesting and I thought I would share with you my email (the sender’s name has been blacked out) because I need my patients to know and be aware of what these schemes are all about. See the email below:
A snippet from the email is shown below. This is being completely transparent with you and how much these lenses could potentially cost you and how much we could make off selling them. WE are, however, concentrated on the health of the eyes that have been entrusted to us–not making a buck here.
At face value, one might look at this and say, “Wow that’s a cheaper lens,” not me! Immediately, I recognized the material, being that I have been prescribing contact lenses for 15+ years it rang a bell that I decided to dig a little deeper. Check out the facts below (credit http://www.CooperVision.com):
And then a simple Google search of “Vertex Contact Lenses” found:
So, what is the deal here? I’m not going to sit here and implicate but I am going to state facts. It was well known and documented by doctors that private label contact lenses exist. Many lenses are the same and relabeled due to negotiations from corporate buying groups and such. The best thing to ever happen to contact lenses is UPP which stands for Universal Pricing Policy and most contact lens manufacturers are going toward that. What UPP has done is bring everything to same price point and protect patients from getting unauthorized, uncertified contact lenses for the sake of saving a few dollars. On the flip side, some of these online retailers are not obtaining their lenses from the manufacturer and you could be receiving rebranded, inaccurate contact lenses. Contact lens manufacturers like Alcon are now providing a Gold Seal of Authenticity to assure you are receiving the correct lenses for an authorized source.
If you have questions, please feel free to reach out to us!
As promised here are some progress photos of the new space. We anticipate paint and flooring to be going in soon. Things point to being completed around mid-February but the lease isn’t up at the existing space until July. We look forward to providing you better parking at our new place!
This was the before
And now we started to tear up a few things!
We are in the final phases of completion!
This is a common question that I have been asked throughout my entire 15 year career when it comes to dilating the pupil during my examinations. I even created a link on our website long ago (Why Dilate My Eyes) and we have our after dark, late night appointments readily available for patients. Although technologies like the OptoMap have been available as long as I’ve been in practice it does not suffice as a substitute to a dilated eye exam, it is even defined in Texas Optometry Board Law (see (B.) the 4th line) as not even qualifying as part of a complete eye examination. I have become aware that some practices in the area are saying otherwise and also charging additional for this testing. I thought I would post an article from Review of Optometry. This is “doctor talk” and I thought I would highlight a few things for you all to read.
Additionally, dilation of a child is usually one of the most accurate ways to determine their prescription to rule out an latent hyperopia (farsightedness) or over-focusing. As always, I strive to take care of your eyes and ocular health in the most comprehensive way.
the-dilation-dilemma (Steen, J; Review of Optometry; June 2016)