Thursday, October 27, 2016

Why did my co-pay go up?

It happens almost every day:

Crazy RxMan: "Your total is $20 today, Mrs. Amountwatcher."

Mrs. Amountwatcher: "What do YOU mean, $20? It's ALWAYS been $15. YOU made a mistake. Get on the computer RIGHT NOW and fix it."

Crazy RxMan: "We submitted the claim to your insurance, PAYNOW, just as always, and the claim came back this time for $20. Something might have changed with your insurance or formulary. Perhaps you received a letter in the mail about a co-pay increase for this medication. There's a lot of reasons why it might have gone up, but it's not because we made a mistake."

Mrs. Amountwatcher: "No, I did not get a letter. Nothing has changed. YOU made a mistake. I demand that you call them and find out what is going on."

Crazy RxMan: <sigh> 

Here we go again. If we are not currently busy, I will call the insurance for the patient and once they tell me the co-pay did indeed go up I will hand the phone to the patient so they can hear from the insurance that the co-pay has gone up. Other times I just tell the patient I will be happy to keep the medication in will-call until they "straighten it out" with their insurance. In that case they just come back a few days later and pay the new price.

This scenario has played out sooooo many times I can't keep track. For some reason people refuse to be the caretakers of their own insurance information. They refuse to open their mail or read the fine print on their insurance documents. They just assume we're trying to "get them" at the pharmacy, and once they find out that yes, indeed, their co-pay has gone up and it has nothing to do with the pharmacy, do you think we get an apology?

Co-pays change. Prices increase. Policies change. Insurance changes. The entire system is dynamic. What's true today isn't always true tomorrow. STOP blaming your poor pharmacist or pharmacy technician when you get bad news at the pharmacy. We're doing the best we can to deliver your medication to you. We don't need a beating at the register.

Tuesday, October 25, 2016

Is NOW a Good Time for a Flu Shot?

If you're a pharmacist or technician, you hear it all the time. "Is now a good time for a flu shot?" they will ask.

The answer is NO.

Let's analyze the day:

9am ~ I just opened and I have a crap load of reports and labels to print for the day. Plus all the Oxycodone addicts are lining up waiting for their "do not fill until [today's date]" prescriptions to magically appear. Now is not a good time.

10am ~ The first tech arrives and starts in on the labels. People start filtering in from physician offices. Now is not a good time.

11am ~ The fax machine has started spitting out physician scripts at an alarming rate. Sick people are waiting for their medications to be filled and the order has arrived. We have yesterday's orders to fill and waiters. Now is not a good time.

12pm ~ People are rushing in to the pharmacy to pick up their prescriptions on their lunch break and immediately after we check them out we hear the "Oh, and I need XXXX filled." Plus we're still working on today's drug order. Now is not a good time.

1pm ~ Physicians are done with their lunch (they get a lunch) and now they're faxing and e-Scripting over a whole new batch of prescriptions to fill. People are lining up at the pick up window because "My doctor said it would be ready when I got here." Now is not a good time.

2pm ~ All the people who saw their physician after lunch are now running to the pharmacy with scripts in hand, expecting them to be filled in five minutes or less, and they're not happy about that... even though Wagmart across the street has a minimum ONE HOUR wait. Now is not a good time.

3pm ~ I have one tech on the phone trying to get a claim to go through and another tech still messing with today's order. I'm trying to hide in the corner to nibble on a sandwich. This is my first time today to have something to eat. Now is not a good time.

4pm ~ Moms are in the store with their kids fresh out of school picking up medications and asking 3.8 million questions about infant Tylenol. Old folks have their entire bag of medications and pulling out each bottle and shaking it to determine if they need a refill or not. The order still isn't put away. Now is not a good time.

5pm ~ The dinner rush is here. All the people who were kind of enough to request their prescriptions the night before using our automated system are now on their way home from work. They're tired, crabby, and want service now because The Walking Dead is on tonight. Hurry up. Physician offices are trying to clear out their refill requests before leaving for the day and our fax machine is trying to keep up. Now is not a good time.

6pm ~ One of the tech leaves for the day, leaving us to fend off the wolves alone. The dinner rush continues. The order is finally finished but now people are here asking about their refill requests and yelling at us because we faxed to their old doctor (not knowing they switched doctors). We have to refill the business card holder because people grab cards since they're going to call the 800 number to complain about our poor service. Now is not a good time.

7pm ~ The last tech leaves and I'm alone. People are still picking up medication, plus now the "night people" show up -- people with fake scripts that I can't verify because the physicians are all cozy on their couches at home watching The Walking Dead. Arguments ensue because I refuse to fill without verification. More business cards disappear. Now is not a good time.

8pm ~ Now I get the onslaught of people coming from Urgent Care or discharged from hospitals with a pile of scripts... things they can actually wait for until the next day, but they're all worried because they just came from the hospital (oddly, some are with scripts dated two days ago) and they need it now. Now is not a good time.

9pm ~ I just closed the door. I want to go home. I'm tired. Now is not a good time.

Monday, October 24, 2016

Unsolved Mysteries at the Pharmacy

I really want to understand something. I really do.

Recent scenario:

A line forms at the pick-up window. The tech is busy helping people get their meds. I'm at the drop-off window which also has a line. I have two people filling out flu shot consent forms and another person pacing back and forth at the end of the line.

The computer is indicating to me that there are e-Scripts waiting to be processed. Two of them are for a lady that is now at the register. She's likely been told by her prescriber "Ok, I sent them off. They'll be ready when you get there."

Before the tech starts looking for her meds I tell the lady that I saw her scripts on the computer and haven't filled them yet. With a disgusted look on her face, she belts out, "Well how long is this going to take?"

I tell her 45 minutes to an hour, which is pushing it. We're slammed right now and her meds are not an emergency. She says something but I'm too far away to hear what she said. But I can tell it was nasty. So, loudly, I tell her to look around. I pointed out all the people around her that are also waiting and that we just received her prescriptions, electronically, moments ago and that it's just not physically possible to make them "appear" any faster. She whispers something to the tech and takes off.

Later after we get caught up, I ask the tech what she said. She quotes to me what the nasty old woman said.

"I never liked that man. He's made me wait before."

I'm sure she'll complain and get a gift card. Maybe it's cheaper to just hire more technicians instead of handing out gift cards all the time, but what do I know?

I don't know if I will ever know how people think. They think that once they leave the doctor office next door the prescriptions will immediately be ready for them when they get here... like a drive-thru at McDonald's.

I want to understand. I really do.