Sometimes it falls upon your phriendly pharmacy staff to phone your insurance company. It is a necessary evil but one which we shall undertake to provide superior customer service. . . or at least get you your refill since Mail Order is the Devil Incarnate and . . . but I digress.
Now, phor your reading pleasure, I present. . . Tales Phrom The Pharm Side.
Uber-Tech: CP, we have a problem,
CP: Go phor CP.
UT: Apparently, Ms. Golightly's prescription is too soon.
CP: Dear Holly? How dreadful. I shall call for an override.
UT: That's why you're the best. Always looking out phor the little guy.
CP: I haven't even had Breakfast yet.
<pluckily dials insurance>
Practically Below Microbes: Thanks for calling Rejections R Us. How may I thwart your efforts and phrustrate you today?
CP: If only everyone was so honest.
PBM: Huh?
CP: Nothing. I was calling to get a mail order override for a lovely patient on her brand new medication that was processed by mail order today and not received yet from mail order since it was processed today by mail order.
PBM: Okay. And you are trying to bill it for what date?
CP: Today. 10/1/17.
PBM: Okay. I see that the patient's mail order processed a claim for a 90 days supply on 10/1/17.
CP: Correct. I can't quite figure out how they can bill a claim immediately but take 3 weeks to ship it to the patient. Baffling. Any who. . . I'd like an override so the patient may receive medication phrom me to begin therapy today.
PBM: Okay. Is the patient low or out of medication?
CP: As I stated earlier, before your teleprompter kicked in to gear, this is a new medication, so she can be neither low nor out since she never had any.
PBM: "We can only do an override if the patient has not received her mail order yet."
CP: Are you listening to yourself? Do you understand the words that are coming out of your mouth? I told you this was a new medication. Today. YOU told ME that mail order processed the claim . . . TODAY. Now how in the 7 layers of Pharmacy Hell can the patient have sent a prescription to mail order, had it filled, taken all of it, been out of it, and received a new prescription for me to fill all within nanoseconds? It bends the time-space continuum.
PBM: I have to enter a reason in order to process the override.
CP: Words are wind. I wonder why I waste so many of them being practical. I bet you tested really high on the parroting part of your interview. Say what.
PBM: What?
CP: Good dog. Now please process the request for my patient; who has no medication; because she never started it; because mail order billed it today but won't send it for weeks; but I need to do all this legwork to lose money; because I care.
PBM: Ok. So the patient is out of medication?
CP: Your parents wouldn't happen to be Cersei and Jamie by any chance?
PBM: Um. I don't think so.
CP: Yes. She is "out" in layman's insurance parlance.
PBM: Ok. I entered the override. Be sure to document on the hard copy the override I provided.
CP: GOT it.
UT: That sounded rough.
CP: We could save so much time if the conversation weren't so robotic. A simple, "Oh her mail-order didn't arrive and you need an override? Here's it is. G'Day!" would be amazing.
UT: As you always say, people today are being trained WHAT to think as opposed to HOW.
CP: You actually listen to me?
UT: You talk a lot. All phreaking day. Must be osmosis.
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