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How long should it take my doctor to receive viscosupplementation drug.
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Helgramite
New Member
Joined : May 2015
Posts : 14
Posted 6/22/2017 5:36 AM (GMT 0)
I'm a 71 year old male and had a partial knee replacement a few years ago with excellent results. I developed pain in the other knee this year and my orthopedist's PA ordered a viscosupplementation drug three weeks ago. I do not know which brand. My insurance is traditional Medicare.
In your experience, how long should it take to receive the drug? A second PA, who said he would notify me when the drug arrives, does not know when to expect it. I have also asked, by email with no reply, why the drug needed to be ordered when other orthopedic practices seem to have the drug in stock.
Thank you for your help.
straydog
Forum Moderator
Joined : Feb 2003
Posts : 19850
Posted 6/22/2017 12:58 PM (GMT 0)
Hello & welcome to Healing Well. My thoughts are before ordering the medication they had to get approval with Medicare & dealing with them can be time consuming at best. I know when I had both of my knees were done my ortho gave me a script
to take to the pharmacy to be filled. They had to order it once it was approved. I also had private insurance at the time, not Medicare. They did not keep this on hand in their office & I highly doubt any dr does for that matter. It is an expensive medication. I am betting your hang up is with Medicare. I would call their office & inquire to see if Medicare is holding things up.
Take care.
Helgramite
New Member
Joined : May 2015
Posts : 14
Posted 6/22/2017 3:28 PM (GMT 0)
Thank you Susie. I'll let you know what I find out. I do know that two other group practices said that they keep this type of medicine in stock.
Post Edited (Helgramite) : 6/22/2017 9:34:40 AM (GMT-6)
straydog
Forum Moderator
Joined : Feb 2003
Posts : 19850
Posted 6/22/2017 3:56 PM (GMT 0)
When my knees were done several years back, the pharmacist old me, its a good thing you have excellent drug coverage, each vial was $2,000, yes you read that right, lol. Knowing this, I do understand why a dr would not keep it on hand in their office. My other thoughts are the drs that do keep it on hand, may very well be using it on lots of patients, just my thoughts.
Helgramite
New Member
Joined : May 2015
Posts : 14
Posted 6/26/2017 9:43 AM (GMT 0)
I have a response from my doctor's PA: "The Supartz injections we have ordered for your knee should be covered in full by Medicare. For our patients with Medicare insurance, we order these injections in bulk. Shipments can take a few weeks to arrive, so we do expect one soon."
Here is some info about
the drug from its internet site: "The physician’s office must buy and bill SUPARTZ FX for Medicare fee-for-service patients. Medicare fee-for-service does not require prior authorization; however, Medicare requires documented improvement from the first series for patients to receive a second series of treatment .
I think "buy and bill" is opposed to ordering from a speciality pharmacy where the non-Medicare patient would be billed by the pharmacy. Anyway, if they had told me it was going to be over three weeks to get some relief, I would have done something different.
Helgramite
New Member
Joined : May 2015
Posts : 14
Posted 6/26/2017 9:47 AM (GMT 0)
My signature line is from the prostate cancer group and I don't know how to suppress it for this group when using Quick Reply.
straydog
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Joined : Feb 2003
Posts : 19850
Posted 6/26/2017 12:49 PM (GMT 0)
At least you now know what the protocol is for the drs office. Since I was using private insurance at the time it was handled differently. Hopefully they will get their supply in soon. I am sorry to read you have had such a long wait. However, I honestly do not think there is anything different that you could have done in this situation. By the way, Supartz is what my ortho used on both of my knees. I have had 5 scopes on my knees for various problems & they would each time try to clean up the knee as they cannot just go in & clean out all of the arthritis. Something that helped me back then & even now is to get in a pool & exercise my knees. This helps my knees tremendously. You are weightless in the water & cannot injure the knees. I have much more mobility & have had more than my fair share of PT with them. Water therapy has helped more than anything. I sit on a noodle & do leg kicks around the pool in the summer. If you can get access to a pool I highly recommend it. Perhaps joining a YMCA.
To remove your sig line you have to go into your profile & edit it out. However, you would have to remake it when posting in the PC forum, which may be a pain.
Take care.
Helgramite
New Member
Joined : May 2015
Posts : 14
Posted 6/26/2017 5:24 PM (GMT 0)
I think I'll go to a different doctor and not see a PA first. I will ask for a partial knee replacement like I had on the other side. If I can get it soon, I should be able to keel in my canoe by the next spring paddling season.
I just don't see a reason to go though all the shots and PT to eventually get a replacement anyway. I want to have fun while I'm still young.
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