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Wednesday, March 19, 2008

A manual for filling a prescription


Twenty-five years ago I graduated from a five year program for pharmacy, a veritable manual for dispensing medicine, if you will. I realize now that these times demand a manual for picking up one's prescription. Fortunately you do not need a five—now six—year degree. But there is still a need for preparation. Times have have been a'changin'.


One: Prepare to wait. (See following.)


Two: If you have a new insurance card bring it. You may think we pharmacist's copy it or run it through some swipey gizmo but we don't. It does, however, have a phone number on the back of it so we can call and find out the numbers we need for billing. The numbers on the face of the card are a trick: they are probably wrong or missing entirely. Sometimes the insurance company puts a few letters in there to try and trip us up and we need to call and find out which letters we can ignore. Anyway, we need the phone number to call the company and get the information we need (after being on hold for twenty minutes).


Three: Please let us know how to spell your name, as we cannot read the doctor's writing. Don't worry, we won't guess at the pills; we will call the office and ask what the medicine really is supposed to be. No we won't actually speak to the doctor; he is busy. And no, we won't actually talk to the nurse; she is busy too. But we can get in touch with the secretary. If she can decipher the handwriting (she can't) we'll be all set. See step one.


Four: Here is a little hint: The word is pronounced GEN-AIR-IC. Not GEN-ET-IC. That just irritates us. And yes, they are the same as the brand. Many of the GEN-AIR-IC drugs are the brand drugs put into different molds or just different bottles. If you like the fancy labels just tell us and then we can charge you more. Otherwise we are going to try and save you money, though some people don't like that.


Five: Some people like to think we only have to count some pills and stick a label on. Not so. We do really look for dangerous stuff, like interactions and allergies and doctor mistakes. Sometimes we play a little game and see how many mistakes we can catch in a day by doctors. Wrong drug. Wrong strength. Maybe wrong patient (that one's a hoot!). But most of the time is spent on the phone calling the insurance company (see step one). One caveat: if you want fast service DON'T STAND AT THE WINDOW TAPPING YOUR FINGERS AND STARING AT THE PHARMACIST. We like to put those people at the end of the line just to irritate them as much as they irritate us. One of the few little chuckles we get in the day.


Six: If you think it is funny to show up at the drop-off window thirty seconds before we close for lunch and say “I just made it!” it isn't. You're going to wait. And wait. And wait some more.


Seven: After a half hour, go to the pick up window. The prescription isn't going to be done, but we can then tell you why it isn't done. That gives us a measure of satisfaction; we can at least tell you that we are working hard to try and put the squeeze to your insurance company because they have rejected your prescription. We like to tell you how much we hate the insurance companies because, well, we really hate them a lot. We especially hate them for telling us all of this rigmarole is because they are saving everybody so much money. I know they aren't saving anybody anything—well, they do save themselves some money—and to hear that more than once a day is just the worst.


Eight: Go back to the waiting area or shop some more. We have to call your insurance company again since they rejected the claim. This is kind of funny, or would be if you weren't the person calling or the person waiting. You see, the company we call isn't really the insurance company. No. Your insurance company contracts out the billing to a second company. That is who we are now calling. That way the person “helping us” can say “I'm sorry; the insurance company does not allow for this drug, but you can call 1-800-BLA-HBLAH and they can assist you.” So we get to call someone else. So they can help us help you some more.


Nine: Go back to the counter. We can then tell you that we are very sorry (we really are) but that your insurance did not allow for the drug your doctor selected. However we can call your doctor (see step three) and tell them that (they love to hear from us). They can then call your insurance company. Not the company we call, but the real insurance company...unless that company lets the other company do that authorization thing, but it's kind of hard to tell which does that sort of thing, but after a few calls the doctor will find all that out, don't you worry. This is the iffy part. If your doctor does not yell loud enough, or, sometimes, cry, you might not get what you need. We are sorry about that. We are also sorry that when you ask us to call your insurance company and see if we can't straighten this mess out, well, forget about it. How long will it take? Um, no idea.


Ten: See step one. You see, we've just gone through the above steps for every person who was ahead of you, so we are now so backed up we're really just playing parchesi back here. Hey, it beats

talking to insurance companies.

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