Monday, December 2, 2013

The Lantus Jerk

Ring... ring... ring

Tech: "Thank you for calling Goofmart Pharmacy. May I help you?"

Mr. Diabetic Patient asks the tech if it is all right to use Lantus that's been frozen. She puts me on the phone with the patient. I tell the patient no, it can't be used. So then the patient asks me if I can transfer his prescription from another Goofmart pharmacy in FarAway state. I look up the patient on our state of the art super computer and pull up his information. I do the transfer and try to run the prescription. It is REFILL TOO SOON because he just filled it four days ago.

I tell the patient that it is too soon to refill on his insurance, BUT that if he calls his insurance and explains the situation to them they MIGHT be able to do an override and he can get it filled. DP tells me he doesn't have time to call the insurance and states, "It's YOUR job to call the insurance, NOT mine."

Politely I try to explain the situation to him again. I tell him that if I call the insurance they're just going to tell me to have him call the insurance. I tell DP that if he wants, we can fill the prescription for cash and he can straighten it out with his insurance when he gets back home. 

DP puts his wife on the phone. Our conversation was short because every time I would try to say a sentence she would cut me off. This happened about five times so I just stopped trying to talk. Then she starts screaming at me that this is an emergency and that her husband needs his insulin and he needs it right now and the airline froze his Lantus and he needs his insulin right now because it is an emergency. I'm repeating myself because she did.

Politely I try to explain the situation to her. She puts her husband back on the phone and before he starts screaming I ask him if he wants us to fill the prescription for cash. Once again he tells me that I need to call his insurance and I told him one more time, NO, they will ask me to ask him to call them.

"Fine, I'll call my insurance."


Five minutes later... Ring... ring... ring...

Me: "Thank you for calling Goofmart Pharmacy. This is Crazy RxMan. How may I help you?"

"This is Stunned Pharmacist at Goofmart Pharmacy in FarAway state. I just received a call from my patient DP who is vacationing in your state. He wants his Lantus transferred and doesn't understand why you won't fill it for him."

At this point I'm extremely aggravated. Why won't this imbecile just call his insurance? I explain the situation to Stunned Pharmacist and she agrees with me and is now wondering about the sanity of her own patient. She tells me she'll call him and try to explain it to him. I tell her it is too bad she's not with him so she could give him banana slices and draw pictures for him.

Thirty minutes later... Ring... ring... ring...

"This is Overpriced Insurance. I'm calling about patient DP who is on the line with me and wants to get his insulin filled but says you won't fill it for him."

Did this complete idiot listen to anything I told him?

"Yes, he just filled it four days ago. It's refill too soon."

"My computer shows it was filled 35 days ago."

I sigh. This is going to be fun.

"Check again. I just submitted the claim. Refill too soon."

"Please wait a brief 1-2 minutes while I talk to my supervisor."

Ten minutes later I'm seriously behind on prescriptions for patients in MY state when yet another person comes on the line, tells me that DP is on the line with her and to try to process the claim again.

This time it works. I tell them I will have it ready to pick up in 3.5 minutes. The lady asks me, "Is there anything else we can do for you today?"

I pipe up immediately, "Can you please confirm for me that in situations like this the pharmacy can not generate a vacation override... the patient must call the insurance first?"

"Thank is correct, sir."

"Thank you." I hang up.

An hour or so later a very sheepish little man slinks in to ask for his Lantus. He refuses to make eye contact with me as the tech checks him out.


And this, my friend, is one of MANY, MANY reasons why your pharmacist looks miserable.


pharmaciststeve said...

That is what we get for doing our job so well nearly 99% of the time.. that when we run into a "road block".. it is so far from their perception of normal... that they cannot understand why there are exceptions to "the norm"

Anonymous said...

What state is this? In California I call for vacation overrides all the time. I hate it, because usually they are leaving tomorrow before the sun rises, but I do it. Lol

Unknown said...

I use my SCC code of 3 and if doesn't go thru then the ball is in their court. Now that Express scripts and Merck have merged SCC 3 works a lot now.