February 17, 2012

Swistle's! Pharmacy! TIPS!!

Rob has strep, so now I am the only one of the seven of us who hasn't had it this winter. Waiting for his prescription, I thought of some Swistle's! Awesome! Pharmacy! TIPS!! It's one of my favorite things, when someone has worked in a certain field and can give Insider Info.

1. Wait for it. It's not always possible, of course, but if it IS possible, waiting for the prescription (rather than leaving and coming back) is the best way to reduce the largest number of pharmacy issues. (Plus, waiters get bumped ahead of come-back-laters.) Most problems that halt a prescription in its tracks (insurance info not up to date, insurance won't pay because they don't realize this is a dose change or a replacement for a spilled bottle, person not in the computer or can't be found in the computer) can be fixed in about 2 seconds if there's someone there to help solve the mystery.

2. Don't expect them to call you with these mysteries, or with anything else. They almost never will, even if they say they will. Instead, you will find out when you arrive to pick it up. I'm not going to defend this, because I am very frustrated when I'm the customer and it happens to me; I'm only going to tell you it's the way it IS. It's the sort of situation where it's better to work with reality than keep struggling futilely against it. If your insurance persistently causes problems and you're sick of showing up only to have someone say, "Um, that'll be $193.50" and then have to wait while they call the insurance or fill the prescription they didn't fill because it wouldn't go through, or if your pharmacy techs keep saying, "Um, we haven't filled anything for him before?" because they mistyped your child's name, I recommend calling before leaving the house to make sure the prescription is ready and the insurance went through. You shouldn't have to do that. But this brings us back to the subject of reality, and of working with it.

3. If it's a refill, call it in ahead of time and pick it up later---like, the next day. On the spectrum of prescriptions, highest sympathy/speed/priority go to prescriptions written that same day for antibiotics, or for painkillers for someone recently injured; lowest sympathy/speed/priority go to refills that could have been called in but weren't, or prescriptions written two weeks ago and brought in 15 minutes before closing time, and now the customer is saying they should have taken their pill this morning but didn't. This is the perfect time for that "A lack of planning on your part does not constitute an emergency on my part" sign, and will cause the resentment that inevitably comes from being forced to compensate for someone else's choices while suppressing the related feelings. It's not a good idea to get resentment simmering in someone preparing something you will be swallowing.

4. I think that the absolute most common pharmacy complaint I heard while working there is "WHY does it TAKE so long?" A prescription goes through roughly five steps of checks and re-checks and processing, some of which are to keep you from dying from a drug interaction, and some of which are to keep you from having to pay full-price for the medicine, and some of which are to make sure you have the instructions you need for taking the medication. Those are nice things, I think we can agree on that.

The more important reason it takes so long, however, is that you have to wait your turn. Most prescriptions are called in by a doctor or by a customer, or are dropped off to be picked up later---so there can be fifty prescriptions lined up and not a single visible customer waiting. A 20-minute wait means the pharmacy cut you ahead of a bunch of people who were there first but the pharmacy is willing to gamble they won't show up in the next 20 minutes. A 30- to 60-minute wait means several people have already been cut into line and there isn't room for another.

Which brings me to another tip: Having the doctor call it in doesn't necessarily help. I think the image is of the doctor phoning the pharmacist directly, and the pharmacy springing into immediate emergency action knowing the customer is ON THE WAY! Whereas actually the prescription is put at the end of the line. And sometimes, the doctor chooses to leave a message on the pharmacy's voice mail instead of pressing 4 to speak to the pharmacist directly, and sometimes those messages don't get checked for awhile. And sometimes the doctor puts the prescription in a pile to have the nurse call in later. It's a system riddled with flaws and solvable issues, I agree. After working in a pharmacy, I usually choose to bring the prescription in myself, or else when the doctor says "I'll call this in" I say "Tell them I'm on my way."

5. Know your insurance. Ha ha, I'm just kidding: it's not possible to know your insurance. I've read our handbook again and again, STRAINING to understand, and I still get surprised all the time by what they will/won't cover. By "know your insurance" I mean "realize that insurance can be confusing and kind of unpleasant, and that the bills are submitted by one computer talking to another, so even if they WEREN'T unpleasant, things are likely to get screwed up."

Here are the most common insurance issues:
  • Usually a covered medication is covered only every X days. So, for example, if you take a daily pill, and your insurance covers it, the most likely is that they will pay for it again when you have 5-8 pills left. If you try to be smart and prepared and fill your birth control prescription a week or 10 days in advance, they might reject the claim.

  • This also means that if there is something irregular about the time you're refilling it, it would be a good idea to mention this to the clerk so he/she can override the insurance's rejection. If I knew that a customer was doing an early refill because they spilled their medicine in the sink, or because they were going to be traveling, or because they needed a second bottle for school, those were all problems I could fix. If I didn't know, all I could do was write "Insurance says too soon" on the bag.

  • If a medication is more expensive than usual, most insurance companies will set up hoops. For example, the doctor might need to call them and tell them YES, he/she really DOES mean the prescription he/she wrote. Or they might want you to take a cheap medication first. Or they might just deny it until you or the pharmacy clerk calls them and says "Hey, remember what YOU'RE supposed to do? You're supposed to PAY for this." Since most of the time we don't know how much medications cost, I recommend thinking of any new medication as a potential hassle.

  • A very common thing for someone with a rejected claim to say is that their insurance company "won't let them have" a medication their doctor wants them to have. A clarification is in order here: the insurance company WILL let the customer have the medicine, it just won't PAY for it for them. The customer will have to pay for their own medicine, but of course they may have it.

8. Some pharmacies are not well-run or well-staffed. I can talk all day about how customers have to realize blah, or should understand snah, but there are pharmacies where you can go in with your prescription for antibiotics and wait for an hour when they said it would be 15 minutes, and then get the wrong medication and have them tell you your insurance won't cover it when actually the pharmacy just didn't make sure they had the info entered correctly, and then ring you up wrong and also say they already gave you back your insurance card when they didn't---and it can pretty much happen that way every single time. I had co-workers who were...well, let's not use words like "incompetent" or "rude," let's just say that not everyone works in the field to which they are best suited. In those situations the only real tip is "Switch pharmacies," which is (1) a tip you could come up with without a former pharmacy technician, and (2) not always practical.

25 comments:

HereWeGoAJen said...

My husband has diabetes and we are chronic prescription people since he takes a whole bunch of different medicines. So I would like to add: be nice to the pharmacy people. I've found that my prescriptions have gotten significantly easier and more accurate as they get to know me. I call the pharmacy and go there multiple times per month and since I am always nice to the pharmacy and don't hold insurance problems against the techs, I am convinced that they have started to work harder for me and I am having fewer problems getting our stuff.

Swistle said...

HereWeGoAJen- GOOD ONE! Yes, I think you're absolutely right.

Janet said...

What?!? You can get a replacement for a spilled bottle of meds??

Can of worms. :)

Sarah said...

My best friend from high school is a pharmacist, and works in a very rough area of Kentucky where their absolute biggest problem is people trying to score narcotics either for their own addictions or to sell. So I would add, based on her many complaints and rants, that if you're going to a pharmacy in a rough or high crime area, expect to possibly be treated with a certain level of suspicion/hostility if you're trying to do ANYTHING unusual with a prescription for pain killers, ADHD-type meds, or antidepressants. It's not YOU, it's just the way it is.

Swistle said...

Sarah- YES! Even in my non-rough area, anything involving controlled-substance medications is on a different level of suspicion. So that now I get all fumbley and stammery if I fill anything like that myself, as I try to look Super Innocent and Non-Druggie.

LizScott said...

I love this, because: YES. I think a lot of frustration that comes with moving around in the world with other people comes from having no perspective regarding what other people are dealing with.

I am *totally* guilty of running into the super market with a script, looking around, seeing no one in line, and going "um, can't you just grab it off the shelf, I mean, come on." So it was good for me to read this as a nice reminder that, yeah, I'm not the only person in the world (Yes, I know: no duh. But reminders never hurt.)

Also, I will say to HereWeGoAJen's point - in almost EVERY area of my life, being nice and respectful to the people doing things for me (and yes, while it might be a techs "job" to fill the script, it is still an action they are taking on my behalf, not just a service I am due) has gotten me way farther than not. I remember working as a waitress and as a coffee maker (obviously not on par with the same importance as pharmacy tech, but still), and the people who were rude? I mean, dude: I'm getting your coffee. You have put in charge of the coffee situation of your life. And you're being a dick? I guess that means I can give you decaf.

PinkieBling said...

These are great! I had to stop mid-read and call in my refill so as to give them plenty of time. :)

Favorite line: "...customers have to realize blah, or should understand snah..." SNAH! Love it.

Josefina said...

This is great. Very helpful. Thank you!

Nellyru said...

I am convinced insurance companies are the root of all evil and will be the demise of modern civilization. I mean, what if all businesses were run that way??

Sarah said...

Great post, Swisle. What I love the most about it is that it's actually informative. Lately I've been reading the Reader's Digest "What your [doctor, waiter, pilot, etc.] won't tell you". And they just end up coming across as bitchy, whiny, and how you can make [doctor, waiter, pilot's] life easier and a rant on how the general public SUCKS. Not Swistle, she'll teach ya something that helps you, while helping "them".

Alice said...

this makes me wish i had worked in more helpful industries!! i mean, i did work in the airline industry, but things have changed so much since 2004 that most of my advice doesn't even work anymore.

(except "don't check your luggage unless you absolutely have to, and if you DO have to, try not to have anything valuable in it." i threw bags for 1 day in philly and OH MY GOD.)

the rest of my experience in corporate america is pretty... normal. and unhelpful to most.

clueless but hopeful mama said...

I love this. A real service you are providing here, m'dear.

Now, can you please explain the DMV to me?? :-)

Life of a Doctor's Wife said...

I use a pharmacy inside my supermarket, and all of these tips ring VERY true. Especially the one about being nice! It helps SO MUCH. Not only because it doesn't kill the spirit of the poor pharmacy tech, but because it keeps ME calm and curbs MY impatience.

But I did once see the PHARMACIST there holding the lid of a pill container BETWEEN HIS TEETH. Not MY pill container, but FTLOG that is not okay.

M.Amanda said...

Yeah! I appreciate the info. I hate being the person who makes a person's job more difficult, even when it's just because I'm ignorant of what the trials of performing their job really are. I'd rather be educated.

Also, Yeah! to all the other comments, too. I agree, be nice! I'll serve the person who needs help, but I'll bend over backward for the person who asks super nicely and is understanding about issues that arise.

Jessica said...

I was a pharmacy tech for 7 years and I think this is a great summary!

The only suggestion I have (and it has nothing to do with being a former technician, just as a customer), is when I get our prescriptions filled in the supermarket I have to stay RIGHT THERE or they assume I've left. If I go grab a loaf of bread or something and come right back, my prescription has been bumped to the end of the line. It's way faster to stay in their sight the whole time, then go get the bread afterwards. Hell, if I even look on the shelves RIGHT THERE for some Tylenol and they can't see me they bump it. This drives me CRAZY as it's not how things worked in my pharmacy. It was an independent pharmacy and we did everything we could to encourage browsing. Yes! Go look at the shelf! We'll come get you when it's ready!

Jenny (Bring A. Torch) said...

Oh YAY, I was hoping you'd do one of these!

Little Bird said...

Something I just learned today....talk to your pharmacist if you have prescriptions that you need to fill in a week's time or so. I'm having surgery next week and I have the scripts for the stuff I should have at home when I'm discharged. My belt-and-suspenders husband wants them filled the the stuff safely stowed in the kitchen. However, one of the meds is a liquid antibiotic (jaw surgery) and has to be discarded after 10 days. So the pharmacist supplied it to me as a powder with another bottle filled with the measured amount of distilled water. I can mix the two when I'm discharged and have the medicine fresh. Soooooo much better than either running to the pharmacy when I am discharged or having the meds go bad.

CARRIE said...

I don't have any issues with pharmacies, although I do have some control issues with the mail-order pharmacies. I just got a notice that I can get a 3-month supply for the cost of a 2-month supply if I do the mail-order thing. So being a cheapo, I want to do it, BUT the lag time between sending in the new RX and actually receiving the RX from some distant pharmacy makes me all anxious and need my antidepressant even more than I normally need my antidepressant.

Anonymous said...

One more tip is to look for independent pharmacies in your area. Since these pharmacies generally do not have as many customers as the chain stores, you will have less wait time and more personalized attention from the pharmacists and staff. And if you have insurance, your co-pays will be the same as they would at any other pharmacy.

Christina77 said...

I would recommend that anytime you are using a mail order pharmacy program for the first time, that you ask your doctor for two scripts. One for a one month supply to be filled locally, and one for the 90-day supply to send in to mail. Your first mail order claim will always take longer than subsequent fills. Allow 2 weeks for your first fill. And don't wait until you're almost out of meds to request a refill. Mail order usually allows you to request your refill once approx 65% of your current supply should have theoretically been used. At retail, it's about 75% before you'd get a "refill too soon".

And if you get a new script for a med you've never used, give your insurance company a call or go online BEFORE you fill it to find out if there are any prior authorizations, step therapy requirements, or quantity limits. These will save you from unpleasant suprises at the counter. Also, print off your plan's preferred drug list and bring it to the doc's with you, so that they can see which meds would result in the lowest out of pocket costs to you.

Kira said...

Oh, I have a question! Recently I got a prescription filled at my local, much-used pharmacy. The guy who helped me was...oh my, a CHILD, and I'd never seen him before, and he was totally flustered. And when I got my medications, one of them was sort of screwed up. As in, the instructions said to take one pill a day, when I was really supposed to take one every six hours (I called the doctor to double check, because this was fairly important), and the bottle, which was supposed to have six pills, and which CLAIMED to have six pills, actually had seven.
I didn't do anything about it, but now, a week and a half later, I still have the bottle sitting next to my bed, with that one orphan pill in it, and it bothers me. I don't want to rain down difficulty on the poor, flustered, child of a pharmacist. But am I being irresponsible by not complaining?

Swistle said...

Kira- Hm! That is tricky! I'm not sure. Is it certain that the guy was the pharmacist and not a technician/clerk? I do think you could just not report it. I also think you could call and tell them that it had all ended up okay but that you wanted to let them know in case they needed to change anything in the computer; this would give a responsible pharmacy a huge stir-up, but without making it feel like you had to do a Big Confrontation (if that kind of thing makes you feel like you'd almost rather leap off a cliff, as it does me). And if the prescription was for narcotics, it would solve the mystery they'll have encountered when they tried to balance the narcotics inventory, while also giving them even MORE of a stir-up.

Swistle said...

(I should add that it's likely a stir-up wouldn't get the guy in Big Sad Disproportionate Trouble---since it's absolutely unavoidable for people to make occasional mistakes. UNLESS this was habitual, in which case he NEEDS to get in Big Trouble. So it's kind of win-win that way.)

Anonymous said...

I was really mad at my pharmacy because they told me that the manufacturer stopped making the birth control pill I take. I found out that actually the pharmacy stopped carrying that brand and it was available at other pharmacies. I was really upset that they lied to me.

Swistle said...

Anonymous- I'd be pissed.