Thursday, July 31, 2008

I HATE insurance companies!!!!

For laypersons reading this blog (no that doesn't mean you get laid a lot - it means you're not in healthcare...), you probably have no idea just how much we pharmacists and techs go through with insurances on a daily basis. Yeah, you may hear a bit of our difficulties when we tell you your prescription is no longer on the formulary, but we deal with that kind of inconvenience hundreds of times every day! The damned insurance companies can do whatever they want, with no notice to us or you, the insurance holders, whenever they want.
Last month your copay was $25? Well, this month it's $50. Or this month, that drug isn't covered at all. Last month the ID number we submitted was correct, this month it's not, and they didn't bother to send you a new card.
Last month, if your insurance wanted prior authorization to cover your prescription (insurance speak for 'we want to know why this person has to have this expensive drug instead of a cheaper one that will do the same thing') we would fax the doctor with the alternative drugs that are covered - if the insurance is kind enough to tell us what those options are - and a phone number to call if they want to keep you on the same med. This month, they expect me to call them directly (and if the doctor does, they won't help the doc, but instead tells them to have me call), then ask me all kinds of questions the doctor has the answers to and I don't. What is the diagnosis, what drugs have been tried and failed, yadayadayada...
Last month, if I submitted a claim for $25, I might have gotten $20 from the insurance company (and your copay would be $5). This month, I submit the same $25 and get only $13 from the insurance company - but your copay stays the same, so I lose money.
Why am I ranting about this? My doctor's office got tired of the crap from my insurance company, and cancelled the contract with them (the insurance wanted to reduce reimbursements by 7% - with inflation higher than it's been in decades, that's a HUGE cut). Now, I'm mid-treatment, and facing the prospect of surgery with little or no coverage from my insurance. Luckily, the office said I still can see the doctor for 60 days, and I also have coverage under my hubby's insurance. But this just pushed me over the edge...
I've said for a long time that insurances are the thorn in my side, but now I'm thinking that it's more like the knife in my back...

Tuesday, July 29, 2008

some people.... I swear....

Today, there was this gal who was already ranting up a storm the moment I walked in (I closed today). Being the ultra-observant, responsive, support-my-staff manager that I am, I approached the customer and asked what was going on and if I could help. Turns out Medicaid was denying her methadone script. She was freaking out telling everyone who would listen that she was pregnant and that her withdrawals could kill the baby. In my state, Medicaid only allows two fills of the same drug per calendar month, and this was her third. After some research, I decided we could call and get an override, and told the gal that she should let her doctor know not to write 10 day supplies of anything for her if she's going to be on them long-term. She bitched and moaned the whole time we were contacting medicaid, told me about having it stolen from her when she left her drugs on a picnic table in a park (WHY the hell you would just leave methadone lying around, I'm not sure....) As all this is going on, I see her bouncing a baby on her knee - was it hers, I asked? Nobody knew. hmmmm. She gets her drugs, leaves, and as she leaves, tells her friend that she's never coming to this f-ing pharmacy again. WTF? We just helped you get your fix! Then, not FIVE minutes later, Medicaid calls US and says they noticed many irregularities... Like the story about the picnic table - she told Medicaid that the person who was picking her script up from the pharmacy for her stole it. Like 90 days worth of methadone being filled over the last 30 days in a total of 6 separate pharmacies. I look at her profile, read it all off to the medicaid lady, and we start suspecting that this gal isn't pregnant at all, and this "withdrawal will kill my baby" line is BS. First off, no record at Medicaid of any prenatal care. Second, a script for Plan B (the morning after pill) just 2 months ago. We're beginning to think that she LOOKS pregnant from post partum weight (the baby she was bouncing was less than 6 months old), and she's scamming us all....
Oh how I hate that! And worse yet, if you're successfully scamming me (after all, I did get you your drugs today), at least be NICE to me! You can bet I'll be outing her to her doctor - already left a message for him to call me...

Monday, July 28, 2008

My fault, again...

Had a customer try to blame me for her recent hospitalization today. She said that because I refused to fill her Ambien script (I didn't refuse, her insurance did - it was 2 weeks early, and her plan is one that pays for 30 tablets a month, not one of those that limit 10 or 14 a month) she ended up in the hospital. She went TWO whole nights without Ambien and ended up in the hospital. Now, last time I checked, 2 nights of insomnia was not a medical emergency. But, overdosing on Ambien for the first 2 weeks of the month, then abruptly discontinuing it could cause some nasty withdrawal - maybe that was it. Must have been my fault - I forced her to take all those extra tablets, right???? Whatever....

Tuesday, July 15, 2008

Happy happy day!

We've been running short-staffed for a while. There just never seems to be anyone qualified who applies for the tech positions. Then, like magic, I get multiple resumes of highly qualified applicants. One came in today to accept a job offer, and another came by for a preliminary interview - they BOTH rocked! No stupid person could ruin the excitement I got from knowing I'm going to be back at full staff soon....

Friday, July 11, 2008

Drive through pharmacy

So - who's the moron that decided a drive through in a pharmacy was a good idea? Come on, stand up and show yourself - I'd like to throw something at you!
Seriously - drive-throughs are for fast food joints, and having one at a pharmacy invites the people who think things should happen immediately to come to my store.
No, you can't just sit and wait for your script to be filled while you're in the drive through. It's for dropping it off or picking it up - but not all in the same transaction.
No, the drive through doesn't have different hours than the pharmacy - you can't come to the drive through before we open and expect to be helped (we're not a friggin' Jack in the Box!)
No, I'm not your personal shopper. If you want something other than a prescription, you'll have to get your lazy butt out of the car and come in.
No, a box of a hundred syringes won't fit in the drive through tube system. Neither will the 25 scripts you're picking up at once - and I'm not standing here all day to send the tube back and forth with 3 or 4 things each time.
No, you can't expect a heck of a lot of privacy in the drive through. Everything I say to you comes out of that very loud speaker there, so anyone in the next lane, or even just walking by might hear me tell you how to take your Viagra. If you don't want anyone to know what you're getting, then come in the store.
Thanks.
Oh - by the way - I'd also like to throw something at the architect who decided that the drive through station in the pharmacy should be way at the opposite end of the pharmacy from where the majority of work gets done. Could you please stand up, too?

Monday, July 7, 2008

Insurance cards

I'm so tired of people showing up without their insurance cards... Do these people not realize that this is the mode of payment for the prescription they just presented??? Would you go shopping at the mall, not have your Visa or MasterCard, then when you respond "credit" as the cashier asks how you're paying today would you say "I don't have the card with me - can't you just look it up?" NO! Then why do you think I can look up your means of payment???
With the exception of Medicare Part D plans, I can't look up your insurance info - you MUST have your card. (this was the ONE thing the government did right with part D...) Don't get mad at ME because YOU didn't bring it with you...

Friday, July 4, 2008

Day before a holiday

I want to post a sign - a really big one, with bright red lettering - in my pharmacy that says "Failure to plan ahead on your part does not constitute an emergency on mine" Except that it seems like 90% of my customers can't read, so it wouldn't do any good...
It was amazing just how many people came in yesterday with PILES of scripts - 5 or 6 per person - expecting them to be done immediately because they were leaving town and in a hurry. Most of these scripts were written about a week ago. We always try to be honest about how long filling the scripts will take, so a lot of the day we were saying it would be an hour or so. "What? THAT long????" Um, yeah... You've got 6 scripts yourself, and I've got 22 people waiting ahead of you... "But I'm leaving town!" Sorry, we'll go as fast as we can...
What we really wanted to say, but exercised remarkable self-control, was "Well, Mr. Dumbass, why didn't you think of that when the doctor wrote these 6 scripts on June 27th instead of waiting til 3pm on July 3rd when your flight leaves at 6pm?"
I gotta find a sign maker....

Thursday, July 3, 2008

Stupid criminals

Some forgeries are pretty good, and we miss them until someone points out to us at a later date that the person is known for passing forged prescriptions. Some are more obvious, and others are downright outrageous. We look at them and KNOW the person HAD to be higher than a kite when writing their own script.
Recently, a gal who used to work for a doctor and stole a prescription pad upon her termination from the office presented us with this:
Hydrorodone/APAP 1750/17.50 #80 - 1q46hprn
Soma #80 - 1750/17.50 tid
Xanx 2mg #80 (no directions)
We told her we'd have to call the doctor for the lack of directions on the "Xanx", and she took off. We confirmed with the doctor's office that this was a forgery (like confirmation was necessary? HAHA!) and made a note in her profile, thinking she'd never come back.
Lo and behold, last week, she was high enough to try it again! This time she completely left the strength of the "hydrorodone" off the script, but we didn't tell her we were calling anyone. Idiot stuck around long enough to end up hauled out in handcuffs.
But wait! There's more!
The next day, I get a call from the office manager for the doctor, and she said our stupid criminal had the nerve to call the manager up and ask for help getting out of this legal bind - "Can you call the police and tell them the doctor gave me permission to write my own scripts?"
Yeah. Right. Must have been high again...

Tuesday, July 1, 2008

Yup, my fault - again....

So we get this call from a drug company today. Apparently, one of my customers called the 800 number on the box of her Gynazole, wanting her money back. The company called me and asked if I'd refund the customer if the company sent us a replacement. "What was wrong with it?" I ask. "Nothing, it just didn't work." "No hole in the tube or defective applicator?" "No, it just didn't work" Then, I actually said this out loud to the lady from the drug company - "And this is your and my fault how???" She laughed. I refused to refund the money - had the product had some sort of manufacturers defect, no prob - I'd refund and replace in a heartbeat. But, after reviewing the customer's profile, I came to the conclusion that the doctor keeps misdiagnosing bacterial vaginosis as a standard yeast infection. And THAT is not my problem...
So I've decided that I want refunds on all the pain meds I've had since the end of April - my rotator cuff tear is still there and still hurts....