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The optician won't give me my prescription!
April 24, 2013 12:56 PM   Subscribe

My ophthalmologist won't release my prescription. Is there anything I can do to force them to do so?

My vision insurance covers one eye exam per year, and I went in for it around the beginning of December. I didn't have the money to pay for new lenses or contacts at the time, so I told them I'd come back to place my order when I could afford it. I went back today, and they informed me that I would need a new exam, as they won't use prescriptions older than three months. The new exam, of course, would need to be paid for out-of-pocket.

So, while the prescription is still relatively fresh, I'd like to take my business elsewhere.

The catch? They won't release my prescription. Legally, I think they have to, but the FTC stipulates that they (may) only be compelled to do so on the same day as the exam:
Sec. 456.2 Separation of examination and dispensing.

It is an unfair act or practice for an ophthalmologist or optometrist to:

(a) Fail to provide to the patient one copy of the patient's prescription immediately after the eye examination is completed.

Provided: An ophthalmologist or optometrist may refuse to give the patient a copy of the patient's prescription until the patient has paid for the eye examination, but only if that ophthalmologist or optometrist would have required immediate payment from that patient had the examination revealed that no ophthalmic goods were required;

[...]
The irony, of course, is that my current pair is now approaching its sixth or seventh birthday, the lenses are trashed, and my new prescription is considerably different in any case. I really want new glasses. This is a "normal" ophthalmology practice, not a chain/discount/free exam-type business. Am I SOL?
posted by pullayup to Work & Money (32 answers total) 9 users marked this as a favorite
 
Find a new optician/opthamologist, give them the authorization to have your previous records forwarded to their office. Now you have your prescription, and can buy your glasses from them.
posted by Ruthless Bunny at 12:59 PM on April 24, 2013 [6 favorites]


I think there's another way to read that reg; namely, that the doctor has to give you the script as soon as the exam is over -- and not make you wait some unspecified period of time. The only time they can decline to give the script once the exam is complete is if you haven't paid.

I would say that if you go back to them and confidently say that they are in violation of FTC rules, so you'd like your script now, please, they will hand it over. They may be pissy about it, but I very seriously doubt that they will get into a big fight with you if you confidently tell them they are violating applicable law.
posted by devinemissk at 1:00 PM on April 24, 2013 [7 favorites]


I've been in a similar situation, and called and asked for the prescription to be faxed to my number, giving the reason that work needed to order safety glasses for me. Then I never went back there again.
posted by Slap*Happy at 1:01 PM on April 24, 2013 [9 favorites]


Sounds bogus to me. Contact the state certifying or examiner board (in which state are you?).
posted by bluefrog at 1:01 PM on April 24, 2013


I don't think that's what the FTC is stipulating - what they're saying is that it has to be provided immediately, eg, the can't say "We will give you your prescription but only after 90 days" or some shit. Also note that it doesn't say they will provide it on request; it says that it is an unfair act to fail to provide to the patient one copy of the patient's prescription. They have not done this; they are in violation.

I would strongly recommend filing a complaint with the FTC and informing the ophthalmologist that you have done so. They are in the wrong & full of shit.
posted by Tomorrowful at 1:01 PM on April 24, 2013 [6 favorites]


Go in there, and ask for a copy of your prescription. When they say no, say that Section 456.2 of the FTC requires that the ophthalmologist or optometrist must provide the patient a copy of the prescription and that you expect to be given a copy of your prescription.

It is extremely unlikely that the person working behind the desk is going to be familiar himself with the precise wording, and simply name dropping the section might scare them into giving you what you want without any further hassle.


You could also go to wherever you plan on buying glasses and have them call your ophthalmologist's office requesting a copy of your prescription.


This is so fucking annoying. They're you're medical records. You have my permission to unleash teh crazy on them if they don't comply.
posted by phunniemee at 1:02 PM on April 24, 2013 [5 favorites]


...and not make you wait some unspecified period of time.

Right, that's how I read it, but apparently they disagree.
posted by pullayup at 1:03 PM on April 24, 2013


Just to clarify: The FTC complaint itself won't actually make the FTC go after these guys. But it'll help the FTC get data to know this kind of thing still happens, and it'll add to the seriousness of when you go in and demand what the law provides you.
posted by Tomorrowful at 1:04 PM on April 24, 2013 [1 favorite]


Do they have an active Yelp presence? Negative reviews on Yelp often result in positive outcomes.
posted by acidic at 1:05 PM on April 24, 2013 [2 favorites]


pullayup, do you mean they've already told you that their reading of the law is that they only have to provide the script right after the exam and not after? If so, I'd politely tell them that, fine, you're filing a complaint with the FTC as well as with your state consumer complaints division, and in the meantime, you'll be having your new provider call for your medical records. Because that reading of the reg is really a bit of a stretch (and I speak as someone who spends a lot of time reading regulations).

And on preview, what acidic says -- and it can't hurt to mention to the office that you'll be sure to share your experience via social media, either Yelp or Facebook or Twitter.
posted by devinemissk at 1:08 PM on April 24, 2013


Definitely tell them you're planning on leaving a Yelp review, posts on their Facebook page, etc. You might also want to try contacting Consumerist.com about this -- they can be amazingly helpful in cases like this. Also, interested in Warby Parker glasses? They'll contact your doc for you.
posted by BlahLaLa at 1:08 PM on April 24, 2013


According to the FTC's website, prescriptions are valid for at least a year, unless there is a reasonable medical reason for a shorter expiration period: "A prescriber may set an expiration date of earlier than one year only if that date is based on the prescriber’s medical judgment about the patient’s eye health. In these cases, the prescriber must document the medical reason for the shorter expiration date with enough detail to allow for review by a qualified medical professional, and maintain the records for at least three years."

The same page also indicates that prescribers must give you a copy of the prescription immediately after the exam, "even if the patient doesn’t ask for it." Sounds like they are in the wrong, according to the FTC's own explanation of its rule, if they didn't give you a copy then, which they were obliged to do.
posted by brianogilvie at 1:11 PM on April 24, 2013 [2 favorites]


I'm not your lawyer or a healthcare lawyer, but don't you have a right to a copy of your medical records under HIPAA? See here:

What Rights Does The Privacy Rule Give Me Over My Health Information

Health Insurers and Providers who are covered entities must comply with your right to:

Ask to see and get a copy of your health records


Again, I'm not your lawyer, or a healthcare lawyer, and you should get legal advice. Perhaps your insurance company or your employer has a healthcare advocate?
posted by Admiral Haddock at 1:24 PM on April 24, 2013 [1 favorite]


I guess they think that by doing this they might squeeze a bit of cash out of you? Perhaps you could make it clear to them that they have already lost that possibility. And furthermore there are two possibilities: either they give you your prescription now and you go away forever, or you bother them with daily phone calls and government complaints and bad reviews online until they provide that prescription. Make it an easy choice for them.
posted by PercussivePaul at 1:25 PM on April 24, 2013 [1 favorite]


I know it doesn't seem like that much time but your prescription could have changed in 3 months. Their policy is in place to help you, not take your money. It is a prescription, not a sofa that you liked.

Call, nicely, and let them know that you didn't understand about vision changing. Ask them if they can make an exception for you and see you as a cash payment at a significant discount, because you really do need glasses.
posted by myselfasme at 1:26 PM on April 24, 2013 [1 favorite]


If prescriptions regularly change in three months time, then every glasses wearer should be getting a new prescription every three months. There may be something in pullayup's medical history that means they should get a new eye exam and a new prescription every three months, but that seems extremely unlikely considering this is the first they've heard of it (and not, say, at the time of the original appointment).

I would not be understanding about a doctor that refused to give me my medical records on request. I would get a new doctor.
posted by muddgirl at 1:38 PM on April 24, 2013 [12 favorites]


It's not about vision changes, as kind of a thought that may be, and it certainly isn't going to make much difference in three months if you're already wearing six year old specs. Opthamologists, but more likely, optometrists are usually reluctant to provide a script because they make a big chunk of cash on those 300$ glasses you order from them that you can get for 60$ online. It's crummy of them to deny you your records and at very least I'd change docs. If worst comes to worst and getting your records from them is impossible, I've gone many times to WalMart vision clinics for the basic optometrist exam for 100$ out of pocket with no insurance coverage and gotten glasses online for another 100$ (I've got a hefty prescription but not so complicated I have to really see an opthamologist for management). If worst comes to worst, it'd still be cheaper than another visit and paying your scummy eye doc hundreds of bucks for marked up glasses.
posted by takoukla at 1:42 PM on April 24, 2013 [1 favorite]


And if you have survived for six or seven years without updating your prescription, I'm betting your vision problems are mild enough that you could even be able to get those glasses online for far cheaper than I ever could with my coke bottles.
posted by takoukla at 1:44 PM on April 24, 2013


This is infuriating. I would absolutely go in and cite the regulation mentioned above. I would also tell them, very calmly, that you're deeply concerned by their business practices, and by the notion that they may be taking advantage of patients who do not know the law. You are so concerned that you are prepared to contact the licensing board of the prescribing optometrist, write a letter to the local alderman (or whoever the rep is for your immediate area), and contact your friend at the paper, who takes a keen interest in local business and news.

Do this all with UTMOST courtesy, preferably with a friend who can serve as witness, preferably while dressed in business casual. I'm betting you'll get your prescription in under five minutes.
posted by artemisia at 1:46 PM on April 24, 2013 [5 favorites]


They totally are holding your prescription hostage to try and sell you their incredibly marked up glasses. I think it's where they make the majority of their money...not on appointments. It's a crappy practice but one that most people just kind of accept although I agree that I don't think it's legal. You've paid for a service and deserve to have the records of that service.

If you can pry the prescription out of them make sure it's complete and includes your PD distance. This is a critical measurement to ordering glasses online and one that my eye doctor tried to charge me an extra $25 for after I'd just had a full eye exam. I thought (and still do) that it's totally bogus that this measurement wasn't included in the main exam, but in his office, he does the primary eye exam and then passes you off to the eye glass person who measures the PD distance. Anyway, I complained and they ended up giving me the prescription with the PD measurement and refunded my $25...but the office staff acted like I was taking $ directly out of their purses.
posted by victoriab at 1:49 PM on April 24, 2013 [4 favorites]


but your prescription could have changed in 3 months. Their policy is in place to help you, not take your money

Sorry, no. And I mean this kindly. 3 months is a very short period of time in regards to vision exams. Can your vision change in that period of time? yes, sure. but it typically does not, and withholding your prescription in that time frame has nothing to do with helping the patient and everything to do with trying to squeeze extra money from the client.

I would go in tot he office on a moderately busy period of the day, ask the receptionist for a copy of your prescription, bring the relevant legal cites, and literally not level until they provide the documents. Be polite, be vocal and be specific. They will not want you in the reception area with other patients being denied your documents.
posted by edgeways at 1:53 PM on April 24, 2013 [11 favorites]


I see a possible second problem here: check for your state regulations, but it's usually the law that a prescription is good for ONE YEAR after the exam, not a mere three months..... so besides holding your prescription hostage so they can force you to buy glasses from them, they're also apparently forcing you to pay for more-frequent examinations.

What the outcome, once this is more-or-less resolved, NEVER go back to this bunch again!
posted by easily confused at 1:55 PM on April 24, 2013


One possibility is that they're just misreading the rule and their perspective isn't coming from a place of "We're out to screw the consumer" but a place of "We don't want to violate rules by giving prescriptions out when we're not supposed to; we're supposed to only give them out immediately after the exams." (For the record I think that reading of the rule is stupid, but people make stupid mistakes like this all the time, and it might feel safer to them to refuse to provide the record than it does to provide it. There is this weird dynamic with releasing information where, even when it seems clearly appropriate to do so, people seem to default to reluctance).

Also, I'm not sure how much time you have on your hands, but showing up in person with the regulations and approaching them with a "Hey, I'm not sure that I understand your point of view on this, can you explain to me why you see it the way you do, because I read it this way" attitude might resolve this more effectively than flat out threatening them with a legal complaint.

If they dig in their heels you can still raise the issue by saying, "Okay, I see now where we disagree, so it looks like my only option is to take this up with the FTC and Attorney General's Office. Are you sure I can't just get my prescription? I'd really rather not do that." That script might allow them to save face and grudgingly provide the prescription.

If it turns out that they are, in fact, being douchey about this, the manner in which they respond to your somewhat less-confrontational and personal request for your own prescription will let you know this, and then it's time to move on to plan B, which is kick this up the ladder to the FTC/AG's office, etc.
posted by MoonOrb at 2:17 PM on April 24, 2013


Their policy is in place to help you, not take your money.

This is indeed possible. Or rather, let's be cynical about it: It's possible the policy is in place to protect the office from potential malpractice/negligence claims. In which case it could have been the doctor's idea, or a business manager's, or the insurer's. I'm not offering any opinion whether such a policy is necessary, wise, or legal, merely saying it's possible this is what somebody was thinking when they implemented it.

For you, the merit to considering this possibility is that it's often more successful to negotiate with someone after first understanding where they might be coming from. Honey versus vinegar, etc.

Several people have suggested arguing your point by citing law. I'm not your lawyer and I cannot give you legal advice. I don't know whether this is a good tactic for your circumstance. However, I can tell you that generally speaking when that tactic is used, it's less often in the form of showing up at somebody's office and more often in the form of a certified letter. Waving a printout of federal statutes at a receptionist might sound neat on the Internet, but it's one of those things that may come off differently in person. Good luck!
posted by cribcage at 2:27 PM on April 24, 2013


I had a confrontation like this with my optometrist except that in my instance I had explicitly told him ahead of time I was getting the exam because I wanted to order eyeglasses online; so subsequently performing the exam, taking my money for it, and then refusing to give me my prescription was basically a case of fraud.

Watch out for the trick victoriab mentions, where they give you an incomplete prescription that doesn't include enough information to actually manufacture glasses with.

After he pulled that one on me, I called his office and one of his office managers was kind enough to surreptitiously give me the full prescription once he was out of hearing range.
posted by XMLicious at 2:33 PM on April 24, 2013


Yeah, I had to ask specifically for pupil distance to be included on mine.
posted by rhizome at 2:45 PM on April 24, 2013


FWIW you can get an eye exam at Walmart for $50, walk out with a prescription, and order your glasses online.
posted by DarlingBri at 2:58 PM on April 24, 2013 [3 favorites]


I had to ask specifically for pupil distance to be included on mine.

In my case I had researched which bits of information I needed in advance but the optometrist acted as though he had no idea what the pupil distance requested the order forms I'd looked at was and actually claimed that he didn't even know how I could find out that information.
posted by XMLicious at 3:04 PM on April 24, 2013


Thanks, everyone. At this point they're closed, but I'm going to go back tomorrow brandishing a printout of Eyeglass Rule to make a slightly more forceful case that they owe me a copy of my prescription. I've gotten "takeout" prescriptions before, so I know what to ask for.

To be clear, I didn't cite the FTC to them today, and they didn't cite the FTC to me--it was more of a handwavey "you'll need a new exam and then we can talk" excuse from a non-ophthalmologist staff member than a flat-out refusal. I'm only going to resort to Yelp etc. if they won't budge tomorrow.
posted by pullayup at 4:42 PM on April 24, 2013


In that case, skip talking about the FTC and go straight to HIPAA. People fear it, and asking for your records rather than just the prescription should yield the crucial pupil distance (unless your current glasses aren't from them, in which case apply the same tactic to the other office).
posted by teremala at 7:26 PM on April 24, 2013


Just echoing above that this is ridiculous. Prescriptions don't expire after 3 months. I've even gotten my eye doc to reorder contacts when it's been more than a year.

In addition to above suggestions I'd file a BBB complaint. I've had a lot of success with those.

Oh and it's not clear to me if you're ordering glasses online or just from another optical shop, but eye docs don't typically take pupil distance (something you need when ordering glasses) so that's not going to be on your scrip FYI. I was thinking about getting Warby Parker glasses last year so I did have the optician at my eye doc take my PD and she didn't flinch about it, FWIW.
posted by radioamy at 7:34 PM on April 24, 2013


I don't see how comparing this to releasing medical records would help. It's a prescription like any other, not simply a record. That being said, they are being asses about this, and should issue you the prescription if it is that close to your last exam! Another way of vouching this in a way that may get them to write the script is saying that you are going to be traveling and need a copy to take with you abroad for emergency purposes. That used to be common practice, I think. (Then you can go travel 'abroad' to a new doctor or optician... . Even if its just one block over :))
posted by NikitaNikita at 8:49 PM on April 24, 2013


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