The Pharmacy Chick

Flying the coup in retail

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….

12 Comments »

Comment by Magpie

January 4, 2012 @ 8:41 pm

An accurate picture of the past four days. (sigh) But you forgot to add that in 2012, Walgreen’s no longer accepts Express Scripts insurance, so we are all living in transfer hell. I can appreciate that! us too…

Comment by Emma

January 4, 2012 @ 9:24 pm

Hear. Hear.

Comment by Erin

January 5, 2012 @ 7:03 am

” . . . but the best I have is an empty Planter’s honey roasted peanut jar, and it’s not talking.” PC, you kill me!
I think I have said “I’m sorry, but I can’t answer questions about your insurance plan” appx 99 times in the last week.

Comment by WarmSocks

January 5, 2012 @ 7:54 am

Ah, so for Christmas, I should’ve given my pharmacist a Magic 8 ball on a fancy stand with a sign saying, “Answers about your insurance here.”

I’m so glad that my insurance plan year runs from August 1 to July 31, so I don’t have to hassle with changes this time of year.

Comment by Ginger

January 5, 2012 @ 12:35 pm

It’s not fun being on the benefits coordinator end right now either. We made changes to our pharmacy coverage for this year and have sent out quite a few communications about it to employees over the last few months. It’s amazing how many don’t bother to read anything we send and so of course they don’t understand why they’re paying a different amount. On top of that when I came into work on Tuesday (we were closed Monday for new year’s day), I had half a dozen voice mail messages from employees who had gone to the pharmacy on Monday to fill prescriptions only to be told they had no prescription coverage at all. Apparently the insurance company had “coded something wrong”…that took most of the day on Tuesday to get straightened out.

Comment by IAPharmer

January 5, 2012 @ 2:24 pm

A couple of large employers in my area chose a plan that only covers antibiotics and diabetic meds, there are a lot of unhappy people because no one told them. They expect me to know it all.

All I tell them is that I sent their claim and the insurance company said it is not covered. Call the 800 number and ask them I did not choose the plan, what do you expect me to do about it!Seriously? that is about the dumbest plan I have ever heard of. I mean, I thought one of our employer groups was whacko when they set up a plan that excludes anything that is remotely psychiatric. That means no sedatives, no anti depressants, no anti psychotics, etc. NADA. But ONLY antibiotics and antidiabetics? No cardiovascular? Cancer? pain? wow…

Comment by beth

January 5, 2012 @ 6:52 pm

Best.Post.Ever.

Comment by Kat

January 5, 2012 @ 11:43 pm

Amazingly I only spend 8 minutes on hold with my insurance on Jan 3, with 2 transfers and about 3-5 repetitions of my ID #, DOB, and Name. I was quite surprised when someone picked up so soon.

Comment by Lowcountry CPhT

January 6, 2012 @ 9:06 pm

About the plan that IAPharmer mentions: Considering that there are pharmacies that now give away antibiotics and diabetic meds for free, what’s the point of having a plan at all? Or maybe that’s the next step.

Comment by PharmGamerChick

January 7, 2012 @ 2:14 am

OMG, insurance that only covers antibiotic and diabetic meds? I’ve never heard of that before. So what happens if you get in an accident and is bedridden and now requires Lovenox shots?

On that note, would there ever be an insurance that only covers pain meds? hahahaha.

Comment by Tracy

January 8, 2012 @ 8:30 pm

bwhahahaha!!
I need to copy this and hand it out like little bag stuffers. except no one reads those… hmm. think it can be shrunk down and put on the oxycontins? you *know* people are still out lookin for the oxycontins”oc”s. or maybe the vicoden..

Loved loved loved this post! Im sharing with my pharm friends=)

Comment by Vagabond Rx

January 15, 2012 @ 4:48 pm

I am a Canadian pharmacist at a Shoppers Drug Mart in Northern Canada. We consider that it is up to the patient to provide us with their current insurance info. If it doesn’t pay, for some reason, we will make a reasonable effort to correct (e.g. check numbers on the card, D.O.B etc), but if they want the med today, they pay for it and send in their receipts for reimbursement to the plan.

I can’t imagine going through what you U.S. pharmacists do. Yikes.

p.s. when am I going to be able to just swipe their card and get all the info into my system without entering it all by hand? Does anyone out there have that?

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