Wednesday, April 9, 2008

Why you have to wait so long at the Pharmacy

WARNING: Reading this may upset you. The author cannot be held responsible for your reaction to this post. If you are on medication it is strongly advised that you take your medication before reading this post.

Every day the wait times at the pharmacy can vary from as little as 20 minutes to over 2 hours. "Why," you ask? Well there are a myriad of reasons for your long wait. I shall list just a few of them:

  1. The Doctor wrote the prescription incorrectly:
    1. For a strength that doesn't exist
    2. For a medication that doesn't exist or is no longer produced
    3. The doctor didn't sign the script for a medication that the law requires a doctor's signature (and no the nurse cannot sign for the doctor, don't even ask.)
  2. Your insurance coverage has changed and you haven't given us your new card. While your medication is ready, we now have to go back and input your new insurance card and resubmit the claim to the correct insurance. (Don't read this and say you have never done this, because we all have.)
  3. You have just turned 65 and have more insurance cards than Donald Trump has real estate, and you don't know which ones are current. But want me to try all of them and find out which will give you the best price on all 12 of your prescriptions. Never mind, that while I am preoccupied with finding this information out that 6 other people have dropped off new prescriptions that need to be filled today and 14 others have called in refills for 30 different medications. And 7 of those refills need to be filled before I go home this evening, because they took their last dose today and they NEED their medication by 3:00 pm because that is the only time that they can get a ride to the pharmacy. Did I forget to mention that it is now 2:30 pm and that I have 150 prescriptions that arrived before you?
  4. Let's not forget that by LAW employees need to take breaks and go to lunch. Just like you, the people working in the pharmacy need to eat too. By about 1:00 pm I get hungry and you don't want to deal with me if I haven't eaten all day, trust me. Instead of having the Pharmacist and 4 techs, there is now the Pharmacist and 2 techs, so it will take a bit longer to get you prescriptions filled. Don't take your prescription in at noon and expect to have it filled in 10 minutes, it ain't gonna happen!
  5. Your insurance now requires a prior approval on your breathing medication that they covered last year. This means that I need to call the doctor's office and have them call the insurance company. The insurance company wants your doctor's office to justify why you are on this medication. Your insurance needs proof that you have already tried the less expensive brand of breathing medication that they do cover and that it hasn't worked. Because you are not the only patient that your doctor's office has to deal with today, your doctor's office might not be able to call on this until the next day. Please understand that under the best of circumstances that this process takes at least 24 hours. But in most cases it takes longer. So please don't yell at the nice people in the pharmacy, we are only trying to help you. If you want someone to yell at call your insurance company.
  6. You walk up to the counter and tell me that you need all of your medications refilled. I ask you for your birth date and look you up in the computer. I find 5 people with the same birth date. I ask your name. You look at me like I have 5 heads and in a huff give me your name. (We won't mention that I see nearly over a hundred different people each day and I don't remember everyone's name). I pull up your file and see that there are 5 different medications that you are taking. I ask which ones that you need refilled and your response is all of them. I order "all of them". You return in 15 minutes expecting them to be ready, even though I told you that it would take at least 45 minutes to get them filled. You are just hoping that a miracle happened while you were browsing the latest CD from Barry Manilow, Iron Maiden, Michael Jackson, or Madonna, take your pick. Meanwhile, your insurance company won't let us fill 3 of them because you just got them filled last week. You yell at the tech at the pick-up station for 15 minutes while she is trying to explain all of this to you. After your tirade you look in your bag and realize that you did indeed get your refills last week and also that you have a list of the medications that you needed filled today. You sheepishly admit this, but never apologize for yelling at her. And then when you look at your 2 filled prescriptions, you are shocked that your blood pressure medication now has a co-pay of $65. You yell some more at the tech, who then explains that you must have a deductible, a spend-down, or that you are in the doughnut hole. You continue to scream at the tech, who is only doing her job. Insisting that you don't like doughnut holes and that you have never eaten doughnut holes. (If you don't get this one ask your pharmacist, when he/she is off duty). The tech looks everything up on the system and yes, last month you only had a $4.00 co-pay, but this $65.00 co-pay is the price that the insurance told us to charge you. You are just sure that that medication is on the $4.00 generic list. Your medication is in fact a brand name medication, which has no generic. But you insist that we only charge you $4.00. The tech explains that we can't do that and hands you a list of $4.00 generic drugs. She also explains that you can take the list into your doctor on your next visit and see if there is another medication on that list that the doctor could prescribe for you to help save you some money. You yell that you are moving all of your prescription across town to my competitor because they only charge you $4.00. Good Luck!

And now I offer up this little entertaining gem of a story that was sent to me as an e-mail. I don't know who wrote this, but kudos to you because we have this happen just about everyday.

Why your pharmacist hates you.....

I offer the following prescription scenario:
You come to the counter. I am on the phone with a drunk dude who wants the phone number to the grocery store next door. After I instruct him on the virtues of 411, you tell me your doctor was to phone in your prescription to me Your doctor hasn't, and you're unwilling to wait until he does. Being in a generous mood, I call your doctor's office and am put on hold for 5 minutes, then informed that your prescription was phoned in to my competitor on the other side of town. Phoning the competitor, I am immediately put on hold for 5 minutes before speaking to a clerk, who puts me back on hold to wait for the pharmacist.

Your prescription is then transferred to me, and now I have to get the 2 phone calls that have been put on hold while this was being done.

Now I return to the counter to ask if we've ever filled prescriptions for you before. For some reason, you think that "for you" means "for your cousin" and you answer my question with a "yes", whereupon I go the computer and see you are not on file.

The phone rings.

You have left to do something very important, such as browse through the monster truck magazines, and do not hear the three PA announcements requesting that you return to the pharmacy. You return eventually, expecting to pick up the finished prescription.....

The phone rings.

.......only to find out that I need to ask your address, phone number, date of birth, if you have any allergies and insurance coverage. You tell me you're allergic to codeine. Since the prescription is for Vicodin, I ask you what exactly codeine did to you when you took it. You say it made your stomach hurt and I roll my eyes and write down "no known allergies" You tell me......

The phone rings. have insurance and spend the next 5 minutes looking for your card. You give up and expect me to be able to file your claim anyway. I call my competitor and am immediately put on hold. Upon reaching a human, I ask them what insurance they have on file for you. I get the information and file your claim, which is rejected because you changed jobs 6 months ago.

An ***hole barges his way to the counter to ask where the bread is.

The phone rings.

I inform you that the insurance the other pharmacy has on file for you isn't working. You produce a card in under 10 seconds that you seemed to be unable to find before. What you were really doing was hoping your old insurance would still work because it had a lower copay. Your new card prominently displays the logo of Oklahoma Blue Cross, and although Oklahoma Blue Cross does in fact handle millions of prescription claims every day, for the group you belong to, the claim should go to a company called Caremark, whose logo is nowhere on the card.

The phone rings.

A lady comes to the counter wanting to know why the cherry flavored antacid works better than the lemon cream flavored antacid. What probably happened is that she had a milder case of heartburn when she took the cherry flavored brand, as they both use the exact same ingredient in the same strength. She will not be satisfied though until I confirm her belief that the cherry flavored brand is the superior product.

I file your claim with Caremark, who rejects it because you had a 30 day supply of Vicodin filled 15 days ago at another pharmacy.

You swear to me on your mother's'....

The phone rings. that you did not have a Vicodin prescription filled recently. I call Caremark and am immediately placed on hold.

The most beautiful woman on the planet walks buy and notices not a thing. She has never talked to a pharmacist and never will.

Upon reaching a human at Caremark, I am informed that the Vicodin prescription was indeed filled at another of my competitors. When I tell you this, you say you got hydrocodone there, not Vicodin.

Another little part of me dies.

The phone rings.

It turns out that a few days after your doctor wrote your last prescription, he told you to take it more frequently, meaning that what Caremark thought was a 30-day supply is indeed a 15 day supply with the new instructions. I call your doctor's office to confirm this and am immediately placed on hold.

I call Caremark to get an override and am immediately placed on hold.

My laser printer has a paper jam.
It's time for my tech to go to lunch.
Caremark issues the override and your claim goes though.

Your insurance saves you 85 cents off the regular price of the prescription.

The phone rings.

At the cash register you sign....

The phone rings.

.......the acknowledgement that you received a copy of my HIPAA policy and that I offered the required OBRA counseling for new prescriptions.

You remark that you're glad that your last pharmacist told you, you shouldn't take over the counter Tylenol along with the Vicodin, and that the acetaminophen you're taking instead seems to be working pretty well.

I break the news to you that Tylenol is simply a brand name for acetaminophen and you don't believe me. You fumble around for 2 minutes looking for your checkbook and spend another 2 minutes making out a check for four dollars and sixty seven cents.

You ask why the tablets look different than those you got at the other pharmacy. I explain that they are from a different manufacturer. Tomorrow you'll be back to tell me they don't work as well.

Now imagine this wasn't you at all, but the person who dropped off their prescription three people ahead of you, and you'll start to have an idea why your prescription takes so damn long to fill. And that every person in front of you does the same thing.

Ok well that is my brief list of problems that can happen in the pharmacy.

Take Care,


P.S. I am going to check my blood pressure now.

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