Facebook and Twitter

and follow my blog on Twitter @pharmacynic to receive notifications on new posts.

Monday, October 23, 2017

Why Your Pharmacist Is Phrustrated

Did you ever wonder what goes on in the restaurant's kitchen while you're enjoying the atmosphere and a bottle of Malbec in the dining room?
I'm sure lots of things happen we don't know about.
Perhaps they overcooked the steak.
Perhaps the risotto is phucking runny.
All that we, the diners, see is a beautiful meal that tastes good and doesn't kill us.
Unlike pharmacy, in a restaurant there is not a third party between you and the chef to phuck with your order.
Imagine someone grabbing the tickets phrom the wait staff then altering them based on their own made up "guidelines" before handing it off to the chefs phor preparation.

(Remove the "Oscar" phrom her steak. We're not paying for that up charge and she doesn't need the calories.)
(She needs a prior authorisation phor the Filet. She can start with sirloin or a T-Bone but that's it.)
(No calamari appetizer. Eat a salad.)

Then when you phinally receive your meal, it barely resembles your original order.
This is how the pharmacy does work.
We receive your order, enter it into the computer, cross our phingers that no one phucks with it and it gets stuck in the Reject Wasteland, then deliver it to your table, er hand.

Here is what went on behind the scenes last week at my pharmacy phor one patient:
(I'll phast phorward to the part AFTER I called the CNP to correct her on the dosing of this particular medication.)

Uber-Tech: What's up?
CP: Twenty-five years and my life is still, trying to get up that great big hill of hope, for a destination.
UT: Really?
CP: Sorry. You led me to it and it phelt apropos of the situation.  Just another in a long line of phrustrating rejections.
UT: Do go on.
CP: I have to call this insurance company for the dumbest reason ever.
UT: What's that?
CP: The prescriber wrote for "Zithromax 500mg tablets. Take all 4 tablets by mouth together as a single dose."
UT: Typical.
CP: Right? It's the normal, FDA-approved dosing for Gonococcal urethritis and cervicitis.
UT: I'll call phor you.
CP: Thanks.

<10 minutes later>

CP: Well?
UT: <ahem> "The insurance limits the dispensing of Azithromycin 500mg tablets to 3 tablets in a 30-day period." and before you ask, they also limit the 250mg tablets to 6 tabs dispensed in the same period so no, we cannot do what you're thinking.
CP: But it is a legitimate, FDA indication. A single, 2 Gram dose.
UT: They said you could request a prior auth.
CP: Right. I'm sure the practitioner wants to start that tonight since she already went home, it being 4:15pm on a Friday night. So the patient can pay out of pocket for a single tablet or wait until Monday in the hopes that her prescriber will begin the P/A process AND that her insurance will cover it.
UT: Pretty much.
CP: Too bad insurances weren't such assholes about paying phor opioid prescriptions. I guess they're not receiving kickbacks phrom the manufacturers on antibiotics.
UT: What are we going to do phor her?
CP: Same thing we do every night, Pinky. Take care of the patient and tell her her insurance sucks. I'm not above explaining #WhyYourPrescriptionTakesSoLong and rightly blaming the meddling middleman.
UT: Bill the 3 tabs on the insurance and then 1 tab as cash?
CP: You got it.
UT: Want to go phor sushi and saki after work?
CP: That is disturbing. And, yes.

No comments:

Post a Comment