Friday, April 4, 2014

Another Reason...

...why your Pharmacist is beating his head against the wall:

5:30 pm on a Saturday

"I'm here to get my son's prescription." The lady is some sort of healthcare worker or just likes wearing scrubs and a name badge on a lanyard.

After getting the patient's name and birth date, I ascertain with our state of the art computers that the patient isn't in our database. In fact, we don't have anyone in our computer with that birthday. That rarely happens. So I verify with mom the name and date of birth. She rolls her eyes.

"It was just sent over. The doctor said he just sent it."

I check the computer again. Nothing has been sent over. I tell the lady, who rolls her eyes again. I ask her if she's sure it was sent to MY pharmacy. I tell her we have a Flea Market Grocery across the street and a Wagmart close by. No, I'm told, it wasn't sent there.

She walks away, disgusted with me.

5:45 pm 

"I called the office and they said it was definitely sent over."

I fiddle on the computer. Nothing. I tell her.

"They said they have a confirmation."

I fiddle on the computer and finally it pops up. Apparently it was sent but took awhile. Sometimes it's like that, I tell her. It's not really an immediate process like email. I get the patient information and run a claim.

"DENIED -- DUPLICATE CLAIM"

[So for those of you keeping score at home, this means that the prescription was first sent to another pharmacy before it was sent to me and they processed the claim]

I tell her I can't process it because some other pharmacy must have run the claim before me.

"That's because they sent it to Wagmart."

Ok, didn't I just ask her if it was sent to a competitor? Oh, why yes, I did and she argued with me that it wasn't. Had she mentioned that before this whole process would have been a lot easier.

"I'll have to call Wagmart and get them to reverse the claim so I can process it."

As God as my witness, this miserable woman rolled her eyes again. Really?

I call Wagmart, get the claim reversed, process it, and get the miserable witch out of my sight.

Ok people, here's the golden gem of wisdom for the day... if the pharmacist asks you a question, don't freaking lie! This whole process would have been easier for everyone if she had just answered my question or told me up front it was sent to Wagmart first.

Arrrrgggghhhhhhhh!


1 comment:

Anonymous said...

Hear, hear! Just like today when I asked a pt if she had her new insurance card. She says, "No, it's the same one on file." I reprocess it again just to give her the benefit of the doubt. It comes back as rejected (as expected). I asked to see her insurance card. She says she doesn't have it. Then when I give her the option of waiting while I call the insurance for her info, she says, "It's okay. I don't have insurance."