Oh it's not going well. LOL

[PrincessNancy96]

I don't blame the pharmacist on this one.... they are innocent.. right now I blame the billing department at the pharmacy we are required to use.. why because when I spoke to the doctors office she has the confirmation number and time she received and sent all the approval info... I'm contacting the pharmacy again tomorrow decided to cool off and that way nothing was said out of anger... afterall DH has enough meds for now... but I won't be nice if it starts getting close...

 

[StitchIsOurHero]

Sending pixie dust to you, Buffy!!

Nancy--tell DD congratulations for playing on A team tonight!! And good luck with the pharmacist--our pharmacist frustrates me!!

Shauna & Faerie--hang in there! Faerie, feel better soon!!

to everyone!!

 

[vanyel]

Hang in there guys! Don't get me started on our healthcare system, including the insurance industry. Hope everyone gets better quickly and PN96, you get that pharmacy straightened out!

Bamb - congrats to your DH on the new job.

 

[New England Eeyore]

Good luck to you and DH, Buffy!

Getting up on my soapbox:
Be nice to your pharmacists, ladies. I can't tell you how many times a day I get yelled at for things that are completely out of my control. Doctors, nurses and secretaries at doctor's offices claim they've done something when they have not; insurance companies set up rules and restrictions that we have no control over - pharmacists are caught in the middle. Most people have NO idea what we do all day, how much we go out of our way to help our customers even when our hands are often ultimately tied by insurance companies, often to NO appreciation by the customer.

Nancy - I think you use a specialty pharmacy which might be different, but it sounds like you need to be calling the insurance company to make sure they have entered the authorization correctly in their computer system. Pharmacy billing is computerized - if the pharmacy is billing it and getting a rejection saying it hasn't been authorized, it's probably an error on the insurance company's part.

 

[TPCShauna]

I so hear you on being nice to the Pharmacist. In my case, it's the Pharmacy Tech. that I am nice to because he truly DOES bend over backward to help me. Part of my insurance frustration at the time though is occurring specifically because of the pharmacy. They received a denial from my insurance to fill a prescription LAST TUESDAY and never told me so that I could run interference. I didn't find out until Friday afternoon when DH arrived at the pharmacy to pick up the prescription.

I know that the pharmacy is stuck between the doctors and insurance and I try to take that into consideration but I need them to work with me a bit as well.

 

[StitchIsOurHero]

Good luck to you and DH, Buffy!

Getting up on my soapbox:
Be nice to your pharmacists, ladies. I can't tell you how many times a day I get yelled at for things that are completely out of my control. Doctors, nurses and secretaries at doctor's offices claim they've done something when they have not; insurance companies set up rules and restrictions that we have no control over - pharmacists are caught in the middle. Most people have NO idea what we do all day, how much we go out of our way to help our customers even when our hands are often ultimately tied by insurance companies, often to NO appreciation by the customer.

You're right about the pharmacist, NEE! I think my frustration at my pharmacy stems more from the front person (who's not a pharmacist). She just kind of blows people off. I know what you mean about being caught in the middle, though! Our actual pharmacist is really nice.

 

[ddavis860]

Good luck to you and DH, Buffy!

Getting up on my soapbox:
Be nice to your pharmacists, ladies. I can't tell you how many times a day I get yelled at for things that are completely out of my control. Doctors, nurses and secretaries at doctor's offices claim they've done something when they have not; insurance companies set up rules and restrictions that we have no control over - pharmacists are caught in the middle. Most people have NO idea what we do all day, how much we go out of our way to help our customers even when our hands are often ultimately tied by insurance companies, often to NO appreciation by the customer.

True, so very true. And it does stink to be time one in the middle. However, I also feel that sometimes there is a total lack of the human. I'm not saying all the time, but in the midst of all those computer entries, and denials, there is a totally frustrated patient that is ill, or in pain, and just so stinkin tired of the red tape...

(Getting on my soapbox)I don't have the answer, just a comment. I have had my DR office on more than one occasion call in to refill a script for me. Every time I tell the script # and what it says on the directions, and have her repeat it back to me. Many times I get the wrong # of pills...the pharmacy says the Dr office called it in like that, the Dr office says they did it right...Once the Dr himself called me and blamed me for using an old script # (which was not true!!!). Bottom line is only 1 time did a pharmicist call the Dr office for me to straighten it out. All the other times it's been on me. Honestly, I wanted to kiss him! He got to the bottom of it, communicated with me, and I could tell he cared. The other times, I was frustrated, and in tears... (getting down)

So, as a consumer, it's really hard to know where the breakdown is...and sometimes I feel I am the one in the middle... If someone would tell me where the breakdown was, I would be more than happy to go to the source of it...

 

[PrincessNancy96]

Good luck to you and DH, Buffy!

Getting up on my soapbox:
Be nice to your pharmacists, ladies. I can't tell you how many times a day I get yelled at for things that are completely out of my control. Doctors, nurses and secretaries at doctor's offices claim they've done something when they have not; insurance companies set up rules and restrictions that we have no control over - pharmacists are caught in the middle. Most people have NO idea what we do all day, how much we go out of our way to help our customers even when our hands are often ultimately tied by insurance companies, often to NO appreciation by the customer.

Nancy - I think you use a specialty pharmacy which might be different, but it sounds like you need to be calling the insurance company to make sure they have entered the authorization correctly in their computer system. Pharmacy billing is computerized - if the pharmacy is billing it and getting a rejection saying it hasn't been authorized, it's probably an error on the insurance company's part.

They are on my list to deal with today NEE!!!! It's just frustrating because we are utilizing the same company as last year, the same insurance...so I don't understand what the hold up is since nothing changed but the OOP expense.... Now, NEE if you want to come by my pharmacist you can.. I won't yell at you!

 

[MyLittlePiglet]

I love my pharmacist. When she made the bag I put up look like a toddlers drawing so that I would talk to someone and the person checking me out would too... the reason.... right after (okay not immediately but soon thereafter) DD3 was born I had to be put on meds that could have made by birth control ineffective.... that you for that warning !!!!!!! LOL I didn't want 2 a year apart so.

That being said.... I am fighting with hospital collection agencies over DDs birth because insurance was filed incorrectly and hospital sent it to collections right away... I am reporting them becuase I also gots bills that they didn't even send to insurance at all.... it is a racket at this particular hospital.....

 

[piratesmate]

Good for him Buffy! I hope he likes his new position. Working where you aren't happy is really draining. You both need a break!

 

[mommy2mrb]

congrats on DH new job Buffy!

and to the rest of you, keep plugging away at them it will get cleared up eventually.