AMI R251.27 question

[gajabear]

DoDMERB requested AMI R251.27/ pharmacy records from age 13 to present.
I have Kaiser as my insurance and was able to obtain the documentation from the Medical Records Department which showed

1. Name of medication.
2. RX #
3. NDC # of Medication
4. Pick up/ Sold dates
5. Pick up location
6. Prescriber name
7. Amount of copay paid

And I received another AMI requested from the DoDMERB as below.

DOES NOT REQUIRE A PHYSICIAN'S APPOINTMENT: Please provide copies (NOT ORIGINALS) of ALL pharmacy records from age Please provide copies of all pharmacy records from age - 13 to present. Please note, this is not a request for a copy of your medication list in your medical records. You must request a report from the pharmacy where you fill your medication for the date range indicated. In addition, your individual pharmacy location may only keep records for about 2 years. You will need to inquire about procedures for getting records from the main/corporate office or research this information through the company’s website.

Is there anyone who had to submit AMI of R251.27 who can guide me what information is missing from my submitted documentation and what I need to request to medical records/ pharmacy? Thank you...

 

[GoCubbies]

DoDMERB requested AMI R251.27/ pharmacy records from age 13 to present.
I have Kaiser as my insurance and was able to obtain the documentation from the Medical Records Department which showed

1. Name of medication.
2. RX #
3. NDC # of Medication
4. Pick up/ Sold dates
5. Pick up location
6. Prescriber name
7. Amount of copay paid

And I received another AMI requested from the DoDMERB as below.

DOES NOT REQUIRE A PHYSICIAN'S APPOINTMENT: Please provide copies (NOT ORIGINALS) of ALL pharmacy records from age Please provide copies of all pharmacy records from age - 13 to present. Please note, this is not a request for a copy of your medication list in your medical records. You must request a report from the pharmacy where you fill your medication for the date range indicated. In addition, your individual pharmacy location may only keep records for about 2 years. You will need to inquire about procedures for getting records from the main/corporate office or research this information through the company’s website.

Is there anyone who had to submit AMI of R251.27 who can guide me what information is missing from my submitted documentation and what I need to request to medical records/ pharmacy? Thank you...

When did you submit the AMI the first time?

And when did you get what looks like a 2nd request for the same info?

 

[gajabear]

When did you submit the AMI the first time?

And when did you get what looks like a 2nd request for the same info?

AMI was submitted on 10/31 and another request as above received after they checked on 11/4. DS is very confused and I don't even know how to help him. He did contact the DoDMERB case manager.

 

[GoCubbies]

AMI was submitted on 10/31 and another request as above received after they checked on 11/4. DS is very confused and I don't even know how to help him. He did contact the DoDMERB case manager.

That’s what I was going to suggest.

Contact the case manager to see why the pharmacy records were asked twice.

Sounds like a mistake on the DoDMERB side.

 

[Amomynous]

My son had this request as well. I called our pharmacy, they printed out the records for the dates needed. Very easy. Son submitted the records and dodmerb cleared him very shortly offer that.

 

[justdoit19]

To me, it reads that OP provided insurance printed records. And that DODMERB is requesting pharmacy (vs insurance) records.

Perhaps that’s it?

Regardless, contacting the case manager is the way to go.

 

[gajabear]

To me, it reads that OP provided insurance printed records. And that DODMERB is requesting pharmacy (vs insurance) records.

Perhaps that’s it?

Regardless, contacting the case manager is the way to go.

Yes, that was my initial thought... Kaiser Permanente is our insurance company which provided medical care as well as pharmacy. DS has been using Kaiser pharmacy only, but then DoDMerb is experts and they should know that Kaiser is not only an Insurance company. Still waiting for case manager's response.

 

[GoCubbies]

Yes, that was my initial thought... Kaiser Permanente is our insurance company which provided medical care as well as pharmacy. DS has been using Kaiser pharmacy only, but then DoDMerb is experts and they should know that Kaiser is not only an Insurance company. Still waiting for case manager's response.

Most people in DoDMERB are clinicians and not healthcare administrators.

In addition, most people in DoDMERB have practical experience in Tricare, and not Kaiser, HCA Healthcare, UnitedHealthcare Group, etc…

So there’s probably not a list in the DoDMERB offices that say these HMOs, PPOs, etc have their own pharmacy and such. For all they know, people go to Walgreens and CVS. Seriously, DoDMERB is an expert in medical accessions and not which HMOs have their own pharmacy.

 

[gajabear]

Most people in DoDMERB are clinicians and not healthcare administrators.

In addition, most people in DoDMERB have practical experience in Tricare, and not Kaiser, HCA Healthcare, UnitedHealthcare Group, etc…

So there’s probably not a list in the DoDMERB offices that say these HMOs, PPOs, etc have their own pharmacy and such. For all they know, people go to Walgreens and CVS. Seriously, DoDMERB is an expert in medical accessions and not which HMOs have their own pharmacy.

Thank you for the information, I didn't know that! I'll update once DS finds out more information to resolve this matter and definitely will share it. Thank you.

 

[gajabear]

Update: Documentation submitted was total of 4 years since 13yo(2019-2023). Missing current year...