And Hilarity Ensues!!

One of the absolutely funniest things, ever, happened to us today --

Patient comes in. I don't know how old he was, but obviously old enough to go to a geriatric center to see a doctor. Let's just call him JB Dumbass, for lack of a better name.

Mr. Dumbass comes to drop-off. I was up to my ass in rejection, so Part Time RPh takes the prescription, after he told me he would not talk to me anyway.

Seems that good ol' Dumbass left his hard copy at his house, but he wanted us to call the geriatrician to get them to phone in the prescription, since he didn't feel like going home for it. He lived 5 minutes away, maximum, in traffic.

RPh calls, and gets transferred to a voice mail. He INSISTS she calls back! She does, gets a person, and they tell her they'll try to get a nurse, but if one doesn't pick up, she has to leave a message. Two minutes pass, and she's dropped into voicemail. She leaves the message. She then offers him a few pills to get through. "Well, I haven't taken any in a week! I need a few!" This is for his amlodipine.

We give him a few, and he goes to our drinking fountain by our restrooms. He comes back. He then proceeds to take a seat in our waiting area for the next THREE HOURS before finally conceding defeat in that they won't be calling back anytime soon. I'm not exaggerating when I say 3 hours. Seriously. It was the most ridiculous thing ever.

We had another crappy day, but thoughts of TPA and how hilarious a blog this could make helped us pull through.

Also, I'd like to thank Mr. and Mrs. Shithead, for taking a big dump on our company, once each, for dragging competitor coupons for gift cards to us. Five dollars total on each RX, $30 coupons for each. A $25 profit for each. Sick. I hate coupons. I'd like to see them try again, because I do mark in patient's profiles when they are allowed their next coupons, because if they're gonna use them, I'm gonna do what my supervisors said, and force upon them the limitations the originating pharmacy making the coupon forces. It's nice that most of them say ONE COUPON PER 6 MONTHS. It really makes my job a bit easier, and I take pride in forcing these people to try again somewhere else. I'm sick of my company being shat on be cause they want their free gifts for coming. I can't wait until TPA gets this practice outlawed. I'll do anything to help!

Also, lastly, I may or may not end up buying a domain name of my very own for this blog, now that I've got a renewed interest in posting. We'll see.

Edit: I forgot the moral of the story -- when the office called back, at 4:30, we explained that he had the prescription at home, and they were flabbergasted when we told them he'd sat there for 3 hours. They told us they would not encourage bad behavior on his part, and that he had to bring the script in. Vindication was never quite so sweet as this.

If last week wasn't a full moon week, then we're fucked

Honestly. Remember that post I made Thursday morning? The one right below this one? Yeahhhh. The rest of the week went just as bad, in fact, Thursday had me on the verge of tears most of the day. I'm going to forget everything and just let go, because if I don't, I may quit that job I need, even as underpaid as I am.

On that note, too, I want to add that I'll be mailing my dues check for The Pharmacy Alliance shortly. TPA has me truly stoked for my profession. If we all take a stand, we may be able to make our profession what it's supposed to be -- a PROFESSIONAL business -- and take it back from the brink of us being the glorified cashiers we are currently becoming. If I could afford it, you KNOW I'd be in Galveston at those meetings, putting my 10 cents into 'the bowl'. I'm going to spread the word -- my hope is that others do so, and continue to do so, if they already are. I haven't been this excited for something like this in a very, very long time.

We were so screwed yesterday

You know how every time you have your day planned, and it seems to go your way, then it blows up RIGHT before you have to leave? Yeah. That happens a lot to me.

Yesterday morning, my longtime part-time pharmacist's new buddy who came in and bugged the piss out of her about prenatals came in AGAIN, and made us show her every damn bottle so she could pick a brand she wanted to take. She says she's allergic to fish oil, and miscellaneous other things, so she was going over every single ingredient, and tying both me and New RPh up all damn morning. After that, I got a new customer via phone whose insurance card had not arrived, so he wanted to call in his insurance along with the rest of his info, but he did not have his BIN, and just said 23*. Tried the typical condor code, and no go. Tried the other regular processor, and no go. Told him I'd have to call the other processor, since he said he was pretty sure it was under that one.

He told me I had to call him when I got it through to tell him the copay. Uhhh, generic Ambien is always covered; never seen it NOT covered by any 23* plans, so I'm sure it will be, but NO! You must call me! So, I waited on hold for 10 minutes for the lady to tell me, like my previous rant, that since I did not know his social or his 10 other addresses, I could not get his correct info. I was resigned to call him for his social security number. When I got another rep, they tried to get me to verify his addresses anyway. I was starting to get angry, so I read off the social, and finally got all his information. $10 copay. Call the guy back (btw - he was born in the 40's, I believe, so the New RPh and my intern that came in a little while later teased me and told me I was being Mommy for him, and I said not only did I not want that old of a child, but he should be able to do this himself at his age and provide me with the correct insurance information! But they do lie, and that is a whole other can of worms). He told me he'd like it ready by 4, but he didn't plan to come in until later that evening, or possibly the next day. Uhhhhh, okay?? We got it ready, whatever.

After THAT, a Suboxone representative, with some asenine title, came in and handed me all this information, after I told her I don't carry it. Then, she handed me a package of pamphlets, and here's what made me so mad at her -- she tells me to just 'slip these in someone's bag if you think they need help with their problems'. Yeah, oh-fucking-kay. I'm gonna piss off one of my customers, because you want me to sell more of your drug that I DON'T CARRY! The doctors that are allowed to prescribe it DON'T send their patients to my store! Seriously, what the fuck does this woman want me to do, just say, "Well, Mr. Doe, you buy an awful lot of hydrocodone and oxycodone, and it tends to get stolen quite often; I think you should go find a doctor that can prescribe you this wonderful drug, and maybe get a little help." Seriously. The people who come to my store that have issues KNOW they have issues, but they refuse to get help for it. I'm not going to piss them off, because they do pay good cash for their legit rx's, even if I question the doctors' sanities for writing for so many damned controls. Not to mention, something like that has to be approved and distributed by CorpoPharmacy. I restrained myself, after giving her the dirtiest look, from throwing her out of my pharmacy for even suggesting something so asenine. New RPh, Floater RPh, Injured RPh, and My Oldest & Favorite Intern all agreed that this was an absolutely ridiculous request on her behalf, and applauded me throwing those damn packets right into the trash, where they belonged.

It also just made me laugh, because I spent the last 20 minutes of my shift on hold for a Welfare prescription, where the 5 day old child hadn't been added on for an OTC product, SURPRISE, SURPRISE. Then, I got stuck, because someone whose call I took that morning came in to get 5 prescriptions and wanted me to do them for her.

I was supposed to leave a little early yesterday, because I had somewhere to be. Instead, I left 20 minutes late, and cancelled my plans.

* - after reading Pharmacy Mike's site, I decided since I was complaning about The Other Processor's reps, I might as well just blank out the plans that guy had, and such, so the 23 is actually a veiled way of saying **** *****/**** ******* (a popular insurance plan, that you may now be able to figure out). Not saying anything mean about "23"; because I like 23, and had them as a child, and now have them again as a CorpoPharmacy employee. I just wish their prescriptions help desk (who is luckily not my help desk for my prescriptions) would get their shit together, and not make life difficult for me on an already shitty day.

A Few Things Today

1) Yesterday was my first day back at work since being hit with the dreaded influenza. It's going around our chain's local area right now, apparently. One of the first things I had to deal with was a woman who was so impatient, she told the pharmacist on duty (who got the drive-thru for me yesterday out of pity, since I was barely able to stand up, a week after my flu) everything she needed was written SOMEWHERE on the blank from the local emergency clinic. We got her name, address, date of birth, allergies, insurance ... no phone number.

Pharmacist on duty enters the insurance info. No go. It says there's a problem with the cardholder id. I take over. It's entered correctly, but in pharmacy, you usually need to drop the 3 alphabet characters at the beginning of the ID. I drop 'em, and still, no go. I do everything I can think of before I call Anthem for help. What happens when I finally get through, after a possibly 10 minute hold? My new Mexican friend at Anthem tells me he won't give me the date of birth (which is apparently the problem -- NOT the ID, as their rejection told me it was) for my patient, because she's recently moved, and I don't have her old addresses, nor her phone number. She had a very unique last name, and I'm sure she was the only one, since he told me she was, but since I couldn't give him anything else, he told me it was a violation of HIPAA to tell me any information without verifying where she lived or her number. I told him she'd recently moved here (true story), yet he wasn't having any of it. I'm not racist, in any way, but you have to think -- with outsourcing and everything, do these people REALLY know the US laws? I mean, we have to follow them to the letter every single day. When they leave their job, they don't have to think about it at all, nor is it relevant. My point was that I'm a healthcare provider, and it's not a violation of HIPAA to tell me her information. When the patient's mom came in later, I asked for any old addresses, and got a handful, and got a recent phone number, too. I call Anthem back, sit on hold for an agent, pass the mom's insurance problem (different carrier and everything) to the pharmacist on duty as I'm working on the daughter's, and when I get a lady (still slightly foreign), and give her all the precious information, she said if I'd've called right back, she was sure anyone else would've cooperated with me, without needing all that extra information. My patient's care got delayed, and I was really irritated that I'd spent a good 20 or so minutes on hold between the two calls. If I would have been feeling better, I would have asked for the first guy's supervisor and had it taken care of on that specific call, but I was feeling like crap and just didn't feel up to fighting.

2) A patient got mad at us today, because she called a prescription in for us to phone her doctor on Friday. We sent an electronic request, as that's the doctor's preferred method of receiving refill requests, and we sent another one yesterday. The lady neglected to tell us she also had a new prescription on file. She comes in and tears me a new one, and I just filled her new prescription from on file. She had the worst attitude I've seen in a long time, and she said we should've called to tell her the doctor wasn't responding quickly enough for her liking. They were out of the office by the time she'd sent the request in Friday, and that doctor doesn't work weekends. Is it my fault we waited an appropriate time for a non-essential medication to be sent back to us? No. It was not fun.

3) A regular came in today. He's not been around too much since his wife sadly passed away, but he's still a regular. He hands me 3 prescriptions, and tells me he wants them submitted for 5 month supplies. First problem -- 2 of them, cholesterol and blood pressure meds, are written for just 3 months at a time, and the 3rd, a sleep aid, was just one month at a time (with 11 refills for a C4 ... when will they learn?!). I explain these restrictions if I'm billing his insurance, then I see in his file he has Caremark. Anyone who's dealt with insurance knows Caremark's stringent 30 days only rule. I run them, and of course, it comes up 30 days only. I tell the man, and he freaks out, and tells me he always gets 90, then realizes he's been doing mail order, then changes his mind and insists to me that they'll pay for 90 at retail. I explain the situation, and he gets mad and takes all 3 prescriptions back, even the sleep aid. I explained that his sleep aid needs to be re-written for #90 with 1 refill if he wants to be able to use it through mail, but he brushed me off since I guess my answer of Caremark only allowing 30 days at retail was not good enough for him.

FYI to Patients

As a somewhat veteran of the pharmaceutical distribution industry, at the retail level, I feel it's necessary to remind all patients of the following few things:

1) Do not stick your credit card in your mouth while digging through your purse, then hand it to us. That's disgusting, and can make us sick.

2) If you're sick, and getting an antibiotic or something, please attempt to not cough all over the pharmacy, the registers, or us.

3) Most important!! - When you're sick, and you are hesitant to hand over your prescription that you've coughed over, you should hesitate a little more in shoving the money we've watched you cough all over at us. Not only is that also disgusting, but it can make your resident technicians get ill with the flu, and not be allowed to work for a week.

Thank you for your time. Your regularly (or not) scheduled updates from the CPhT Extraordinare will resume whenever this tech is allowed back to work.

It Never Ends

Sometimes, I just can't imagine the days I have at work.

Two days ago, a regular, let's call her Amy Irrirating, drops off a prescription for her kid. Now, she literally takes 100 mg of Paxil a day, in tandem with a few other similar drugs at equally high doses, and it's a wonder she can even have any type of feelings at this point. So, she came through my drive-thru, chatting a mile a minute on her cell phone, and just thrust her kid's prescription at me through the window. I know the patient's in my computer, so I didn't bother to get any other info, and since she was practically yelling (people over 40 never seem to realize you don't have to yell to be heard on a cell phone, no offense to anyone over 40 who is sane and realizes this), I wanted her out, so I asked when she was going to pick it up. She ignores me. I ask again, and she puts on a pained expression, holds her phone up by her shoulder, and flashes me a "2-0" with her fingers. How rude! She drove off before I could say anything else. When I glance down at the rx -- cefdinir. 1 & 1/2 tsp qd x 10 days. NO STRENGTH. Argh. I give her a call -- no answer. Leave a message. She comes back in about a half hour. It's been lunch at the doctors' since she dropped off, so we couldn't get ahold of them. She gives my co-tech a terrible time at the window. Is it our fault you stopped us from correctly serving you by ignoring us? Finally, we got it taken care of, and she ambles down about 2 hours later. My pharmacist in charge told me we no longer have to wait on people if they're going to do that -- we'll just tell them we'll be happy to help them once they've ended their call -- and her two bosses already told us before that that's more than appropriate.

Yesterday, I answer a call from a local SuperChain. It's like a Walmart-type of store, but on a slightly smaller scale. The pharmacist tells me he wants to transfer me a prescription in, so I pass it to my pharmacist. Turns out, the patient lived near us, but had never been to us. Okay, we get all the info we need off them, including insurance, and we process the Factive-5 prescription. For starters, who writes for Factive?! It's never covered for less than $40. That price is exactly this patient's total. As I ruminated over the debate to order vs. not to order (since I basically do inventory at work, too), it hit me -- that irritating rep who stops in every 2 or so months that didn't leave us alone until I got the box in and showed him we'd given in and ordered his stupid drug, yeah, he gave me a few coupons. With just a moment or two in our coupon drawer, I found what I was looking for -- a Factive coupon for $50 off, still in date until April. I reprocessed his claim, and BAM! No copay. $0. SuperCPhT* saves him 40 bucks.

The guy comes in about an hour later. The other tech waited on him. He was very weirded out that we had his Cigna information on file. She politely explains that the SuperStore pharmacist wanted us to have it ready, since he didn't think it would take very long for this patient to come in. Then, she explains that the $0 copay was due to me finding a coupon and saving him $40, and instead of him being grateful, he started freaking out. "I've NEVER had a copay for $40. Something MUST be wrong!" We told him, "It doesn't matter. Nobody prescribes this drug for that reason, but we saved you $40, and you get it for FREE!" "Oh. Cool," he replies. No thank you's, no sorry's for his outburst. Nothing. I'm a nice person who, contrary to complaints to my supervisors over following the law and not giving out new/transferred rx giftcards to seniors on Medicare that I'm "scamming them", isn't out to screw the patient. I try to go above and beyond -- not because the CorpoPharmacy suits want me to do it, but because I'd want somebody to do that for me. These kind of things kind of make me scratch my head, and wonder why I try sometimes. It prompted me to clean out my coupons, at least. We only have a singular Factive coupon, and some Akurza Lotion/Cream coupons that we'll never use, left over. Hopefully, next time I decide to be nice and use these things, the patients will be a little more appreciative. I mean, hey -- I could've easily charged the guy $40.

I Live!

An update! Finally! I've been busy absorbing my greatness at gaining the CPhT title, as well as taking a well-deserved vacation. In the past 2 weeks, I've worked a total of 5 out of 14 days. Not shabby!

The beginning of the year has gone fairly smooth. I've not had too many expired insurance policies popping up. I also haven't seen too many insurance lines going down yet. My single complaint is that it appears that approximately a quarter of my patients who have coverage through plans served by Medco have varied from the 1000000000001-style ID numbers, and now have ID numbers starting with 600, and some weird group number that ends in PDP, and they aren't even Medicare plans. None of these Medco plans with these weird ID numbers and group numbers have sent out their new cards, it appears, because everyone we dealt with in the past 2 days said they'd received such cards. All I have to say, though, is that the Medco hotline has a great automated system to deal with this.

Honestly, as I've been out of the game for so long, I really don't have much to say. I'm sure the next few weeks will garner many more amusing anecdotes to post, but for now, I guess I'm done.

I've Been Busy, But...

I just wanted to take a second to announce that I'm now a nationally certified technician! Take that, Pharmacy Chain! Now you have to give me a raise! Mwuah ha ha....