Can insurance companies look up your current drug prescriptions if you don't use insurance to pay?

[Anonymous]

So I just learned that doctors can look up your drug prescriptions...not just controlled substances, but anything. Does anyone know if health insurance companies can do the same thing? Obviously they know if you use them to pay for it, but what if you ask the pharmacy to not run the prescription through insurance and then you pay cash?

[Anonymous]

Yes.

[Anonymous]

Anonymous wrote:Yes.

Based on? The medical records supporting billing aren't very detailed.

It works for doctors/providers only to the extent you use pharmacies and doctors that use Surescripts (which is, admittedly, most).

[Anonymous]

If your carrier is getting your medical records for billing purposes then it would likely be on notice. Otherwise I can’t think of how they would know.

[Anonymous]

You really want your doctor and pharmacist to know ALL your prescriptions so they can catch anything that could interact.

[Anonymous]

Why would one NOT want their doctor to know?

[Anonymous]

Anonymous wrote:Why would one NOT want their doctor to know?

STD, Plan B, psychiatric drugs...

[Anonymous]

Anonymous wrote:Why would one NOT want their doctor to know?

OP is asking if health insurance companies can look this up. Probably... because almost everything can go into you electronic records now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why would one NOT want their doctor to know?

OP is asking if health insurance companies can look this up. Probably... because almost everything can go into you electronic records now.

If you pay cash, remind the provider that HIPAA only applies to insurance companies for purposes of payment and that you've already paid. Explicitly tell them you are not authorizing the release of medical records to any third parties.

[Anonymous]

So what is Epic? I had a meet and greet with a new concierge doc a few weeks ago and she mentioned being able to see most all records in Epic. So, this must be a somewhat-universal electronic medical record. The question is, how universal is it (or OP, the ? is can the insurers see it) and what is in there (for OP, does it include all prescribed meds?).

Anybody know? I'm wondering about this too.

[Anonymous]

Anonymous wrote:Why would one NOT want their doctor to know?

There are three outside parties here: doctor, pharmacist, and insurance company.

OP is only asking about the insurance company.

[Anonymous]

EPIC is what medical groups call (what patients know as) MyChart.

[Anonymous]

I applied for “no medical exam” life insurance and was denied because somehow they found out I take certain prescriptions.

So that info is out there somewhere. I don’t remember telling them who my insurance carrier was.

[Anonymous]

Yes. Life insurance can look it up too.

[Anonymous]

Anonymous wrote:I applied for “no medical exam” life insurance and was denied because somehow they found out I take certain prescriptions.

So that info is out there somewhere. I don’t remember telling them who my insurance carrier was.

They are in the data from MIB that is available to insurers. When you applied for “no liquids” underwriting, you signed off on them using any available information to underwrite you.