whats up with the pharmacies lately?

[Robert871]

anyone else notice that they are becoming rather difficult to deal with lately?

i do not get sick often, nor do i require a prescription very often when i do. but friday i started feeling bad, ear ache, sinus pressure, soar throat, cough, fever. anyways so i broke down figuring i finally caught another upper respiratory infection like i used to when i was younger. so i go to the doc and he gives a prescription for an antihistamine, antibiotic and a nasal steroid.

so we go to wally world to get the script filled because sams was out of the question what with 71st going to be a madhouse on saturday... and we get there at 1:20 and the girl at the counter informs us they are closing the pharmacy at 1:30 for an hour lunch. and they wont even begin working on putting my pills in a bottle till sometime after that....

so fine, we leave and go to walgreens, right off the bat they tell me the antihistamine (poly sist forte, or something like that) is on back order and no place in town is going to have it, but i can double up the dosage of some over the counter stuff and get close to the same results. fine.. not their fault.

so 30 mins later they call my name and i pick up my 30 capsules of antibiotic, and a pre-filled boxed package that is the dose pack of nasal steroid. i understand that its the sick season and they are busy, and i figured its always taken at least 20 mins to fill a prescription. and i know it probably has to be counted, and double checked, and verified by the pharmacist and a tech or whatever, i do not care and i do not want a lecture. i get it, thats to be expected its fine.

so fast forward to today, my father has caught the same crap i have, apparently its going around, or maybe he caught it form being in the house with me, who knows, anyways, so he gets his doc visit in this morning, and they drop the prescription off at the pharmacy, then come home because its about an hour wait, and they said they would call when its done. so an hour and a half later they call and tell my mom that his order is in queue and will be filled sometime tomorrow morning..... its 2pm now... and if i am not mistaken this walgreens is open 24hours a day. . . . . well she tells the lady on the phone that this is ********, its 30 capsules and we need him to start the antibiotic today so he can get back to work as soon as possible. "okay, we will have it done in 45 mins". . . . .

really?

i just do not understand it... people are sick... everyone has a life and has things they need to do, and cant or shouldn't when they are sick. you are in the industry to get the people the meds that a full blown doctor has already designated them to use to treat what they have going on, and you can actually stand there and prioritize how fast and when you will start on someones order? i mean, if having it done in another 45 mins was an option the whole time, why the hell not just fill the damn thing and then call and tell us its done, whats the deal this this freaking run around and trying to tell us it wont be ready till tomorrow?

i mean, seriously? you are going to call someone up who has already put up with being sick all night, decided to go to the doc, spend 2-4 hours and a hundred bucks getting a piece of paper to allow them to purchase meds, then you are going to tell them that you cant start their order for another 18 hours or so, and when they *****, you will go ahead and do it in 45 mins?

forgive me if i am ignorant, but something sounds screwed up....

is this a sign of socialized medicare to come, should we start expecting to take 2-3 days before we can start getting better once we accept that we are sick and start the process of getting some freaking medicine?

anyone else notice similar issues with exceptionally long times to fill a prescription, i.e. more than a couple hours at the most busy of times?

 

[Glocktogo]

What pisses me off is when I drop off a Rx, come back later in the day to pick it up and they say they can't fill it because the insurance company doesn't have a pre-authorization on file from the Doctor. Ummm, isn't the Rx from the doc supposed to BE the authorization for me to get a scrip? And WHY did the pharmacy not contact the Dr.'s office to have them get the Rx pre-authorization to the insurance company? Why didn't my insurance company call my doc? Why did none of the three entities bother to do a damned thing to make sure I could start the Rx as intended? Why am I expected to know which Rx requires pre-authorization and get it done? And WHY does the insurance company require a "pre-authorization" at all? They say it's for patient safety. Ummm, if I didn't trust my doc to prescribe me meds, I wouldn't go to them!

 

[HMFIC]

Sounds like you girls need your yearly exam and some pamprin.

 

[twotonevert]

I never had any issues with CVS, but that was after I could have pulled every hair out of my head dealing with Walgreens.

 

[HMFIC]

I can say that because I happen to be sick right now too. Woke up with head stuffed full of snot and throat on fi-yah.

It's probably the bubonic plague or something that would kill the rest of you dead in 5 minutes. I'll probably just need to eat an orange and get an extra 5 minutes sleep tonight.

 

[smax]

What pisses me off is when I drop off a Rx, come back later in the day to pick it up and they say they can't fill it because the insurance company doesn't have a pre-authorization on file from the Doctor. Ummm, isn't the Rx from the doc supposed to BE the authorization for me to get a scrip? And WHY did the pharmacy not contact the Dr.'s office to have them get the Rx pre-authorization to the insurance company? Why didn't my insurance company call my doc? Why did none of the three entities bother to do a damned thing to make sure I could start the Rx as intended? Why am I expected to know which Rx requires pre-authorization and get it done? And WHY does the insurance company require a "pre-authorization" at all? They say it's for patient safety. Ummm, if I didn't trust my doc to prescribe me meds, I wouldn't go to them!

Your entire issue is that YOUR insurance provider requires the pre authorization before they will cover the drug. Your doctor had no idea that the drug they prescribed is on your insurance pre authorization list because that list is provided to you not the doctor or the pharmacy. Health insurance is a pita but you can make it easier on yourself if you do a little home work first.

 

[VitruvianDoc]

anyone else notice that they are becoming rather difficult to deal with lately?
anyone else notice similar issues with exceptionally long times to fill a prescription, i.e. more than a couple hours at the most busy of times?

I worked in various Pharmacies for 4 years as a Nationally Certified Pharm Tech and will be glad to provide some insight for you.

Alright, a good efficient tech (such as myself) can get a script typed into the system, medication counted and bottled, in a verification basket within 5 minutes of receiving the script. This is barring no interruptions such as phone calls, drive-thru, drop-off, etc. Reality has it, The phone never leaves my ear. I was always on the phone for various insurance issues typically "refill too-soon" or "Prior-authorization." Most insurance calls take between 30-45 minutes each between navigating menus and waiting in queues. Then on top of this phone call and script filling, you have to pause at least once every 2-3 minutes to answer a secondary phone call or help someone at drop off or pickup.

This results in a script taking 10 or so minutes from time of drop off to the approval queue (barring no insurance holds).
Approval takes however long the Pharmacist takes which depends on the amount of C-II (oxycontin, adderall, etc) drugs waiting to be filled as they and they only are supposed to count and fill those along with the other items waiting approval along with patients needing counseling. Typically it takes between 5-10 minutes to get a prescription reviewed and approved.

Total time ~20-25 minutes for 1 script. This is during an average day with an average work load at a store who does 350 scripts a day. Such a store typically has 2 techs on duty all day (typically overlap during the 3-5pm rush so have 3 techs then) with one pharmacist.

At CVS where I worked, we got no lunch break. We ate on our feet and typically had 15 minutes to eat. This is against OK State law, but it went on regardless. So those pharmacies that close for lunch are lucky because they actually get to sit down for a few minutes. What results from closing is you get behind a good 20-30 scripts and that puts you an hour behind worth of work and you have to double time to catch up.

NOW, as far as walgreens and the whole 24 hour thing. They have a new thing where unless you state that you are going to need your Rx the same day, they automatically bump it to tomorrows queue in order to keep up with those who will be arriving that day. That is walgreens policy. Thats why a simple phone call and change it can be done.

What pisses me off is when I drop off a Rx, come back later in the day to pick it up and they say they can't fill it because the insurance company doesn't have a pre-authorization on file from the Doctor. Ummm, isn't the Rx from the doc supposed to BE the authorization for me to get a scrip? And WHY did the pharmacy not contact the Dr.'s office to have them get the Rx pre-authorization to the insurance company? Why didn't my insurance company call my doc? Why did none of the three entities bother to do a damned thing to make sure I could start the Rx as intended? Why am I expected to know which Rx requires pre-authorization and get it done? And WHY does the insurance company require a "pre-authorization" at all? They say it's for patient safety. Ummm, if I didn't trust my doc to prescribe me meds, I wouldn't go to them!

Pre-auths are a pain in the ass for us as much as you.

At CVS, we will have a pre-auth forwarded to your doctor within 10 minutes of receiving the pre-auth reject from the insurance. Then, its up to your doctor to call the insurance company and provide necessary documentation to get the pre-auth over-ridden otherwise they have to change the medication. If a Doc does have the necessary paperwork to over-ride a pre-auth, a good insurance company will take 48 hours for it to be approved and put into the system. Typically it takes the Doc 24 hours to respond to a pre-auth request because most do them before they open in the morning and start seeing patients. Total time is about 3 days.

What is a pre-auth?
Its when a doc writes for a medication that is NOT on your formulary of your prescription plan or is and is a Tier 3 or higher. Therefore you as a patient have all the access you need to take a list of drugs to your doctor and show them which ones your insurance doesn't cover or will typically require a pre-auth.

An example of this typically falls into the blood pressure or cholesterol medicine world. Any statin drug for cholesterol is going to work in a similar manner and are of the same drug group therefore in the insurance mind, everyone should be on the cheapest statin drug available. It increases their bottom line. However, in real world, different patients respond to different statins differently. Most docs will play around and find the best one for a person. Sometimes the newer statins that don't have a generic work best but the insurance doesn't like this since they cost a bundle. Therefore they slap a pre-auth on the newer, more expensive one stating that you must try the cheaper generic version before they will pay for the expensive one. A doc must then provide documentation that he tried the cheaper one and that it was ineffective. Then and only then will the insurance cover it.

And, you have the Gov't to thank for that as part of the medicare cost reduction act back in the early 2000's included provisions that allow insurance companies to do this.

 

[JonN06]

Thank you Doc, that's a very informative post.

 

[tRidiot]

Pre-auths are da debil.

Yet one more reason I said bye-bye to clinic medicine.

Next time it takes you 2 weeks to get in to see your doctor, make sure you write a thank you letter to Medicaid/Soonercare, Medicare, your insurance company, your Congressmen/Senators and everyone else who has heaped millions of new pages of documentation on your physician to fill out. All while doing everything possible to limit their reimbursement. And then watching over their shoulders to make sure they're doing things the way the bean-counters and administrators think they should be done... not the way your doctor thinks.

75% of clinic medicine these days is dictated by insurance and government. Not by your doctor.

And people wonder why no one wants to go into primary care, or why it takes forever to get things done. Screw that. No way in hell I'm going back.

 

[BadgeBunny]

I love the pharm tech at the Sam's Club we go to ... she takes very good care of me!! She spent the better part of an afternoon looking for a pharmacy that had something they were out of (drug shortage ... guess it's a popular med amongst the doctors). Then she was kind enough to fax my prescription over to them and then give me a call and tell me where it was. (Yes, I take her cookies occasionally now.)

Before that the small pharmacy in Bethany nearly killed me screwing up my prescriptions ... It was always the doctor's fault according to them. Last time it happened I went back to the doctor's office and asked for a copy of the prescription ... yeah ... right ... we changed to CVS right then. I LOVED the guys and gals at CVS ... then my insurance dropped their contract with them ... blah!!

Tried the mail order route with ExpressScripts for a little while ... a VERY little while ...

So I LOVE the gal at Sam's!!!