I have a patient. He has a G-tube. He can only take liquid nutrition. This patient is a child. He takes pediasure. This means I need Prior Auths for his insurance.
I get a PA number on his most recent script from Friday. Great. Called the PA line to activate it. This medication has been denied because it is not for a child.
What? The child was born inbetween the year 2000 and today. He’s a child.
Called the insurance. Spent close to 45 mins on hold being bounced around. Finally find it. Childs DOB was entered into the PA system as **/**/8002. This child is not due to be born for another another 6000 years. Wonderful.
Spend the next half hour finding out if they can fix it on their side or if we need the MD to get a new PA.
Nope, new PA needed. Great. Called the doctors, informed them that they needed to cancel the old PA and get a new one. Fine, the one nurse laughs, they giggle a bit about the dob, and promise they’ll fix it.
I called back today and got Ms. PriorAuth-Nurse. (Ever office has that one nurse that handles all the PA’s.
I was informed (after spending 15 mins on hold with the office) that she was buisy today giving shots, and that she gave up after spending 15 mins on the phone with the insurance. The insurance told her that they never logged us activating the PA. Well no duh, we can’t because you fubar’d it. (I kept that observation to myself)
I explained that we can’t activate it because we can’t enter the PA in for the correct patient.
She continues to whine about the time she has to spend on hold for insurances. Look, lady, I know. Hell, I just spend 15 mins on hold to talk to YOU.
Then she informs me that she had to spend a whole half hour on hold to get the last PA, why should she have to get a new one? Can’t we just change the DOB?
No, because there is no way this insurance computer system will accept a younger than a day old, let alone 6000 year into the future.
She gets real snotty now, Suggesting that we should just give the patient the stuff and she’ll fix it “later”. Thats nice, but I already have given them a whole case already. Now I need to be paid for the other 9 cases, plus the one I advanced them. I really need the problem to be fixed by friday so I can bill the rest of the stuff. I suggest she either get another nurse to cover her so she can get it done, or try to do it during the slack time in the morning or before closing.
At this point she becomes really nasty, one of those “don’t tell me how to do my job” rants, how I’m a lowly retail tech, why do I get to tell her to waste a half hour on the phone fixing what wasn’t her problem.
I then inform her that I had spent over and hour and fifteen minutes on hold with the same insurance that day. (trying to get her all the information she needed to fix the problem. Information that would allow her to fix the entire issue in under a half hour.) I hung up on her mid rant.
Now I’m really good friends with another nurse in that office. I called back to get the secretary again and request my nurse-friend. I proceed to give her all the information to get it done, under the condition that the other nurse has to at least make a good faith attempt at fixing the problem.
If it gets ignored and its not done Wednesday, I asked her to do it herself. If that’s the case I will ask my pharmacy manager to make a call to one of his golfing buddies. (the head MD at that office)
I hope the insurance puts snippy-nurse on hold for an hour
I know its kinda mean, but I’m not inconveniencing the patient, he’s set until Friday.
Tags: Nurses, Prior Auth | |
November 3rd, 2008
Posted by
lb969cpht |
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What is it about people needing scripts NOW?
Your doctor wrote this RX on the thirteenth. It is now the thirtyfirst. You have had that thing for two weeks. Your not thinking is not my emergency. Your MD screwed up, we can’t fill it.
Listen to this.
Duragesic 50mcg
Tk one patch every four days, alternating with Duragesic 75mcg. DAW, he takes a patch every other day.
Duragesic 75 mcg
tk one patch every four days, alternating with Duragesic 50mcg. daw, he takes a patch every other day.
Box is NOT marked DAW. doesn’t count if its typed into the directions. So sorry, your getting generic.
Now the thinking part. If you are changing patches q4d, how are you using one qod?
Just doesn’t work. q3d yes, q4d no.
Reminds me of a similar incident earlier this week. I get called monday. “Did Dr Whitecoat mail in my painkiller rx?” No.
Called Tuesday. Again, no. I’ll call you when I get it.
Calls wednesday. No I still haven’t gotten it. I will call you when I do.
Calls thursday. Again, no I don’t I will call you when I do.
Calls Friday. No, woman! I will call you the moment I open the envelope and see your name on it!
I get it saturday. I call her. She’ll be down whenever she gets around to it.
I look quick at the RX. It was written Thursday! ARRRGH!!!
Then I take a really good look.
Its IBUPROFEN 600mg!
AAAARRRRRRGHHHH!!!!!!
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October 31st, 2008
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lb969cpht |
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I adopted out my new kitty today to a nice family. Hopefully she behaves.
unfortunately my cats didn’t get along with her to well.
Oh well. She was a little mischievous.
Didn’t occur to me to take pictures. She was so cute. Probably 4 - 6 months old.
T minus 36 hours till I have cable internet!
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October 26th, 2008
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lb969cpht |
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Got home, big package for me. New toys for my PC. Logitech G15 Keyboard and MX518 mouse. I knew it was coming today, so I started out anticipating my new toys.
Today went smooth, we filled a butt-ton of Rxes, but no major problems, no fussy customers, not even a “Hi, I have this rash” coversation.
Then about the time I’m getting ready to go home after my shit ends, I get a call on my cell. Its a guy with Time Warner and they’ll be at my house next week on my day off to setup my new cable TV and internet!
Also, my new houseguest, a kitten, may just become a new member of the family! (I already have 2 cats.)
Now I just need to find a name for her. Pics to follow!
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October 22nd, 2008
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lb969cpht |
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Wow, I know I haven’t posted in a long time. Working long hours, in multiple stores.
Little update.
I didn’t get the job at corporate. Oh well, always next time around.
My new tech is excellent. She was a competitor convert, and knows her stuff. I’d love to fire my anti-tech and let my new girl take her shifts.
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October 18th, 2008
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lb969cpht |
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I applied for a job at corporate. Its in the local district office as a trainer for pharmacy techs. The district is brand new, splitting off from an established district. The guy heading it up is from another new district (my old one in fact)
I was just at the old district office Monday(yesterday) for a meeting (because the new district doesn’t have an office, and the meeting was with the person whose job I’m trying to get.
Today I get a call from the store manager. “Hey, just letting you know you have an interview tomorrow at 1pm at store-in-the-middle-of-nowhere. You can carpool with some other employees with meetings there too, because the interview is unpaid and you can’t apply for mileage. Call me back in an hour so I can see if someone wants to drive.”
Oh WONDERFUL. So not only did you give my less than 24 hours notice, I have to get coverage for MY shift at my store, get to this other store, then wait around for the other two people to finish their interviews?
Oh when I call back? “I called your trainee in to work your shift tomorrow. You’ll need to leave here by 11, so you should come in to work for your regular shift (9-5) and just leave when you need to. You can finish your shift when you get back.”
Oh joy.
Well I better go charge up my PSP tonight so I don’t go insane tomorrow waiting around for forever.
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August 19th, 2008
Posted by
lb969cpht |
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I had a office call me back on a PA. She gave me the number Medicaid gave her. I run it through the phone system. Ok. Ran the script. Came back DENIED.
If medicaid DENIES it, why the frick would you give it to me? You chose to write for Ortho-Tri-Cyclin DAW, you either get the PA or take off the DAW, not give me a DENIED number and let me have to tell the patient that I can’t magically make it work.
Oh and do all this at 2 mins to 5 so you are closed when I try to call you back…
Medicaid does not cover Brand name without a PA. EVER. (few notable exceptions). You know it, and I know it. I noticed right away that it was DAW and informed the patient about the PA.
Your office didn’t. Why? Cause you don’t want to tell them bad news? You’ll tell them they have cancer, but you won’t tell them that it might be a week before your office staff bothers to retrieve my fax and actually do something? (after sending me a “+6 refill OK’d” or three.)
I’m the one who has to cover for you, take your flak for you writing stuff thats not covered.
If your Patient wants DAW, and you write it, why not just get the PA BEFORE that script leaves the office?
Tags: Doctors, Frustrations, Insurance | |
July 23rd, 2008
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lb969cpht |
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Actually not work related at all. I have mentioned a few time previously that I am very technology oriented.
Tomorrow, the parts will be delivered for my new computer. I will be custom building this from scratch, and have very high standards for my work.
I’ll have to post some pictures of assembly and the finished project for you all. (I think I have readers…)
Now for the work related.
Woman comes in. Says she wants to transfer from the grocery store pharmacy down the street.
I say sure, we can do that, let me get you in the computer.
So I ask all the necessary questions, and it seems this woman is getting very agitated.
Rx is for Valtrex. Theres been a recent outbreak, its near the end of the week (order wise, I place my order tomorrow)
“What? How can you be out of this? Its a very common medication!”
“Ma’am, I’m not out, I just don’t have enough.”
“What do you mean you don’t have enough? You have to have enough!
“Well, I have one bottle left. But your doctor wrote for taking two a day.”
“Gimmie the bottle then. You can order more for the next person.”
“Well, the medication only comes in bottles of thirty. So you would only be getting 15 days worth.
“Well, what are you going to do about it?”
“I’ll give you ten tablets to hold you over, I’ll have more in tomorrow.”
“I’ll have you know that I used to work in my fathers pharmacy as a tech!”
At this point she’s making quite a fuss around the counter and the pharmacist walks up.
“Well then you must know you can’t make everybody happy then” he says, “I’m not going to give you all that we have on hand, so the next guy is out of luck. It doesn’t work like that.”
“I’d be happy to call around and see who else has the medication for you, in this quantity.” I said, knowing full well the reason she was coming here, was because the other pharmacy was out.
“Never mind, just give me the 10 pills.”
“Certainly. We’ll have the ready in fifteen to twenty minutes.”
“WHAT?!? I’m not waiting that long for 10 freaking pills! Why is it going to take that long? Thers nobody here!”
(Not true, I have 10 other customers in various stages, all milling about the store not hovering over the counter”
“Well, ma’am, you are a new customer with us, and until I get the prescription billed through, I don’t know if I need to call your insurance, and that can take extra time. We’ll try to have it as ready as possible.”
She’s just as rude at the register. I have the joy of ringing her out. (The other tech is on lunch).
“Thats going to be $15.00 today.”
“But thats what I normally pay for 60!”
“When the computer system runs a partial fill, the insurance returns a copay. Some make you pay all up front, other companies only what you get, still others do it 50/50.”
“I better not have a charge when I pick up the rest tomorrow.”
She storms off, taking the 10 tabs.
I guarantee I’ll see her tomorrow before my delivery comes. Even told her that we don’t usually get a delivery before noon.
Now had she been nice, I would have suggested calling her md and oking
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July 9th, 2008
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lb969cpht |
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Yeah so I disappeared for a bit. No I wasn’t on vacation. I had to do double duty at work. I had.. *shudders* .. Trainees.
Yep, the company just opened a new location, and I got the pleasure of having to train some.
Couple cashiers and a tech. Two other techs were trained at another location.
Today I was informed that my tech was working overtime. (for my company this is horror unleashed).
Apparently the one tech was “sick” the first day, and the other was “sick” on the second day.
Glad we set a good example.
Not the fist time I’ve had trainees either. about 4 months after we opened, I had trainees for another store. Two techs.
I got a shocker. One of my trainees is now a trainee again. She got promoted to management.
So now I gotta take orders from someone I trained…
Ah well. My vacation will come soon enough. I’m going to a Boston and Styx concert the beginning of August.
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July 8th, 2008
Posted by
lb969cpht |
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Old guy pulls up to the drive-thru. Wants a Rx filled and a box of Claritin-D. The RX I can do, but the Claritin-D you have to come in for. Company policy, and also a very practical reason. The Drive-Thru POS terminal lacks a keyboard and a signature pad.
I know he’s trouble, from the way he came flying in, and the way he flings the script into the drawer.
“I’ll be happy to get you entered into our system, but I’m afraid you’ll have to come inside for the Claritin-D.”
“But I’m handicapped!!!” he exclaims as he shows me his parking tag.
“Unfortunately, according to the Combat Methamphetamine act, we need you to sign for your purchase, and I have to enter the details on your drivers license. While I can pass you the signature pad, I can’t enter the data required because I don’t have a keyboard. ”
“Well do it at one that has one!”
” While I can do that, that would mean you would need to come inside, because I have to have you sign it.”
‘Gimme the dang script back, You’ll be hearing form my lawyer, this is discrimination against handicapped people!”
I never even had time to look at the Rx to learn his name….
.
.
.
.
.
The next thing is a new policy from Corporate. Apparently we have to restrict sales of Iodine Tincture to 2 bottles a day, and 15 a week.
Because apparently its now being used in Meth production. If you want more details see This publication.
Great. There’s only 2 ways I can see this being enforced. One you have to have a soft block on it, and require a signature for it like Psuedoephedrine, the other is keeping it behind the pharmacy counter. Both are more work for us.
Also, check out the warning signs if your customer is a druggie…
* Customer does not have a legitimate reason to purchase iodine or cannot justify the quantity requested.
* Customer purchases iodine crystals for animal use but has little knowledge of horses, cattle, or other livestock.
* Customer resists providing personal information.
* Customer repeatedly purchases the maximum amount permitted by law at the shortest interval permitted.
* Customer simultaneously purchases iodine and other products that are used to produce methamphetamine such as acetone, alcohol, camp stove fuel, ether, drain cleaner, muriatic acid, rock salt, road flares, unusual quantities of matches, or the cutting agent MSM.
* Customer purchases over 4 fluid ounces of iodine tincture and purchases hydrogen peroxide at the same time.
Camp Stove fuel? Matches? Flares? Rock salt?
What if I’m going camping in the wilderness, and its going to be icy, and I need iodine to purify water?
Tags: Frustrations, People | |
May 23rd, 2008
Posted by
lb969cpht |
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