Buyers remorse?
Woman comes in for a script for her daughter. Its Lovenox. Doctor warns patient and parents that it will be expensive. She gives us a no-fault auto card. Ran it through, needs Prior Authorization, its over $700. “Yeah, the doctor warned us that you might have to call them if its too expensive.”
That was yesterday. Office was called, insurance was called. Woman comes in today, and no PA. I call, and the phonemonkey tells me that the other phonemonkey didn’t do anything, or even leave a note, but she’ll handle it. She calls me back, and I reprocess. Its non formulary, but the doctor’s PA apparently covered that too, so its covered if I reprocess again. Goes through, $0 co-pay.
I inform her that the insurance covered the complete cost of the medication, and that she saved $7000 dollars. (its printed on the tag)
She’s happy, leaves, then about 2 mins later comes back. That fast she couldn’t have gotten past the photo counter, let alone out the door. She points out the price and asks if thats correct. “Yes mam, I believe I pointed that out when you were rang out.”
“Oh, I just assumed you misspoke! The doctor told us it would be only $700.”
“No mam, this stuff is really expensive, but your insurance did cover it all.” Pfft. Doctors, what do they know?
So she leaves, in sticker shock.
15 mins later, she re-appears. “I want to return this. I talked with my husband and he says we have to return it. He think that the insurance company may limit our claim for damages on the car if this stuff is so expensive.”
Now I’m getting kinda miffed. This stuff is expensive. If she returns it, we can’t really dispense it to another patient if it left the store, so we’re out $7K. Second, her auto coverage should cover something like 25K in medical expenses. I inform her that claims for medical and damage are unrelated, and one should not effect the other, but she does not believe me.
We end up settling on her calling the insurance company in the morning, and discussing how this will effect her claim for damage to the auto, and we’ll hold onto the medication for now. We also tell her to discuss options with the patient’s doctor about getting her on a different medication. Since the pharmacist on tonight was temporary help, we’re going to leave the decision to refund the medication up to the supervisor who will be working tomorrow.
As she’s leaving she threatens that if the insurance is going to limit her claim for auto damage, she’ll refuse to pick it up and that we’ll have no choice but to refund it.
She thinks she left an ultimatum, but since its paid for, if she refuses to come back, we’ll just mail it to her.
Tags: Frustrations, People | |
Good girl, mail that puppy out.
you did your job, I wouldnt have even accepted it back in the first place.
Comment by pharmacychick | May 8, 2008
Why is it that everyone assumes a tech is a girl? I know its like 85-95% but there are male techs out here. Like male nurses.
But thanks. Yeah, our substitute pharmacist is a hospital one that moonlights, so she doesn’t have a big grasp on retail.
Hmm, the black-on-black don’t work so well in the comments field, looks like I’ll be looking for a new scheme…
Oh and I want to point out that the Rx was written for 80 injections not 8, which is why the medication was 10x the price the md thought it would be.
We did call the office and a nurse told us to give her whatever the dr wrote for. Didn’t want to bother double checking it.
Comment by lb969cpht | May 10, 2008