Controlled Medication and SSRI Refill Information

Does my child need a medication check visit? || Options to refill a prescription || Common Questions || ADHD Medication Shortage

Does my child really need a medication check visit?
Because of the nature of these medications, regular medication check visits are required to ensure the medications are working as intend and to monitor the possibility of side effects.
There are different standard timeframes for medication checks depending on the medication prescribed:

  • 1. First time fills of a new medication require a medication check visit one month after the medication is started. This visit is required to ensure the medication is working as intended and to monitor the side effects that can come with starting the new medication.

  • 2. Subsequent refills following the one-month medication check visit must be done every three months for ADHD medications to continue to get refills. These visits are required to continue on the medication to ensure the medication is working as intended and to monitor possible side effects.

  • 3. Subsequent refills following the one-month medication check visit must be done every six months for all non-ADHD medications to continue to get refills.
These visits are required to continue on the medication to ensure the medication is working as intended and to monitor possible side effects. ADHD medications are classified as controlled substances and therefore are required to have more frequent checks. Alpine Pediatrics may only write three (3) thirty-day (30) prescriptions at a time before a patient must be seen. A medication check may be required at any time if a family has questions or changes are needed off the standard cycle of medication checks.

Options to refill a prescription:
Alpine Pediatrics offers three options for controlled substance refills:

  • 1. Using the Alpine Pediatrics Medication Refill Request Page.

  • 2. Calling the Alpine Pediatrics Triage Line by calling any of our offices.

  • 3. Using the Alpine Pediatrics Triage online chat feature, which can be found on the home page of our website by clicking on the chat icon on the bottom right of the screen.

Alpine Pediatrics can only write three (3) thirty-day (30) prescriptions at a time before a patient must be seen. However, The pharmacy will not fill any of these prescriptions automatically, they will only store the written order in their system. You must call the pharmacy and request the medication be filled each month.

Please note that at this time, Alpine Pediatrics will not allow ADHD medication check visits to take place via telehealth.

Common questions about the refills process:
  • How long does it take to get a refill processed?
    A medication refill request for any medication can take anywhere between 1 and 3 business days or 24 to 72 hours.
    This timeframe can vary based on the amount of refill requests received or if the Provider who originally prescribed the medication and will be filling the medication is out of the office or otherwise unavailable.

  • What is the fastest way to get a refill for my child's medication?
    The Medication Refill Request Page on our website is the easiest way to request refills for any medication requiring regular refills, including controlled substances prescribed for ADHD management.

  • Do I have to contact Alpine Pediatrics every month to get a refill?
    Refill requests must be made every three to six (3-6) months, depending on the medication, in order to continue on the medication.

  • Can I call the pharmacy and have them request the refill?
    This will work for non-controlled medications, unfortunately, due to different laws and regulations surrounding controlled medications, like the ones used in ADHD management, many medications requests must be made through our office and cannot come from the pharmacy. However, if your provider wrote three 30 day prescription for ADHD medications and sent them to the pharmacy, you will need to call the pharmacy to let them know you would like those filled. The pharmacy will not automatically fill the prescription.

  • Will I receive a call from Alpine Pediatrics when the refill has been processed?
    Due to the high volume of refill requests the office receives, we do not call families to let them know when a refill has been sent. Please follow up with your preferred pharmacy to see if the refill has been processed.

  • Are refills processed on nights and weekends when the After Hours clinic is running?
    Due to light staffing during our After Hours and Urgent Clinic hours refills cannot be processed until normal business hours when we have the staff to accommodate the refill requests.

  • How will I know when my child is due for their next medication check visit?
    A few weeks before your child is due for the three or six month follow up medication check a text will be sent out notifying you that your child is coming due for the visit. Sometimes, there are other reasons why a medication check will need happen off the three to six month cycle, for example, when a new medication is started your child will need to follow up one month after starting the medication. If a medication check is due off of the three to six month cycle you will be notified when you try to refill the medication that your child is due for a visit.

  • I got a text that my child is due for a Well Visit, can I combine these visits?
    If you know your child is due for a Well Visit and you would like to schedule that visit, please schedule via our self-scheduling page or call your preferred office. These visits can serve as medication check visits and are usually covered by insurance.

ADHD Medication Shortage and Stock Issues

ADHD Medications are classified as controlled substances, because of this classification you can only fill a 30-day supply at a time. The prescription for a 30-day supply is only good for one month. Each refill for an ADHD medication can occur when there are only 5 days or less of medication remaining. Due to the current shortage and stock issues, we recommend you start the refill process when you have 5 days of medication remaining. This will allow more time to ensure you find a pharmacy with your medication in stock. Please be patient wil our staff, as we are experiences a large increase of phone calls regarding the ADHD stock issues and problems with patients maintaining ADHD prescriptions.

Recently many of the generic and commonly prescribed medications for ADHD are facing stock shortages or are completely out of stock. The stock that each pharmacy has varies daily. Alpine Pediatrics is not able to keep an inventory of which pharmacies have medications in stock each day. We suggest you call your preferred pharmacy before requesting a refill from us to ensure that pharmacy has the medication you are needing to refill in stock.

If your pharmacy does not have the medication you are trying to fill in stock, you will need to call around to other are pharmacies until you find a pharmacy that has the medication in stock. Unfortunately, Alpine Pediatrics has no way of knowing what medications are in stock at a given pharmacy. It is the responsibility of the patient to know what pharmacy can fill their medication.

When you find a pharmacy that has the medication you need filled in stock we will do our best to have the medication refill send to the pharmacy as soon as possible. However, this is often not an instantaneous process due to the fact that each prescription has to be reviewed by a Provider and signed by a Provider each time it is filled. This process includes when controlled substance prescriptions are transferred between pharmacies. Currently, most pharmacies do not have the ability to send controlled substance prescriptions to other pharmacies, this means the Provider is the one who has to move the prescription around, which will increase the amount of time required for each refill request.

Please be aware that some pharmacies will not fill a controlled substance prescription (such as ADHD medications) unless that patient has filled other prescriptions at that pharmacy previously. You do have the option of waiting for your preferred pharmacy to receive an order of the medication you are needing refilled, or you can call your insurance provider to find out if it is possible to order the medication through a contracted mail-order pharmacy.

Most insurances will not cover an ADHD brand name medication, or approve a prior authorization to cover a brand name ADHD medication, even when the generic alternative is out of stock in most area pharmacies or facing stock issues nationally. The Alpine Pediatrics prior authorization team will only complete a prior authorization if your child has a documented medical necessity or your child has tried two other cheaper covered alternatives that have failed (this is referred to as step therapy). Please keep in mind that if an insurance provider approves a prior authorization for a name brand ADHD medication, it is often still more expensive than the generic alternative.

If you anticipate needing to change your child's ADHD medication due to cost concerns, stock issues, or if the current medication is not working for your child, you should:

  • 1. Check online for cheaper alternatives using GoodRx, WellRx, or other cost savings website. These websites will often be able to show discount cards for different pharmacies, as well as the cash-pay price for many medications at multiple pharmacies.

  • 2. Call your insurance and ask for the cheapest covered medications for ADHD. After you get the list from your insurance you can call our triage line, and we will work with the Provider to see if these medications will work well for your child. Every insurance has different medication coverage, because of this it is not possible for the Provider to know what medications may be covered or affordable for your child.

  • 3. If you need a medication or dose change you may be required to schedule a medication check visit with a Provider to discuss the change.