Ahem. You may have noticed that PC has been AWOL. She went to her high school reunion. There WILL be stories….very soon!
In PharmacyChickville newspaper, the recent hot item, (other than the weather) is the fact that a huge union-based employer group is having a war during their contract negotiations. Apparently, despite the sagging economy, rolling furloughs, layoffs, and cutbacks, THIS group has managed to preserve (til now) its FREE health insurance. Its the kind of job we all would love to have. Once you get hired, its awfully hard to get fired, and the benefits are pretty nice….kinda rare in todays world. No wonder everybody lines up 10 deep to apply. Since I write anonymously, I cant reveal the employer but suffice it to say its still the bastian of golden parachutes. It is a government based employee group.
Now however, this group can no longer fly under the radar. If you worked for the govt you got the best of the best, with regards to benefits. It was said at one time that the wages may be slightly less than the private sector but the benefits couldn’t be beat. True statement if what my employee friends say is accurate.
Now the hammer is coming down. Money is short and if everybody else is having to pay for health insurance then is reasonable and rational to expect that THIS group should be paying part. Mr Chick and I pay close to $400/month in “premiums” for our employer based health insurance. $4800 per year for our anual tooth check and OB exam. wow. At least we know that if we crash and burn, we are covered….at 80% Yea, even with health insurance we could be bankrupt by a catastrophe. This particular group pays nothing. nada. zippo. Tax dollars pay them all. MY Tax dollars.
the union is having a fit because they may have to pay a small percentage of the premium.
I thought about it for a while and came to this conclusion. They should pay. No, I am not being sour grapes. Its just the fact of the economy. Times are lean and if you are gonna keep the most jobs, then something has to give. I did a mental looksee over the last 15years of my employment benefits and this is what I found.
1. When I was first hired. we had free health insurance. Both Mr chick and I happened to work at the same employer (tho in different jobs) and because we were “double” covered, we had our expensed paid at 100% because what 1 didn’t pay, 2 did. it was nice.
2. later on the policy changed. Each employee had to have his/her own plan, even if you worked for the same company and you could NO longer be double covered, which means that Mr C couldn’t be a dependent on my policy if he worked for the same company as I did, he had to carry his own…AND we had to start paying a small “premium” around 15 bucks a week.
3. Mr chick eventually moved to a new employer. Chick’s employer group wouldn’t even cover him IF he could receive ANY benefits from his new employer, and if I did add him, it was a $200/month fee. Yes folks…two hundred dollars a MONTH . Thank good ness his new employer had health benefits.
4. fast forward thru no deductibles, fixed copays and ceilings to 1000 dollar deductibles, percentage copays and no stop loss. currently the first thousand bucks of all medical expenses are on me each and every year. For the last few years, I haven’t had to file a single claim, because I have had to pay for everything up front. Everything the Dr billed was rejected “subject to deductible”.
And I get to pay $400 per month for the priviledge ..of paying for it myself.
Do I feel bad for this union for being forced into the reality of 2011.
Not so much. Ive been doing it for years.
I don’t know how many of my readers are golfers, but Pharmacy Chick herself is a total golf nut. Hook, line and sinker, carry me away to the golf promise land, when I die please! Honestly I have no idea (other than a wandering mind) how this post came into being but I decided that there is a startling similarity between pharmacy and golf …when somebody comes up to you with a very common problem.
Golf: you just hit your ball into the water AND Pharmacy: You forgot your medication at home and you are on Vacation:
Both of these happen fairly regularily to both the golfer and the pharmacy patient. Both involve a bit of stupidity on the part of the person. The golfer doffed his shot into the water and the customer forgot to pack a critical item. Either way dude, its gonna cost ya…..
In Golf there are always 3 ways to proceed from an “incident”. And, so I realize there is also 3 ways for the patient to proceed.Therefore Pharmacy chick will compare the 3 options
In Golf you may 1) replay from the original spot (penalty: distance and 1 stroke) IN pharmacy , you may go home and get your med at its original location ( your cabinet): penalty: distance and time
OR: you may 2) play from the water ( not always feasible if its under 10 feet of water, but in the rules it IS an option). in Pharmacy you may 2) suck it up and go with what you got: nothing!
OR you may 3) take your penalty stroke and drop no closer to the hole according to the rules where it last crossed the hazard. In pharmacy you may 3) beg the pharmacy to call and transfer your rx to this new location and pay for the rx that you left behind that your insurance will not cover b/c its too early.
I thought it rather interesting ( in my finite simpleton kind of way) how the 3 golf options rather nicely corresponded to the 3 pharmacy options out there.
In golf you have to just suck it up and figure you are gonna take bogey or worse. Ya write down your score and move on. This is where the similarity ends. In pharmacy I get to listen to endless whining about having to shell out a few shekels for medication that YOU HAVE PLENTY OF, but not with you at the moment. “Cant you call my insurance?” ” How come its so much money! Its only 5 pills” “I only need a few days worth! Why do you have to call my pharmacy?”.
I swear I should serve a plate of cheese with that whine! Suck it up. You left your stuff at home. Take your bogey and move on….please?
It would seem that HIPAA has become the catch phrase for everybody to deny everybody else information. It also serves to prove how utterly stupid the staff of a doctors office can be when it comes to what information they can and cannot share.
Case in point:. We had a patient come in with a script, toss it on the counter and tell us they’ll be back in about 2 hours to pick it up. When I finally get to it, I notice we are out of stock. We called the phone number on record and its defunct. I called the Dr’s office and ask the receptionist to look up the most current phone number for the patient.. She tells me she cannot because of HIPAA. ” Look, I gave you the name, the DOB, the DR name AND the Drug the doctor just prescribed, AND why I need the information. YOU most CERTAINLY Can provide the phone number of the patient. I am a health care professional.” She put me on terminal hold then finally relinquished the phone number.
Case II. Pharmacy Chick is doing a DME billing for a Medicare claim and we need the ICD-9 code. I called the office and asked for the diagnosis code for the billing. Phone jockey tells me its protected information. WTF? Check again Missy..
Case III. “Dad” somehow doesn’t know the date of birth of one of his “kids” he is filling a script for. Guessing failed the insurance test. So I called the office to get it myself. The medical assistant gives it to me but then asks me..” Can I get in trouble for telling you?” I said “No, only if you post it on your facebook page!”.
Case IV. Rx fails the DOB test on the insurance claim. The date of birth is correct per the patient, so I called the insurance company. It was a billing for a medicare item. the rep refused to give the the date of birth they had on file. He insisted that the patient had to call to “correct the problem” then we can rebill. FAIL. I broke the news to the patient. I feel bad for whomever he unloaded on at the office. He was not pleased.
Any of you pharmacists out there have any other stories to share about HIPAA failures?
One of the disadvantages (and there are many) of living in a climate where summer is all to brief and the coldest season stays too long is that many people take too little thought into what they dress themselves in during the hot days of summer. Perhaps its because they own so few summer clothes and dont desire to invest much cash into clothing they aren’t going to wear much. Perhaps the long winter has wilted their brains and they have become stupid. Im no prude, but I have some sense of style. I know I have written about this before so its time to launch the 2011 version of WHAT NOT TO WEAR during the summer:
1. No matter what culture, a striped shirt and a plaid pair of shorts with black socks and loafers will look stupid..seriously stupid…
2. Black is only slimming to a point. If you are 250 lbs and are wearing black spandex leggings….you are not looking slimmer….ever.
3. Step away from the tube tops..its never that hot out. .
4. Bathing suits belong in two places….the beach and poolside. They do not belong at the pharmacy counter. Yes I know you have a a hot body and my intern is foaming at the mouth, but I need him to pay attention to the counting tray, not YOUR belly button ring.
5. Same lady every year…. 70 ish.. white shorts and full length nylons. WTF?
6. Good rule of thumb. if you are a man ( or a member of the male species), your shirt should always be longer than your belly…and likewise, if you are a girl, your shorts should be longer than your butt.
7. Second good rule of thumb. Nobody wants to see your underwear…and this applies to girls in thongs and boys in boxers. tuck them in.
8. Do not use John Daly as a guide on how to dress on the golf course. He is a drunk doofus and dresses like one.
9. Shoes …sandles…flip flops…I dont care…but do not walk my aisles in bare feet…Have you ever heard of broken glass? Yea we get that now and then so dont come to me with your dirty and bloody feet looking for help. ( yes its actually happened…more than once)
10. White clothes do a lousy job of hiding your polkadot underwear. Im just sayin….
And lastly…put your sunscreen on. That “burned look” isn’t fashionable anymore either, unless you WANT to be on the cover of Skin Cancer Monthly Magazine.
Actual conversation with Mr Chick this evening:
ME: ” Hey sweetie, I got some of that 8 piece Dark meat cold chicken at Joe Grocery tonight!”
MR CHICK: Cool
ME: Not sure those deli employees know their dark vs light meat tho. I see a wing attached to a huge breast in this one.”
MR CHICK: ” but the wing is attached to the thigh…
ME: “Not in any chicken I have ever seen.” ” leg..thigh…wing…breast…remember?”
MR CHICK: oh yea…………never mind.
Its the day after a holiday and all thru the pharmacy the techs are scrambling and the pharmacist is under water. The phones are ringing off the hook and people are hotter than the fireworks they blew off all last night. ” I want my THIS… I need my THAT…and I must have it NOW” ..that is the theme of the day.
Then about 230 this lady comes to the counter with a bunch of stuff in baggies. Prescription bottles melted with tablets glued to the remains of what used to be a labeled bottle. “What the ____?
” I had my bottles on the stove and I turned it on.”.
Well…alrighty then..thats a new one. One might think that nearly a quarter century in the retail world that most circumstances might have been played out..
Pharmacy Chick answers tons of questions each day. They usually run in 1 of 2 varieties: WHERE is ( or do you carry) X? and What is the best ( or recommend) for X. I dont mind answering questions about my area expertise, but I have to admit I get really sick of having people ask me where crap is all over the store. I must have some sign that only customers can see that says “information booth” on it, because if I ever find it, I will rip it from the wall and burn it to ashes. Tonight, for example I had people ask me for : cool whip, the fruit juice section, bottled water, shoelaces, motor oil and bug spray. If I ever get the privilege of signing my own paycheck I will surely tell all of them what I think of their requests.
But that is not my daily whine today.
If you come to my pharmacy and ask me ” What is Best for X? I am going to tell you. And if I take the time to tell you, I expect that you will grant me the courtesy of believing me and accepting my response. I am not going to lie to you. You asked for the “BEST” and I gave it to you. If you wanted CHEAP, then ask me for cheap. Occasionally the BEST is CHEAP, but not always. Your eyes are all pink and itchy from allergies and I recommended Alaway/Zaditor. Its the BEST. I also recommended Allegra. Both will give you fantastic symptom control, once daily dosing and no sedation. Did you buy it? Hell, no. What you wanted was “CHEAP”. Heck, even generic Claritin wasn’t as cheap as you wanted it to be, and frankly isn’t that great of an antihistamine anyway.
You walked away with a box of generic Benadryl. Enjoy your nap, sweetheart.
Sadly this scenario isn’t all that unusual. If I went to a car lot and asked for the BEST car, its likely I wouldn’t be shown a 1980 Yugo. If I asked for CHEAP, I may have been shown the Yugo. Sure, the Yugo will get me from point A to B ( most of the time) but its not the most effective, reliable, or attractive form of transport.
Everybody asks me for the BEST. They ask for my recommendations. I will always recommend what I would use. I feel its my obligation.
Don’t ask me what I will recommend unless you really want my answer, and don’t look at me sideways when I wonder why you question my answer..