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Wednesday, January 18, 2017

Private Parts...

...or #WhyYourPharmacistIsPhrustrated

January is a chaotic time, especially in the pharmacy. The post-Holiday high has evaporated and the new reality of winter blues and insurance changes settles across the land like a blanket, suffocating any hope of patience or kindness hinted at last month. There are many stories out there. This is but one of them.

Optimistic Wife: Here is our new insurance card.
CP: You are amazing. He is lucky to have you.
OW: We know how you suffer for your trade and wish to make things easier.
CP: Your graciousness does not go unnoticed ... Oh dear.
OW: What seems to be the trouble?
CP: It appears something is wrong with this new insurance. I received a non-matched DOB rejection from them. Please tell me again what his DOB is.
OW: <slightly irritated> I should know what it is. We just celebrated it yesterday.
CP: Thank you. Just wanted to make sure, before I called the insurance, that it was not I who mistyped the information.

<calls insurance>
Helpless In Seattle: What is the reason for your call today?
CP: I am getting a non-matched DOB reject. I was hoping you could provide me with what you have so we may send this patient on his way this weekend.
HIS: Okay. Let me get all the information from you.
CP: <provides patient's name, address, family members, phone number, blood type, favourite movies and TV shows, and employer> Phew. How's that?
HIS: Fine. Thank you. Yes. It does appear that his DOB does not match.
CP: Right. As I told you 10 minutes ago before you started your interrogation. May I have the correct one so I can get the patient's wife on her way to easing her husband's suffering?
HIS: No.
CP: And why, pray tell, not?
HIS: "It is a HIPAA violation."
CP: Actually it isn't. HIPAA is between the patient and his healthcare providers of which I am one. It involves the Patient, the Prescriber, and the PHARMACY. So go ahead and provide it to me and we'll be on our way.
HIS: Is the patient there? I can tell him.
CP: No. He is at home. Convalescing after his stint in hospital. His wife is here.
HIS: Okay. I can tell her.
CP: What? NO! No you cannot. THAT is the very definition of a HIPAA violation. You may need to reread the script you're following. This is why I hate insurance companies. <click>

<calls to get another representative>
<goes through the whole spiel again>
More Forthcoming at Each Opportunity: Yes. I see that what we have differs slightly.
CP: May I have it please?
MFEO: Sure. Just make sure they get it corrected soon.
CP: Will do. We have a place to submit the incorrect DOB so it matches what you have. You know, two wrongs make a right when it comes to insurances.

OW: What happened?
CP: They're dyslexic. They had the year as '65 instead of '56. At least they made him a younger man for you.
OW: Thanks for your trouble.
CP: It would have been easier if the first call hadn't invoked HIPAA as a reason to not provide me with the correct information. She must think she's the insurance version of Negan. "I will shut that shit down!"
OW: Phunny.
CP: Thanks.

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