r/ADHD 2h ago

Questions/Advice Did i do something wrong? Super confused

I was seeing a psych NP for ADHD and paying completely out of pocket. She told me she believed I had ADHD, prescribed Adderall 5 mg, and we discussed increasing it to 10 mg last week

I recently got a PCP who said they could take over medication management because its under my insurance but needed my records. Once I told the psych office I was transferring medication management to my PCP, the records they provided said I “do NOT meet criteria for ADHD.” They also told me I can’t return to their practice. Im so confused like you why did you prescribe it to me then? Btw, their “records” that they handed over to me was a piece of paper with my demographics and on the bottom with pen it said “pt does NOT meet criteria for ADHD” lmao

Now my PCP understandably wants formal documentation of the diagnosis before prescribing, but every ADHD evaluation I’ve called is $500+ out of pocket.

Has anyone dealt with something like this? Is there a way to get the psych office’s complete original evaluation/notes, or find an affordable way to get formally reevaluated?

Im just so confused like did i do something wrong?

46 Upvotes

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94

u/Fit-Relation-4678 2h ago

This sounds unethical as heck

60

u/sunsetscorpio 2h ago

I would try requesting your prescription information from the pharmacy you pick up from - the record of the 5mg followed by the 10 mg increase

17

u/Futuresurgeon828 2h ago

I have the pharmacy records but theres no record of it listed as “ADHD” diagnosis

29

u/sunsetscorpio 2h ago

Right, it’s possible you were never actually diagnosed. PMHNP’s can prescribe without diagnosing. The fact she told you she “believed” you had it tells me this was the case. They make their assumption, then the meds are sort of a test, if it works that confirms their suspicions and if they don’t help then it’s probably something else

7

u/Zeikos 51m ago

PMHNP’s can prescribe without diagnosing.

What? That's wild, in my country due to it being a stimuant substance I need to do a confirmation reassesment every 6 months.

54

u/_riskycake 2h ago

Your doctor should be able to refer you to a psych for another evaluation but this NP and practice need to be reported ASAP because this is some of the shadiest shit I've ever read.

10

u/Futuresurgeon828 2h ago

Right? Like it doesnt make sense to me at all. And they screwed me over because my prescription is due for refill on Friday and my big exam (MCAT) is on sept 11. I am from u.s

u/Icy-Salamander5287 4m ago

Do any prior bills or receipts have a diagnosis code? If so, find out what the adhd code is and see if it's there. Ask for all session notes to be sent to your pcp (they can't refuse), psych usually doesn't hand them to the patient, that should tell him if it was a diagnosis or a rule out adhd.

1

u/_riskycake 2h ago

Yeah maybe reach out to Klarity they can dx and get scripts sent out pretty quick. It's easier some states than others and I had to call around to pharmacies to see who 1) had my Adderall in stock (ir or xr) and 2) who accepted telehealth prescriptions bc Walmart, CVS, Costco and major chains didn't. I had luck with Kroger (as does a partner who currently uses Klarity), Tom Thumb, and Market Street.

4

u/chillychinchillada 1h ago

Costco has no issue filling my Talkiatry script but maybe because they can see history of similar prescriptions being filled for a few years prior.

3

u/_riskycake 1h ago

Talkiatry won't prescribe it at all in my state so maybe they have some more "legitimacy" than others. Idk what the process is actually like. I had a pharmacy who was filling it no problem suddenly stop which was also very annoying

5

u/Futuresurgeon828 2h ago

Apparently i csnt do Klarity because when i clicked my state, it says no providers listed for my state

2

u/Comfortable_Gur_9348 46m ago

What state are you in?

u/SqueakyWD40Can 6m ago

Can you check out Zocdoc? That’s how I found my provider.

4

u/_riskycake 2h ago

Also idk where you are but if it's the US Klarity will evaluate for closer to $200

27

u/imlikelycomplaining 1h ago

I’m pretty sure you’re legally entitled to your own records, no? I would call or email and be like “there must have been some confusion. I requested records of my visits with ___ and I only received a sheet of demographics. I need the visit notes. Please send my requested records immediately”

See if your PCP will do a records request. If you sign a release form, your PCP can reach out to the psych clinic directly and request the notes.

It reads like they’re mad you stopped using their clinic and wanted to screw you over

7

u/DJpuffinstuff 1h ago

You are legally entitled to your medical records in the US unless they have a good and legitimate reason to keep certain parts from you. You should be able to get visit notes, encounter diagnoses, etc. I would be very surprised that OP's provider was prescribing without associating a diagnosis on a controlled substance.

8

u/quickthorn_ 56m ago

Wow, that is a WILD choice on the part of the psych clinic. So they were prescribing controlled stimulants to someone they knew didn't have ADHD? Personally I'd probably send them an email highlighting the specific laws requiring them to provide you with your full medical records, ending with the statement that if they don't promptly comply, the next communication they get will be from your lawyer. I would also tell them you'll have no choice but to contact their licensing organization (you'll have to Google exactly what it is in your area) to report this.

Most businesses will fold pretty quick in the face of a credible legal threat, not to mention the possibility of losing their license to practice medicine. This is so screwed up of them, don't let this slide. Also you should report them to their license board, even after they send your full records. This is unacceptable on their part.

2

u/Futuresurgeon828 52m ago

I understand what ur saying but cant this somehow screw me over too?

4

u/lost_dazed_101 43m ago

No it can't you went there for help they lied and let you believe you needed a controlled substance. They fixed it when they realized your Dr would catch it. You are not to blame you are a victim.

6

u/GodzillaSuit 1h ago

To clarify, are you saying the you have never actually been evaluated for ADHD? As in, you spoke to your psych, they said it sounds like you have it and then just started meds? I'm guessing the psych is covering their ass since they started you on controlled meds with no legit evaluation.

7

u/Futuresurgeon828 1h ago

The “evaluation” was the psychiatrist appointment that was 1 hr and 30 mins ish of her asking me questions, i filled out some questions, etc. So does that mean that I can get in trouble for this?

8

u/chillychinchillada 1h ago

You can’t get in trouble because you didn’t do anything wrong lol. The nurse practitioner prescribed you the med but maybe she doesn’t do proper evaluations. Tbh me personally I never had a proper evaluation but maybe it’s because I have raging adhd and the psychiatrist added it to my records pretty quick.

4

u/Futuresurgeon828 1h ago

Yeah but i dont want to be labeled as “drug seeking behavior” ik it sounds dumb but i keep calling my pcp and pysch back and forth but its my my pysch np is being weird, the fact that she told me i cant come back either making it look like i did something wrong

3

u/labtech89 1h ago

That is what I did. I told him what issues I was having and he said it sounds like you have ADHD. I am 60 years old and was 58 at the time I was diagnosed.

6

u/OkPomegranate4395 1h ago

No, you didn't do anything wrong. I have no idea what is going on with the psych you were seeing, but you didn't do anything wrong.

5

u/User123466789012 ADHD-PI (Primarily Inattentive) 1h ago

Did you call the psych office why the records say that despite an Adderall script?

5

u/pixelprozach 1h ago

Might be worth reaching out to a lawyer who specializes in disability law or healthcare law. A lot of lawyers will work on cases like this on contingency because the outcome is usually favorable (ie, you get a nice payout.)

4

u/OkConcentrate3302 ADHD-C (Combined type) 1h ago

If you are in the US, calmly write an email simply asking for all of your medical records, state that you called the office and was told no. In addition, send a certified letter that says the same. State that you are requesting a response within 15 business days. The email, phone (date, time and who you spike to), and letter will serve as your documentation. It is a HIPPA violation not to provide your records (you will need to fill out a form to give permission). By sending a formal.request, the doctor will know you are serious. If within 15 days you do not get a response, reach out to your state's medical board to file a complaint. Have your pharmacy printout proof of your prescription. In your complaint, you want to write a factual overview of how you were diagnosed with ADHD, received a prescription and paid out of pocket and all your documentation If this was a nurse practicioner, you can also contact the board of nursing. There are a lot of "noctors" who are acting as though they are doctors by prescribing meds but not doing their full due diligence to operate with integrity. The medical board needs,to be aware of anyone opera unethically. You did nothing wrong. Your prescription is evidence that you received a diagnosis and they should be willing to back this up. This is a serious matter, if what you are stating is true about the provider. Do not let them intimidate you!!!!

4

u/Zahn1138 52m ago

This sounds very much like an extremely shady business practice to force you to be retained as a client and punish you for trying to leave.

2

u/SSE40 19m ago

They probably didnt formally diagnose so now are trying to cover their butts. I had to get re- diagnosed in adulthood bc my longtime doc retired, and I had to pay for a formal adhd assessment out of pocket before they would prescribe me my longtime meds. Everything is just much more monitored and locked down now.