The Pharmacy Chick

Flying the coup in retail

Phone Book Fiasco

Filed under: Uncategorized — pharmacychick at 8:02 pm on Saturday, May 16, 2009

Pharmacy chick about had a front porch face plant the other day when (yet again) she found a pile of phone books stacked at her front door.  I cannot think of one thing I couldn’t need any less than another (ANOTHER) stack of phone books. 

When PC was a kid, we lived in a town of about 70,000.  45 years later, I think that town still has 70,000 residents, give or take a few migratory snowbirds.  We got A (1) (singular) phone book.  it was THE phone book, and everybody who was somebody had their name in it.  I remember as a kid, as soon as we got the darn thing, we’d all look ourselves up.  “See, there we are!” we’d all exclaim, with joy and much celebration, as if being in the phone book was some sort of accomplishment.

Fast forward many years, and Mr and Mrs Chick live in “big city”.  We have 6 phones books from 3 different phone book makers sitting in a file cabinet in the office. 4 of them are virtual carbon copies of each other because they are competitors “look inside, our phone books are better!” and the other two are what I call “regional or specialized” phone books. Stack all of them on top of each other and you have approx 12 inches of phone books. 

 More importantly,  The Chicks aren’t in any one of them.  We chose (and pay) to be left out of the phone book after a series of weird and disturbing calls freaked me out.  Always arriving when I was home alone, I decided that it was time for a phone number change. It helped that we also moved shortly thereafter.  New home, new number (unlisted and unpublished) thank you very much.

What prompted me to write about this was not to wax nostalgic about phone books, but the grief they cause the pharmacy.  For some reason (and for several consecutive years)  the phone book has the Pharmacy Chick pharmacy number incorrect in the phone book. 

As with many stores, we have several departments.  The pharmacy department was unceremoniously left out of the dept list and the main store number was substituted with the pharmacy departments number.  You can see where this is going.  All day long we get calls for everybody BUT the pharmacy.  Its also clear that if you call “information” they use the same data base because they give callers the same number. 

 What makes most of the staff nuts however is not the callers. We can deal with that.  They call, we transfer.  What makes us pull our hair out is the fact that most of the other departments do not have people standing by their phones like we do.  We live and die by the phones. We are near the phones all day. They dont, and therefore when we transfer the call and they DON’T pick it up, it rings back again….and again…

We try to be helpful, but its clear that we are the only department which has somebody in the immediate vicinity of phones at all times. I can’t change what’s in the phone book.  I am powerless to correct it but I have reported it.  I might as well be talking to the wall.

And so we keep it up: “Pharmacy chick Pharmacy, this is the Chick!”  “uh, are my photos ready?” “Let me transfer you!”

My character flaw.

Filed under: Uncategorized — pharmacychick at 8:06 pm on Friday, May 15, 2009

I am not proud to admit this, but the Pharmacy Chick has a major character flaw.  I know, I know, it comes as a devastating surprise, considering I am the pharmaceutical equivalent of managerial perfection. (can you detect the sarcasm?)

Pharmacy Chick absolutely hates it when somebody calls in sick/absent.    It happened twice this week and had it not been for the presence of an intern there would have been one pharmacist and nobody else in the department until 1:00 in the afternoon.  Its been especially precarious since the company cut a full time position out of the pharmacy.  Goodbye safety net.  Goodbye source of back up. 

I don’t have a lot of mercy.  You have a shift obligation.  Leaving a message on my machine 30 minutes before opening telling me you aren’t coming does not endear yourself to the Chick.  This is magnified when the person calling in is a relief person already scheduled for somebody else. You know, at the very least, you could have called in again later and spoken with us in person to apologize..  Tacky tacky tacky.

Call me callous, call me unreasonable, but I have worked for 22 years as a pharmacist and have never left the company hanging by calling in without making arrangements for coverage.  When somebody calls in sick/absent/my babysitter didn’t show up/whatever, it has a negative trickle down effect all the way down to the customer.

If you haven’t noticed, the Chick takes attendance very seriously.  To me, there are no excused absences if the absence is not filled. Rip me a new one, tell me I am a loser.  I don’t care.  Its just the way I am. Character flaw or pet peeve,  It makes me crazy.

A Virtual antique

Filed under: Uncategorized — pharmacychick at 9:10 pm on Thursday, May 14, 2009

To fully appreciate this post, you probably would have to have been a pharmacist for at least 15 years.

This guy comes in and wants to fill a prescription.  He is a sweet guy, I’ll give him that.  He hands me the prescription and I ask for his insurance card.  He digs thru his wallet and pulls out his card.  Its a PAID prescription card….with RAISED NUMBERS.    This was a first generation prescription card when we were still using universal claim forms.  The raised numbers were necessary because we used the credit card sliders on each one.

Since PAID was purchased by Medco many years ago, I suggested this might be a pretty old card, and I was right.  Lucky for him, his wife had been here before and I found a MUCH more current insurance on file.  He asked if he should throw it away.  I said,  ” Well you could sell it on E-Bay as a pharmacy antique but it has your social security number on it…”

I did a screen print of his current insurance and told him to hang on to it.

Its been a lot of years since I have seen a card like that. 

Just more fun at the Pharmacy Chick arcade.


Filed under: Uncategorized — pharmacychick at 9:35 pm on Wednesday, May 13, 2009

Some days there aren’t enough walls in the pharmacy to beat my head against.  We live in the information age.  All around us is access to all sorts of information.  I wouldn’t be surprised to get on wikipedia and find my own name there somehow: “Pharmacy chick, the best blog on the planet”..yea right…

That being said however,  getting information out of a patient is another story!

If you are a patient and you come to a pharmacy, you have only one job in the filling process: give information.  Thats it.  I won’t ask you to come into the pharmacy and fill it yourself.  I won’t ask you to call your own doctor for refills either.  However, when I ask you for information, I expect that you will provide it…freely and honestly.  If you dont have what I need, I will tell you how to get it. I’ll never ask you for more than I need, as I am not nosy.  I am not your babysitter/mother/caregiver however. Dont ask me to do your foot work, and I won’t ask you do to mine.

Do not hand me a scrap of paper with some scribbles on it and tell me its your insurance information.  No PBM I have ever seen has mailed out cards on wrinkled pieces of Hello Kitty paper written in crayon ok?   Its not my job to FIND your insurance.  Its my job to PROCESS your insurance, and I am happy to do so.  I am not happy if you ask me to call some handwritten phone number at 7 pm to get your insurance from some lady you allegedly “just talked to”.  If you just talked to her, then you can call her right back and get what I need. 

I’m actually pretty savvy.  I have been known to recognize the processor just by the unique arrangement of the ID numbers.  Sometimes I can guess by knowing the employer.  You work for United Napkin Holders and Paper Cups?  ok, thats Medcrap.   American ZIpper and Fastener?  Thats Expressless scripts… I had a guy today.  He’s a new employee at our hugest employer group in the county.  They always use a certain PBM.  He handed me a scrap of paper with an ID number. I recognized arrangement of numbers and letters as unique to this PBM.  I told him I believed he was (insert PBM here).  He didnt’ think so. “No, I called (big insurance company) and they gave me this number.”  I tried to explain that the (big insurance company) farms out their rx benefits to (big PBM). He was missing his group number, but they usually had 1 of 2.   I ran the numbers and neither group worked.  Of course it was all my fault.  He wanted ME to call and get the rest of his information.  I gratefully declined.  I wrote on his scrap “BIN, GROUP, ID”.  “bring me this filled out and I will do the rest, but I suspect you arent’ loaded yet.”   He stomped off mad.  “I’ll just find somebody who WILL help me”

I looked at his address.  I suspected I knew where he might go so I waited a while then called.  “Hey Tammy, PC here,  did you get some guy with a script for X with a scrap of paper for insurance?”  She confirmed that he had been there but “we couldn’t verify his insurance so he paid cash”.

If only he had proper i.n.f.o.r.m.a.t.i.o.n.

One more for the road…

Filed under: Uncategorized — pharmacychick at 10:29 pm on Monday, May 11, 2009

Since we are on Mom stories, I got one more before we say goodbye to this subject for a while.  To this very day, I chuckle when I think about it.

I was 17 years old, and I was on the way to Europe.  I had been selected to a choir and we were to convene in Calgary Alberta and get on a plane to Amsterdam.  We arrived to the airport early and had time to kill so we were having lunch in a cafe’ booth in the airport.  On the table were packets of condiments: ketchup, relish, tartar sauce, mayo…etc.  My mother was fiddling around with one of the packets smooshing it back and forth in her fingers.

The next thing I knew, she said “Where’d it go?”  “Where’d WHAT go?” my dad asked.  “The tartar sauce…its gone!”  In her hands was a now-empty packet of tartar sauce.  We looked on the table…no tartar sauce. It wasn’t in her lap, her plate or on anybody elses plate for matter.  Then I heard her gasp.  “What?!” my dad said, while my mom pointed to the guy at the NEXT booth.  There was a big splooch of tartar sauce on his shoulder!  How it flied across a table and landed on his shoulder is beyond me, but there it was.  Trouble was, he didn’t know it yet.

She got up,  walked over to the next table and proceeded to tell this poor fellow that he was wearing tartar sauce, courtesy of my mother.  She apologized all over the place and offered to pay for his cleaning. He had no idea how it happened. She showed him the packet.  I have no idea if he ever sent a cleaning bill to my mom because I got on a plane and disappeared for 3 weeks, but its pretty safe to say she quit playing with condiments!

We never let her forget it.

My Mother’s day story.

Filed under: Uncategorized — pharmacychick at 8:50 pm on Sunday, May 10, 2009

Put away the tissues.  This isnt’ going to bring anybody to tears, unless you laugh yourself into tears.  You all know my Mother has moved from Earth into Heaven…lucky stiff…pardon the pun. 

 If there is one thing my mother posessed  was a sense of humor, and she used it extensively.  When I was a kid and we would go shopping, she’d want to hold my hand.  When a kid is five years old, holding a mothers hand is pretty cool, but when you are, say…15, its not quite so cool.  She’d say “Hold my hand…” I’d say “MOOOM! come on, no way!”  Then the coercion would begin.  “I’ll cry” she’d threaten….and then she would stick out her lower lip and make this whiny sound until I relented and held her hand…. I never knew what was worse, hold my mother’s hand or having her pretend to cry like a kid!

When I went off to college she used her humor skills on other people.  When she and her sister got together nobody knew what would happen next.  I wish I had been present for this event because it was a classic.

Her sister (my aunt) had 2 daughters. They lived about 5 hours away, and the girls (my cousins) were pre-teens at this time.  I was in college already.  They had come to visit for a weekend of shopping. One of their trips was to be a furniture store.  The two sisters had this all planned.  My mother, her sister, the two girls and our neighbor all went to the furniture store.  My mother carried a big ..BIG purse.  As they wandered around the store,  they got to the dinette areas.  To the absolute horror of my two cousins,  My mom, aunt and neighbor sat down at one of the tables. Out of my mothers purse came  3 plates,  3 glasses, napkins,  some orange juice, and a bag of donuts.  They were going to have some breakfast….in the furniture store.  “MUUUTHURRR!” WHAT ARE YOU DOING!” they hissed.  “Having breakfast.” was the reply.

Several minutes later the store salesman came by with a rather  confused look on his face and asked ” Um, ladies, is there something I can HELP you with this morning?”  and without a beat my mother said. “Nope, we are table shopping and we wanted to try one out before we bought it”.  Poor salesman, he had no idea what to think.

It was all a practical joke, designed  to have fun at the expense of my two cousins, who no doubt, died a million deaths when their mom and aunt decided to have breakfast at the furniture store.

I wish I could have been there. I’d have brought the coffee.

BTW,  Mom, the next time I see you, I promise, you won’t have to “cry” to get me to hold your hand!

Oxymoron: affordable healthcare

Filed under: Uncategorized — pharmacychick at 10:04 pm on Friday, May 8, 2009

As you know, recently Mr Chick had some unexplained headaches.  For the first time in our married life, he became a real patient. In fact in all the years we have been together, neither of has has required anything but routine care such as dental exams, eye wear, and anual OB exams for me.  In other words, pretty simple.

We have a pretty typical group policy.  We pay $X for Dr visits,  and the basic 80/20 % rate for hospitalization at their preferred rate if we are in the network.  We always use network because its much more expensive or not covered at all if we don’t.  He has the same insurance as the other members of his employer group.  So whether you make $30K a year or $100K a year, the benefit package is the same. Put that into your memory bank, its important later in the story.

I wrote earlier about Mr Chick’s day at the hospital for his angiogram.  What I left out was the price, because at the time, we didn’t have it.  About 3 weeks ago, the EOB’s (explaination of benefits) started to arrive.  HOLY (insert expletive).  Dr MicroNeurosurgeon sent in a bill for $14,000 dollars.  They paid him about $1000 for the preferred rate. (I was glad to see the note that we weren’t responsible for the rest, but it seemed like a pretty small reimbursement) so when I called them about it, they said it wasnt’ billed correctly and was going to be resubmitted.  I still dont’ know what/if we owe anything from the Dr.

A few days later we got the EOB from the hospital….another $14,000 for the 5 hours he was in the  unit.  Silly, me, I thought this might be a duplicate billing. NO, it was not. Apparently the Dr billed $14,000 for his TIME (I am clearly in the wrong profession)  and the Hospital billed $14,000 for their part of it.  WHOA.  We are talking about $28,000 for 5 hours of service for an angiogram.  Not ICU, not CCU, Not even ER, or OR.  Now, I appreciate that an Angiogram is a tricky deal: you run a wire into the brain (from the groin) and shoot some dye into it and take pictures.  But, $28,000?  

Over $5000 an hour.  He checked in, was shaved, hooked up to vitals, sedated, had his test, then spent 2 hours (at $5k an hour) sleeping it off, ate a  banana, walked once around the unit, got dressed and said goodbye.

 I got the bill from the hospital.  My portion was just a tad over $2000. It is my 20%. I have to pay this, and I still do not have the bill from the surgeon figured out since they had some rebiling to do. I may have to pay more.

Remember earlier in the post when I described in bold about our benefits?  I have money in my savings account to pay this bill, in part because Mr Chick and I make a good living.  It still stinks to have to pay it but at least I have the ability TO pay it.  Imagine if you are on the lower end of the income scale.  You have a health issue and need an angiogram.  You have insurance.  They send you the same bill, $2000 for identical services rendered for your portion.  If you make only $30,000 a year, its not likely you have $2000 of disposable income to pay this bill. (sheesh, you may not have $200 of disposable income!)   What happens if you get really sick?  If this place can charge $28,000 for one procedure that took all of 5 hours from admit to discharge, can you imagine what a several day stay will run at 20%?

Houston, we have a problem.

My friend has Kaiser.  She recently had knee surgery. It was a day type surgery but still, it involved a hospital stay, a surgeon and some recovery, Just like Mr Chick.  She said “it cost me $50 copay.” 

I am not saying that Kaiser is the answer.  Her premiums are about the same as mine each month.  She has to stay in network (and so do I to receive best benefits).  I paid $2000+ for an day procedure.  She paid $50.

What’s going on? 

I think my title line says it all.  Just because you have insurance doesn’t mean you can afford health care. If you dont make much money, having insurance isn’t the catch all if you cannot afford to pay your portion for using the benefit.

Any thoughts on a single payer system?  I knew health costs have skyrocketed.  I can see it in my inventory that sits behind me every day  and in the copays I have to charge in the pharmacy.  But this is the first time its been mailed to my house. We racked up in one morning what some people have to live on for a whole year.

 It was mail I didn’t like to get.

De ja Voux

Filed under: Uncategorized — pharmacychick at 7:45 pm on Wednesday, May 6, 2009

May 6 1998 was a Wednesday.  It was the Wednesday before Mother’s day.

Today is May 6 2009.  It is a Wednesday.  It is the Wednesday before Mother’s day

My Mom died on May 6 1998, the Wednesday before Mother’s day.  Its been 11 long years.

Mom,  If the Lord lets you read Blogs,  know this:  I love you, and miss you as much today as I did the first evening I was without you.

Hang on a while.  I’ll eventually get there!

Perhaps the third time will be the charm…but I doubt it.

Filed under: Uncategorized — pharmacychick at 2:16 pm on Tuesday, May 5, 2009

This story unfolded on Saturday.  Jorge handed me a refill bottle for his Cozaar.  I filled it up and noted the copay of around $82.  A quick scan showed his last fill was in late Feb, at which time he paid $10.  I printed his last label and saw he had private insurance in Feb, and starting sometime after that, Medicare-D.  This particular rx and not been filled yet on his Medicare-D plan. (Noncompliant a bit?)  He was not going to like this development. Clearly, Cozaar was not formulary, and only discounted off retail.  (at least they did that for the guy)

He came back in later in the day to collect the Rx and was incredulous (ok, I can accept that) at the price.  I tried to explain that his Medicare-D plan didn’t have this drug on their formulary, and he was responsible for this amount.  No matter how many time I phrased and rephrased this answer, he just kept pushing his card in my face.  “I.HAVE.THIS.CARD, JORGE, THIS IS THE PRICE.”.  He decided he was going to call the insurance himself and he left. 

Sunday morning I come to work and find 2 messages left on the customer line, one from Jorge, and one from his insurance company. “Hi, I’m Julia from Mega-D Health Company…For Jorge Hernandez…..please call for information regarding his claim…”.  Wait just a minute.  He didn’t have a Mega-D Health company card.  He had something else…and it was a valid card. Since when can you have 2 active Medicare-D plans? 

I called up Julia and she gave me entirely different insurance information.  Now, mind you,  Jorge had private Insurance company #1 in Feb,  Med-D plan #1 in March/April, and apparently then added Med-D plan #2 in May.  I put in all the info Julia had provided, adjudicated the claim,  assigning a copay of $30 and sent my thanks and hung up. I left Jorge a message and waited.  End of story….not so fast.

He came in Monday afternoon, still incredulous that it was $30.  (now the patience was beginning to wane). I told him I left him a message earlier (that he claimed he didn’t get) with all this information laid out for him. “I pay $58 a month for this insurance! Everything should be covered” he whined. OH, MY. He thinks everything should be free for his $58 monthly premium.  I told him that “COVERED”  does not mean “FREE”.  Even under state welfare, Med D clients have a copay.  No dice, he wasn’t going to pay.  “I call them again!” he said.  (knock yourself out Jorge, I’ve done my part).

So here’s the thing:  Pharmacy Chick will go thru all kinds of effort and machinations to get a claim paid.  She will call insurance companies,  request PA authorizations,  and bill a claim every day for a month if needed until it pays.  BUT, once I get a paid claim, submitted properly, I am done. Whatever the copay is…stands. 

I am still confused as to why 2 different Med-d plans showed active eligibility. I am even more confused as to how he changed 2 months into the program.  It was my understanding you could have ONE plan at at time and could only switch once a year (or if you moved).

I have 2 days off.  Jorge is going to call his insurance company and unless they have had some gross eligibility-entry error, his copay of $30 will stand. Perhaps he will come in today or tomorrow and pick it up. He will either whine some more about the price and pay it or he will say nothing and pay it.  Maybe he’ll get his Dr to change it to something else. Either way, when I come back to work on Thursday, the first thing I am going to do is check the shelf and see if its gone, and if it is, I am going to check the transmit file and see if anything else was done with the claim.

If its still there, I guess I’ll get to deal with Jorge a third time.  He’s a nice man, don’t get me wrong. I like him a lot. He just doesn’t get it.

Lucky me.

Reason to love Mr Chick # 87,473

Filed under: Uncategorized — pharmacychick at 10:35 am on Tuesday, May 5, 2009

Coming home from work in a driving rainstorm and approaching the house, I knew there was a problem.   Water was pouring from the gutters.  Damn, they were plugged again.  I wasn’t alone in this issue because my neighbor across the street was on his ladder pulling muck from his as well at that very moment.  The thought crossed my mind to sweet talk Beloved Neighbor into repeating the exercise at my house but his expression and wet body caused me to think otherwise. 

Mr Chick was at work, and we have a tall house.  Our little household ladder (that I can maneuver) will not reach the 21 feet needed to get at the gutter, and the extension ladder is too much for me to handle. A quick look at the clock revealed that Mr Chick’s office was closed and he would be on the way home.  No chance to prepare him. He’d been working 10 hours.  I knew that all he wanted to do was get out of his suit, eat the dinner he KNEW I was cooking, and watch the Red Sox /Yankee game.  He did NOT want to pull out that heavy ladder, slog around the wet yard cleaning out the gutters.

I met him in the driveway with the best “You are so wonderful” expression I could muster.  “Um WHAT’s the matter PC”. He said.  I explained the problem. By now the storm had passed so we wouldn’t be IN the rain but daylight was in short supply.  We had to do it now.

What a great guy.  He didn’t complain, whine or groan.  He just changed into his sweats,  and we worked together and cleaned out the gutters.  In 20 minutes they were whooshed out. 

Then he ate his dinner and enjoyed watching the Sox beat the Yankees in their new fancy schmancy stadium.

Thanks Mr Chick, I luv you!

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