Prescription Records: Don’t forget to add these essential details

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Prescription Records: Don’t forget to add these essential details

After recently reviewing many medical records related to our audit defense, the following bears repeating:

When recording your prescriptions, be careful to not only record the dosage and number of pills prescribed, but also record the reason for the prescription. Because most medications have multiple applications and off-label applications. The reason for the prescription use should be made plain and simple as possible. What should also be made plain and simple is how the patient is doing with the prescription that was administered. Also please explain any changes in dosage or medication that took place.

Lawrence F. Kobak, Esq.
Senior Counsel
Frier Levitt
ATTORNEYS AT LAW
(516) 755-7553 direct
(973) 618-1660 office
lkobak@frierlevitt.com

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