But I’m Just a Tech!!

We have been working on a prescription for a customer, now, for close to a month. Usually I don’t have any problems with billing Remicade for our patients, and the boss loves it. The thousand dollar a vial price tag makes sales look good. It’s not much of a profit, but usually, also not a lot of extra work aside from placing the order.

Now, this particular case, the customer wanted up to bill their own plan, as well as their spouse’s plan. The catch… they wanted us to bill THREE infusions worth for a total of 18,000 dollars worth of medication. The number of problems with this particular matter is very high:

1. Our software is not designed to accept prices over 9999.99, so we have to break up the transaction and bill to the insurances on two separate days.
2. The insurance plan requires a manual intervention done by the insurance company to bill such a large amount, which can only be done on each individual day by one of us phoning in to get the intervention done.
3. One plan begins July 1, the other terminates on July 2… that leaves us a 2 day window to get things billed.
4. July 1 is a Sunday.. and a statutory holiday, July 2 is the day most companies are honoring the stat day. Insurance office is closed both days, so we called Friday to have the intervention codes entered in advance.
5. Sunday–bill plan 1–success!!! Bill plan 2–rejected–product requires special authorization. BOO!
6. fax doctor’s office for them to fill out special auth forms… nurse only works Mondays, Wednesdays and Fridays.. forms filled out and faxed by nurse.
7. Following Monday- try to bill to 2nd plan, and YAY special auth works!!
8. Credit return to plan 1- call to regain intervention code to rebill–”sorry we cannot allow backdating more than 7 days” BOO!!
9. Plan 1 now says–hmmm I think we need special authorization on this as well– have the doctor’s office fax us

Well.. it’s now July 25, and the special auth has finally been approved… but.. the coverage was terminated almost a month ago..

The amount of time we as a group have spent trying to get this darned claim to go through, and the amount of times the customer has called to yell at us about getting of our asses and getting the medication si not worth the $20.50 we would get paid for processing this prescription.

Turns out the first infusion is tomorrow, and the customer is likely going to have to do a manual claim for the medication.

GRRRR!

Yesterday was my day off. Most times on my day off I try to relax and totally avoid the pharmacy, but yesterday I decided to go visit my former co worker at the store I used to work for. We still talk a lot and I was really sad to leave there, because I really liked most of the people who worked there. Anyways.. I get there and there are 2 pharmacists and 3 techs standing around in the front, and not being able to work. It seems that their computer system fried, and the IT guys were having a hell of a time getting things back up and running. Usually having one of the computers go tits up wouldn’t be much of a problem, because there are 5 or 6 or 7 computers in each pharmacy. The problem was…. it was their mainframe computer… bad news. None of the satellite computers could be fired up or used, because it was the one with all the network connections and all the data on it that fried.

In any case.. they were mostly just standing around… doing the manual things they could do , scribbling down script numbers and names etc and trying to be polite about the fact that there wasn’t really much they could do to help anyone much at that moment, could you please call back in a few hours.

So my friend and I went for lunch, came back, at which point she offered to go home for the day, rather than just stand around holding the counter up. She was asked to stick around, so that once the computers were back up and running they could fire through as many of the stack of requests that had built up during the day as she could. At this point a gentleman walked up to the till and the conversation went sort of like this

Man: I’m here to pick up a prescription that I called in this morning.

Tech: I’m sorry, sir, our computers have been down all day, and we haven’t been able to access any information to fill any refills

Man: well, I called it in… we’re leaving on vacation tomorrow morning at 7.

Tech: I am really sorry, but we

Man(getting angry): I need my refill..

Tech: I understand, sir, we have had IT working on is since..

Man: this is why the world shouldn’t be computerized. Who’s your manager.

Tech calls manager

Man (very angry now): Why can’t I get my medication???

Manager: (goes through the whole apology again )

Man: don’t you have back ups??? This is ridiculous!!!

Manager: Of course we have data back ups, sir, but a back up isn’t going to help us if we don’t have a computer to plug it into. You’ll have to be patient ro come back tomorrow.

Man : but we’re leaving at 7 am tomorrow morning.

Morale of the whole story, in my opinion… think ahead… don’t leave your refill requests until the DAY BEFORE YOU LEAVE!!!He’s lucky that the medication wasn’t something unusual or very expensive that the pharmacy doesn’t keep in stock and have to order. People should pre plan.. this is medication we are talking about…. it’s YOUR LIFE!! We are not your babysitters. If you need medication to survive and you are going somewhere.. give us some notice and you won’t have a problem. Make sure you have refills before you go to Zimbabwe for a month. Don’t come to us the morning of your Remicade infusion and just HOPE we have it in stock..

I really don’t understand why some people have such a hard time understanding us when we speak slowly, clearly and in perfect English. The pharmacy I work at is in a fairly new, fairly affluent neighborhood, where a majority of our patients are upper-middle class families. You would think that they know how to tell time. They are, after all, wearing designer watches that cost more than a week’s pay for me (I AM just a tech), so you’d figure that when I say, “it will be 15 minutes, and it’s 12:30, that they would come back at 12:45 like I told them to. When they lean on the counter at 12:37 and say, “I’m in a hurry.. I have to get to work”, I look up at the clock and say… “It will be a few more minutes… give us until 12:45″ Do you think they get it???Nope!

What about the old guy the other day who came into the pharmacy with a photocopy of discharge rxs that he got on the weekend. He had brought them to the float pharmacist on Sunday night and asked for random ones to be filled, but wanted the rest back. So, the float filled what he wanted, made a copy of the rest, stamped and signed and indicated which ones had already been filled and gave the guy the copy. Now, it’s Monday and the old guy dumps various bottles on the counter… along with the copy, and asks us to blister back these for his wife, because she needs them and just got out of the hospital. Ok, that is fine.. we will do them for you, but it’s going to take a while.

“Sure, ” he says, ” I will be back in 20 minutes.”

“Uh , no,” we say, “It’s going to take us at least 2-3 hours.. if we manage to get to it at all, today”

“Ok, I’ll be back in 20 minutes.” he repeats.

The pharmacist, at this point in time, is ready to rip her hair out. She manages to convince the guy to go home, and we will call him when it’s done.

The guy leaves and we start trying to make sense of what went on on the weekend. The guy insisted he didn’t want a copy of the rxs so he could take them elsewhere, but the remaining rxs were also not put on file in our system. We put them into our system, and figured out which meds and how many he needed us to fill to make up 2 weeks worth of blisters (filling from what he brought in in the vials and from new)

So we finally get everything billed and ready to pack, and pour out the one medication out of a vial from a competitor, and lo and behold there are about 37 varieties of medications in one vial. What a nightmare.

Eventually we got it sorted and done with and gave the guy a call to tell him it was ready to pick up and he cursed at us saying that he had been waiting hours for us to call. HOURS?? you jsut brought it in 2 hours ago, you jerk!! You’re lucky we got it done so quickly! some people just DON’T GET IT!!!!

Anyways…that was our excitement for the day.

Sundays seem to be bad days for our family getting our vehicles smashed into by drunk drivers. I guess that is a result more of Saturday nights, than Sunday mornings, but in any case, I woke up Sunday morning just after 7 to someone revving an engine and squealing tires. I sat up and listened a bit to see just how close it was, and once I figured out it was REALLY close I got up to take a peek. I threw on some clothes (damn I hate the heat right now) fumbled for my glasses, and flung open the balcony door. I looked towards my parking lot, where the sounds were coming from and spotted a big white beat up truck that was making all the noise. In that exact moment that I realized that, this was indeed the vehicle making all the noise, I also noticed that my car.. my beautiful red baby, was sitting at a queer angle in the lot. I ran for my phone to call the police and ran down the stairs at the same time. The truck took off out of the parking lot with at least one flat tire, and sped off (as best as a truck can go with flats) down the street.

I approached my car, and man… is it smashed. The entire rear passenger door and wheel well are totally broken, and the truck hit it so hard that it pushed it over into the car in the neighboring parking spot. After dealing with the police, who caught the people who were in the vehicle, I finally took more time to examine the damage. Not only did these people hit MY car, they also took out a van, a fence and a couple of power poles. Fortunately no people were hurt, and the police did end up making some arrests.

This doesn’t really have a lot to do with pharmacy today, but I did spend a good deal of my spare time at work today making phone calls to insurance companies, and body shops. I managed to wrangle myself an appointment to get an estimate for repairs, as well. When all is said and done, repairing the car is going to cost someone’s insurance close to $4,500.

As for work, well.. there wasn’t anything too exciting. The typical “I am out of medication, but I don’t have any refills” calls, and one very angry gentleman who I mistakenly told that today was a bonus points day (when the coupon doesn’t start til Wednesday) who threw a hissy fit and told us he would never come here again, just because he missed out on a few freaking points. Thank you, come again.

Welcome to my blog that is going to be mostly work related type of info about being pharmacy technician in a box store style pharmacy in Canada.