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Tuesday, March 23, 2010

What Sears My Patty

You know what really sears my patty? When I get "Rick rolled" by the insurance company hold muzak while waiting to find out why the emergency room prescriptions for a patient's kidney stones that were supposed to be approved by them an hour ago still will not adjudicate.

WTF? I finally get an agent, he asks me the patient name then says "I will resubmit them." and hangs up on me. Meanwhile the patient is standing next to me on his cell suffering through the same "Rick roll" and in major pain when an agent (probably the same rude douche that hung up on me) tells him it will take 30 minutes before the pharmacy will be able to reprocess the claims.

He chose to wait for the insurance coverage rather than pay cash and get reimbursed. So I get the patient's cell number and ask him how late is too late to call because I am going to reprocess the sh*t out of these claims until they work. I tried every 20 minutes for 3 hours then tried calling the insurance people again. Son of a b*tch!! They went home for the night and didn't fix this poor guy-that-is-in-so-much-pain-he-can-barely-stand-up's claim.

So I turn it over to our secondary insurance people with a note to call insurance as soon as they open so this guy doesn't end up back in the ER. At 7:45am one of the rxs adjudicates. Hallef*ckinglujah!

I celebrated a little too soon. The other rx rejects for 5 day supply covered. I resubmit for 5 day supply and I get "prescriber not covered." So I have our secondary insurance people call them again so I can get this guy 5 days of meds. The guy shows up and gets the one that was finally covered and was on his way to work. He decided to have the store near work fill the other rx when insurance approved it on his lunch break so he could pick it up over there.

He is calling to let his insurance provider know how sh*tty their service is. For a human being to endure so much for a service he pays for monthly, well that really sears my patty!


Filet-o-bitch RPh said...

OMG I am in tears!! Sear my patty? Rick rolled? We should work together again...that was fun!!

Grumpy, M.D. said...

Yeah, we play the same game. And the insurance company doesn't give a shit, either.

Big 'N Tasty RPH said...

But Filet, I would have to get another state license and you know how much I hate taking exams...

Marsha said...

have you seen my Confessions of a Pharmacist blog? I think you'd get a kick out of it, as in kick in the ass>

marsha said...

Confessions of a pharmacist, my blog, is looking for feedback.