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.