The Pharmacy Chick

Flying the coup in retail

More issues than Sports Illustrated.

Filed under: Uncategorized — pharmacychick at 4:08 pm on Saturday, January 28, 2012

Some days run as fast and as smooth as a Ferrari.  Other days run like a used Yugo.  Friday was Yugo day….broken down YUGO day…for example:

For starters,  I am so sick of transfers I could just puke.  Walgreens made a real statement by dumping Express Scripts, a decision I admire.  Its rare that a pharmacy stands up to a PBM.  In their eyes Express Scripts is a bucket of crap.  If thats the case, why are the rest of us all fighting over who gets to pick up this bucket of crap?  We have received all kinds of communication from  suits at corporate encouraging us to welcome  this bucket of crap insurance and offering the holder of this crappy insurance transfer coupons, gift cards, welcome gifts, etc.  Let me share 2 problems with this:  1)  lots of extra work and no extra labor.  I’m piling up 25-30 transfers a day. 2)  a lot of these offers aren’t valid for the majority of these customers who get frickin pissed when they dont get the gift card/welcome gifts/coupons.  Tricare is express scripts…one of our major welfare plans is express scripts and several Medicare D plans are Express scripts…none of which are eligible for the incentives….and none of which bother to read the fine print on the offer…leaving us to deliver the dirty news.  So fun.

Friday was also ” brainless customer day”.  I dont need much from a customer to process their prescriptions.  Really, I dont.  All I need is information…information that THEY alone possess, and they either have stored in their heads or on one small plastic card.  I’ve written about this before, but a good rant  is in order.  Because we have had a huge influx of new customers, I’ve endured the frustration of their uncanny inability to process even the simplest requests: Tell me specifically what you want transferred  ” all of them” ( bang head on counter)  and bring me your current insurance information.” Cant you get it from walgreens?”. No, I am using their online tool and that doesnt’ come with the prescription and Wag’s is pretty busy right now.  Cant you get it off their computer? seriously?  do you think that  PC pharmacy can “dial in” to a competitor’s data base and garnish data?  How painful is it to bring out a small piece of plastic and hand it over ?  you’d think I was asking for a pound of flesh.

Jon Doe came to the counter Friday also.  I just knew this was going to be a painful process when he announced ” I am from out of town and I need these workman’s comp rx’s filled”.  I was right…in spades.  For starters he had insufficient INFORMATION.  Handing me only a data sheet from the doctor’s office I asked him for the prescription billing info and he looked at me like I was speaking a foreign language. Knowing THIS was going nowhere I asked him where ELSE he got his WC rx’s filled and he told me Joe’s drugs in ShadyNook.  I looked them up and they hadn’t seen him in 3 years.  Calling him back I relayed this info…and he said ( get this) ” OMG did I say SHADY NOOK?  wow I must have had a brain fart..I moved from there a few years ago..I live in Sunnynook now and go to Sam’s drug there. “So I call Sunnynook and get the billing info..( one hour later and I still have no progress on these 3 rx’s)  I finally process all three…and all 3 reject  ” please call 866-123-3333 for confirmation”  Since NOTHING has gone right from 9 am on today, its not surprising to me that THIS isn’t going well either.  I call the number and the lady ” logs into the payors website” and agrees to pay for the 2 morphine rx’s and denies the concerta rx..claiming that drug is not consistent with his diagnosis.  I guess I can’t argue with that, since I have NO history on this gentleman, and NO idea what his injury was.

I got the pleasure to relay THAT information back to Jon Doe who went about as ballistic as one human go to..I was grateful it was a PHONE conversation and not one at my counter. I was also grateful that his anger was directed at his comp and not at me.  Suffice to say that a 3 hour investment of my time paid off with exactly nothing, other than he paid cash for a 3 day supply of his Concerta and he would “address this issue with my attorney on Monday because my injury is catastrophic and everything should be paid for”.  I typed up some notes of what I had attempted and left it wrapped up in the rx..one copy for file and one copy for him.  I decided I dont want to be on the receiving end of any angry calls from Mr. Doe….or his attorney.

Then I got Mr Chavez.  Nice man actually..and another out of town transfer with NO refills.  Faxing Dr ABC’s office from the info on the transfer slip I get a fax back saying ” wrong doc”..call Dr XYZ.  Well XYZ was in the same clinic at the same fax number ( ?!?!) so I crossed out ABC, wrote in XYZ and faxed it back…to which I got a return note 3 hours later: ” patient not at this clinic”.  Getting Mr Chavez on the phone I relayed this series of events and he said ” Dr ABC covered for Dr DEF..DEF is my current dr..Ive never seen Dr XYZ……”.  Well Dr. DEF practices out of a satellite office…and different fax number. Fax number 3 goes out to DEF… and it is returned just after 5 pm signed by none other than Dr GHI covering for DEF, that Mr Chavez has never heard of…again. I filled the prescription with the caveat for Mr Chavez ” you might just expect this to happen next month..since Dr GHI is on the rx and you haven’t seen him..God only knows where he normally practices…”.

Mrs Browbeat transfers 2 Rx’s to my pharmacy.  Written for 90 days, her plan only covers 30 days at the retail setting.  She wants 90.  She claims she got a letter saying she can get 90. ( and I agree..but probably only mail order).  I show her the rejection that she disses immediately. I want to see this letter she has so I can read it myself, but she wont provide it, insisting she KNOWS she can get 90 days. wash, rinse, repeat…here we go again. I show her the rejection..she leaves mad and its ALL MY FAULT.

Ms OnaleeBrandWillDo is ticked because her Medicare D plan made her take generic Lipitor last month.  She is convinced it doesn’t work despite the fact I show her that its the very same tablets…from the same manufacturer…only tons of $$ less to her…  As far as she is concerned, I filled the bottle with dirty gravel I guess…and its ALL MY FAULT

Dr. Picky writes a renewal script for sertraline for a newer patient of mine who has been getting it filled here for 2 months.  We carry Northstar Sertraline.  He wants Greenstone..of course I know why..its same as Zoloft..  Problem is that I can’t get that one.  We purchase on contract..we get whatever vendor our company has agreed to purchase from. I tried to order Greenstone..they shipped the contracted item.  I really dont care to deviate from the company policy. If they remain competitive in the marketplace by purchasing by contract, I will support that. The special request process is slow and results in higher drug costs because its NOT a contracted item.  The customer didn’t care what she took…but HE did so he made her find a pharmacy that could buy Greenstone and fill it there.  Whatever…

One after another..issue after issue…It was painful to get a simple prescription from hard copy to the cash register without going thru some kind of  suffering.  Loyalty cards that didn’t work.  Medicare D patients insisting they had NO changes in 2012 ( they did).   I even had to listen to squabbling among patients who were arguing who got to the counter first…really? must I listen to this? by the time you fight this out BOTH of you could have been gone..in restrospect I should have offered to flip a coin..

I was so ready to go home. I had to make one delivery to a disabled guy on my way home. Hoping to just drop it off and fly, he wanted to engage in a conversation about his favorite new tv show…for 45 minutes.  My phone was buzzing non stop..Mr chick was freaking out..it was nearly 10 oclock before I hit the garage door.

I’m ready for a Ferrari kind of day.

The HI-light of the day

Filed under: Uncategorized — pharmacychick at 4:44 pm on Wednesday, January 25, 2012

Several months ago, Pharmacy chick started to do something.  I made no announcements of my intentions and so far, nobody except one person has noticed it.  I started to say HI.

What?  Hi?  So what….you might say.  Actually I started to make sure I said HI to every customer I knew by name.  Even if it was across the pharmacy,  I would make myself known to THAT person  ” HI STAN!” .. HI Mr Schuster!”  whatever…sometimes it might initiate a conversation, but most of the times, it has been just a greeting and an acknowledgement that I know that a certain person is there.

I think it is important to acknowledge people, even if I am not the one actually waiting on them…because most of the time I am not.  I may counsel them, but I generally not the one who will ring them up for their refill purchases.

Last Saturday, we had a relief tech working.  I went about my daily routine, and it HAS become  a routine for me, saying HI to everybody I know reasonably well.  After a few hours the tech said…'”geez Chick, do you say HI to EVERYBODY??”  and I responded  “Well, yes I do actually.  They need to know that I know they are there”.

We are never too busy to say Hello.  With all the e-communications that we do now days…txt…email..Facebook…voice messaging… a simple HELLO is that physical connection that says  ” I notice you..and I acknowledge you”.

I have noticed that a lot of my newer transfer customers are getting to know me by first name faster.  I notice that some of my crumudgeons aren’t so cranky. and I notice that I have fewer issues with customers at the counter.  Coincidence?  Who knows.

But I can say that ANYthing we can do to develop and improve people relationships are a good thing…Try it and see 🙂

I love Dr CC

Filed under: Uncategorized — pharmacychick at 11:06 am on Tuesday, January 24, 2012

You dont know Dr CC, and I haven’t actually met him personally, but I love him. WHY?  Because I rarely, if ever have to fax his office for a refill request.  And if I do, most of the time I get a denial anyway….which I actually expect but since some of his patients are slow learners apparently, I go thru the motions.

You see,  Dr CC issues all of his prescriptions on full sheets of paper.  All of them follow the same protocol and he has them computer printed so they are very easy to read and understand.  Best of all there is a disclaimer or EXPLAINER at the end of each on in bold face capitals that says the following ( paraphrased)

ALL PRESCRIPTIONS FROM THIS OFFICE ARE ISSUED WITH ENOUGH REFILLS TO LAST UNTIL THE PATIENT’S NEXT SCHEDULED VISIT. ALL PATIENTS ARE REQUIRED TO BE SEEN TO BE ISSUED ADDITIONAL MEDICATION REFILLS, AND REFILLS WILL NOT BE AUTHORIZED VIA PHONE OR FAX UNLESS CERTAIN CRITERIA HAVE BEEN MET

WE DO NOT ISSUE PRESCRIPTIONS FOR ANY MEDICATIONS ON THE WEEKEND. WE DO NOT ISSUE REFILLS FOR CONTROLLED MEDICATIONS OVER THE PHONE OR FAX

What this means to me is that if I get a refill request from a patient on a medication from Dr. CC that has expired, the patient has most likely either 1) skipped his appointment or 2) taken too much of his medication and run out before his next scheduled visit.

Dr CC has done it pretty well I think, and I wish more Dr’s would follow with some kind of refill policy, the most important of which is this: Issue enough refills to get your patient thru his/her next scheduled visit. It would make my life ( and his/hers too) much easier.  I have this one patient who gets only one prescription: Synthroid. EACH friggin month the dr only ok’s it one time….for 30.  WTF?  I feel bad for her because not only does she have to ask for a refill every month on a maintenance med that has O refills on it, but this Doc takes 3 days minimum to send back his auth.

Now, yes I understand that sometimes you want to TRY a med on a patient to see if it works.  Im OK with that.  AND if you aren’t sure if a patient is abusing a med, put a date restriction on the fills  ” may only be filled every 30 days”.  Ive never met a pharmacist who wouldn’t honor a request like that.

I also used to work for a pharmacist who originated from a state in central US.  He was amazed that the patients went to the pharmacy to request a refill. In HIS state, the patient had to call the DR when he/she was out of refills.  Then the doc took care of the request…called the pharmacy…which seems like a pretty logical procedure.  How did we become the step-n-fetch-it?

Why Yes, that is what it means..

Filed under: Uncategorized — pharmacychick at 11:21 pm on Monday, January 23, 2012

Customer:  My Dr said he called in a prescription for me today.

Me: ( looking up said customer on the computer)  Mmmm. I dont see one finished for you. Let me check elsewhere. ( check fax, answering machine, stack of faxes at the computer and look at list of e-scripts…nothing).. Well, I looked at all of our incoming and pending prescriptions, and there isn’t anything here for you.

Customer:  does that mean its not ready?

_______________________________-

customer:  My doctor said he sent a prescription over for me today.

Me: ( getting his name..looked it up..last rx was in november).  Nope, I dont see anything since November of 2011…but we havent completed all of our pending stuff. let me check the pile of unfilled prescriptions….( and dont find it).  Sorry, I dont have a prescription for Kevin Bumblebutt pending.

Customer:  I saw him send it over the computer.

Me:  nothing has arrived for you…( my other pharmacist comes back from lunch, so I ask him..” Man Friday? did you get a script today for Kevin Bumblebutt?”..yea got one for Bumblebutt, but not for Kevin..some other first name, and not on file here”)

customer hears this as Friday pulls script from  the unknown patient box..Edmund Bumblebutt and date of birth different by one year..so no match in our computer

Me:  we have one for Edmund Bumblebutt  dob 1-1-43

customer: Thats me.  but I never go by Edmund.  I go by Kevin…and the date of birth is wrong..I am born in 42, not 43.

Me: ok, we will get this ready then but you will be Edmund at this pharmacy since that is how Dr is sending scripts over for you..

Customer: you mean its not ready then?

______________________________

Customer:  My dr told me he sent a prescription over for me today.

Me:  hello, Yes he did and I left you a message about 2 hours ago.   We do not have this product in stock, we have to order it for tomorrow. Will be here by noon.

customer: So, its not ready?

Are you needing hearing aid batteries today?

Filed under: Uncategorized — pharmacychick at 10:03 pm on Tuesday, January 10, 2012

Overheard at the pharmacy counter today:

” Sure glad  I didn’t put my money on LSU”

” WHAT? You lost all your money to a LA Jew?”

I thought my tech was going to split a seam…

One of “those” days.

Filed under: Uncategorized — pharmacychick at 11:52 pm on Monday, January 9, 2012

Some days you wonder if EVERY one of your customers was beat with a “stupid” stick on their way in.  Today was that day.

We have tried to be proactive on insurance issues, leaving messages to tell people to bring in their new insurance cards. If we leave you a message telling you that your insurance rejected and we need a new card, do NOT call me back and chew me out because you claim “nothing has changed”.  if NOTHING had changed I wouldn’t be calling you. ( then actually tried to give me the OLD card..like I wouldn’t already know that??

A customer dropped off a prescription for something I had to order.  I told him it would be here tomorrow at NOON.  He appeared to hear all I had to say and said ” Ill be back after work tonight”…( FOR WHAT?) If I have to order a drug for tomorrow, it means TOMORROW..honestly..my wholesaler is not going to zip-line me that drug in two hours. must have rode the short bus in..

NO, I do not have any generic Adderall, and NO, I do not know who has any.   ( seriously? why ask that question?)  I do not have a secret computer access code to the inventory of my competitors…and my Planters Honey Peanut jar crystal ball isn’t telling me when I will get any.  THANKS DEA!  LOVE YA..not so much!

we are undergoing a remodel right now…setting the stage for the next one–there is a huge plywood wall where our wait room USED to be: “Can I use your blood pressure machine?”  Sorry , not at this time, we are remodeling ( duh). we have no wait room right now and no power in that area of the store.” Does that mean NO?  ( and huffs away  mad)

On the same note:  Huge wall of plywood blocking half the store, saws whirling, construction people and orange tape/cones everywhere, big signs saying “pardon our mess”..and 300 people have asked  ” Whats going on?’

Customer KNOWS his insurance has been termed..we called ahead for the new card…he knew it…and failed to bring it.  And he is mad at me because I wont just “give” him the rx.

Actual conversaton:  ME:  do you have your new insurance card?  HE:  YEA, do you need it?….( blank stare)

I have a pile of 30 transfers to get from various WAG’s.  Somebody drops off 4 more, wants to get it in 20 min.  I tell him that 24 hours is the requirement for transfers right now. He leaves….and comes back in a half hour asking somebody ELSE if it is ready.  its under a pile of 30 transfers, and the tech knows it so she goes thru the pile ONE BY ONE in front of him…and finds it.  He gets the drift…finally.

He must have only been slightly beaten with the stupid stick…he recovered.

Preferential Holidays

Filed under: Uncategorized — pharmacychick at 4:32 pm on Thursday, January 5, 2012

Since we just had two of them, I thought I would launch into a personal burr in my butt pet peeve: preferential holidays.   If you are a government employee you know exactly what I mean.  AND, I suppose if you work in a lot of private sectors that copy the govt holidays, you also know what I mean. BUT if you are a retail worker like myself, you might feel a little hosed.

The preferential holiday is the one where the REAL holiday falls on a day where you may already be closed so the blessed few get both the real holiday AND a fake holiday off the next day. This year Christmas Day and New Year’s Day fell on a Sunday.  Therefore the privileged got both the Holiday and the next Monday off.  No mail, no banks, etc.

Pharmacy chick worked both of those days because they were Monday.  PC pharmacy is open on mondays…each and every one of the year unless Xmas day falls on a Monday.  We are open 363 days a year: closed only on Thanksgiving day and Xmas day.  And getting paid for a holiday is a tricky feat itself.  For some reason I don’t understand ( perhaps they are delusional and think we CLOSE every holiday of the year like THE OFFICE DOES) They assume we work 32 hours and get 8 hours of holiday pay.  Therefore, when we work our regular 40 ( because we are open) we have to submit special forms for holiday weeks.  This always seems to create an issue.

I can speak with authority on this issue because I have lived both sides.  My father was a govt employee.  That man got holidays I have never heard of. ” Dad, why are you home today?”.  ” Because its Newt Holmgrem day“.  ” Who is Newt Holmgrem?”  ” I dunno, but we get paid for it“.  ( My apologies if there really is a Newt Holmgrem..I totally made this up).  On the flip side of the story was my mother, an operating room nurse.  Injury doesn’t take a holiday so if she got the call at 8 am Christmas day that a car accident was coming in,  she was out the door.

But Really?  Do non emergency services, corporate offices and the like really need to take an EXTRA day off from work JUST because the holiday was on Sunday?  Personally, I don’t think so.  We were all working on Dec 26 and Jan 2.  Could we reach anybody in the office if somebody was sick? and IT issue?  a customer issue? a legal issue? NOPE….closed.  Personally, I’d like to see a bit of equality. Speaking to our corporate office:  if YOU get the day off, then I should.  if your stores are open, then YOU should be.  We are also open on Labor day, President’s Day, Memorial Day, and you can bet every phone rings to voice mail if you call the office on THOSE days too.

Now I shall step off my soap box…for now.

January Amnesia

Filed under: Uncategorized — pharmacychick at 6:22 pm on Wednesday, January 4, 2012

As a public service message, Pharmacy Chick would like to alert all pharmacy customers that immediately after midnight on December 31, 2011, it became January 1 2012.  I know it may have caught a lot of you by surprise, especially with little or no fanfare that accompanies a typical end of year in the US,  but trust me, I am a professional.   I know what I am talking about.

In addition to now having to date your checks with the year 2012, and seeing all that Valentine’s candy in the grocery stores,  you may also have the GINORMOUS inconvenience of having to give your 2012 insurance card to your pharmacy in order to pick up your prescription and prevent paying full price.  And, since the order of things matters, the time to present that new shiny card is NOT at the cash register AFTER the clerk has rung it up and you drop the phone you have glued to your ear when you see the price….its BEFORE.  Just sayin…

I would also like to re-introduce the word  DEDUCTIBLE to the public’s vocabulary.  It is that portion of expenses that you are required to pay each year BEFORE your benefits kick in.  No, I do not know WHAT your deductible is, but  I am grateful that some PBM’s will at least send us a message ” entire copay applied to deductible”  At least I know what to tell you when you freak.

I personally would like to extend my thanks to CMS for further complicating Medicare D by reassigning BIN numbers and Group numbers to nearly every single Medicare D member that has ever or will ever come into my pharmacy this year.  Not only do most of these people refuse to believe  that their Red, white and blue medicare care is NOT their prescription card, I now have to explain to them that I need a NEW card with NEW numbers on them for 2012. This is not going well.

FAQ:

Why did my insurance do (this terribly annoying thing I am bugging you about) Well, I wish I had a crystal ball that I could summon an answer out of, but the best I have is an empty Planter’s honey roasted peanut jar, and it’s not talking.  Every card I have ever seen has a toll free number on the back.  Call it, sit on hold with the rest of the un-informed and ask your question. ( or at least get transferred around enough until you finally get frustrated and angry and hang up)

Can you call my insurance and ask (the same stupid question above)? Nope, see the paragraph above…make sure you have gone to the bathroom, and are in a comfortable chair when you make that call.

I only paid $X last month…this month its $XX! You are absolutely correct, I can see that on my screen, but as you might know, it is a new policy year with new benefit packages.  You may have been sent tomes of materials to read about your new plan.  But since we adjudicated the claim and it paid without a reject, I can only assume that  changes were made to your plan, and while that sucks, they dont have to ask your permission to do that. Pull all that unread material out of your recycle bin and read it or go back two paragraphs….

I paid full price for in December because I was in my donut hole.  Can I get it rebilled NOW? ( oddly enough I got 3 of these requests today)  No-can-do.  That is fraud.  If you removed the drug from my pharmacy in December, I can’t change a thing..  The only exception to that is if you PICK up, SIGN FOR, and PAY for it after January 1.  Pharmacy Chick never knowingly does anything that would sniff of fraud. The  “guvunment” LOVES to find fraud and if I dont dot all my I’s and cross all my T’s they will hang me out to dry and publish is for all to see.  Nope, I’d rather piss off a customer and fly right than get myself or my company in trouble. ( fyi: we do our best to inform every single person in their donut hole that buying just enough, or waiting til Jan is a good idea if they can.  we never  just LET people pay more than they need to, especially that last week or two of the month)

and Lastly…this one is coming really soon:  YOU PUT IT BACK??? I wanted it filled on LAST years insurance? Every year I go thru this:  Joe Schmoe et.al. orders everything he can around the end of the year…then he doesn’t bother to come in and pick them up.  Each day I get a report called the Return-to-stock report. every prescription on that report has 2 things in common:  they have been on the shelf for 10 days, and they have had at least 2 automatic calls made to the residence on file telling them it is ready.  Ten days is a long time to have  bottles just sitting there.  We aren’t renting storage lockers after all. If you can’t find any time in a 10 day period to pick up prescriptions you wanted, then I am sorry, they will be refunded to your insurer and returned.  This happens all the time, all year long, but it gets more testy at the counter in Jan, and since that report is tracked daily, I can’t get around it.

So, welcome to 2012,  hope its better than 2011 on a lot of things….

Couldn’t have said it better myself

Filed under: Uncategorized — pharmacychick at 12:43 pm on Sunday, January 1, 2012

A couple of weeks ago PC-Ville’s paper reported an article about a new narcotic hoping to hit the market soon.  ZoHydrin,  50mg of pure hydrocodone, with no Acetaminophen to impede its limitations, is currently a SCHEDULE 1 drug according to the DEA.   When I read about this, my first thought was ” Whose friggin stupid idea was this?”, but being the lazy butt that I am right now, I didn’t post about it.   Drug Monkey, however has done a superior job of that today, surpassing anything I would have written on the subject, so I present to you this link:

http://drugmonkey.blogspot.com/

Happy New year!