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Monday, August 31, 2020

Why Insurances Suck #244

CP: Thanks for calling Commiseration Palace, home of CP, Pharmacist du jour, how may I help you?
Nurse Is Calling Explaining Our Niggling Endeavour: I am calling about a prior auth you initiated with us. 
CP: Do go on. 
NICE ONE: I called and they said it doesn't need one. 
CP: Ah. My favourite game to play. I bill it and receive a one sentence reply: "prior authorisation required, have prescriber call 1-800-THATS-A-NO". I call you only to have you call them and have them tell you the pharmacist erred or misinterpreted our "prior auth required" message and that no such auth is required; prior or otherwise.
NICE ONE: Well, they did provide me with this alternative billing information to give to you. They said "provide this BIN, PCN, ID#, and GRP# to the pharmacist and it will go through".
CP: Sure. What the hell. Why not? 
<enters billing info as provided>
Well that worked!
NICE ONE: So it didn't need a prior auth?
CP: Yes. No. Wait. Hold on. What in the actual name of #PharmacyPhuckery just happened? 
NICE ONE: What is it?
CP: The card information you gave me? 
NICE ONE: Yes. What the insurance gave me to give to you? 
CP: Yes. It's not new billing for the patient and her insurance. 
NICE ONE: It's not? That's weird.
CP: No. <laughs> What's weird is it's actually a discount card from the manufacturer. Instead of paying for the medication or approving the prior auth, the insurance looked up a manufacturer coupon and gave that to you to give to me. 
NICE ONE: That's pretty lame. 
CP: No. That's pretty low.  
NICE ONE: That's a lot of unnecessary legwork for the both of us. 
CP: That's a pretty sardonic wild goose chase. Now I know the insurances are just messing with us. Must be today's game on their desk calendar. 
NICE ONE: How to phuck with the pharmacy and prescriber?
CP: Indeed. 
NICE ONE: I can't wait to see what tomorrow brings. 
CP: That's why I get out of bed in the morning; to see what fresh hell pharmacy, insurances, prescribers, and patients have dreamt for me over night. It keeps our one-sided masochistic relationship phresh.
                                

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