Wednesday, June 17, 2009

Go Ahead, Ask Me Why

Did you ever fill prescriptions for a customer who WORKS for the very insurance company you are billing, and argues with you about the copay? This guy today is telling me how the copays are wrong and proceeds to explain some complicated formula of how they are supposed to come out. I also had a guy get mad because the insurance company (that his wife works for) didn't cover his Golytely. Of course both these individuals decided to launch into their little discourse right at closing time.

....... the hell???? You guys know darn well that the prescription is billed online and your company's computer tells us how much to charge you. Why is it such-and-such a copay? ----

I dunno, YOU tell ME !!!


Lovely, CPhT said...

I have never had that happen, but it sure sounds annoying!

I also love the people who think their copay will be cheaper if they go to another pharmacy. Umm, guess again, Einstein!

Phathead said...

I woulda asked him to write down the forumla and his home phone number and whenever anyone else has a problem have the customer call him so he can explain

pharmacy chick said...

I have had it happen several times, in part because my city is the HQ for several hmo's in the area. When this happens, I use this simple retort. "If you feel it is incorrect, check with your supervisor tomorrow at work, AND if it is wrong we will retransmit at your request and refund whatever the difference is." To date, I have never refunded a dime.

Grumpy, M.D. said...

I love it when an HMO employee who comes to me gets pissed because their own company won't cover any tests or meds I order.

Anonymous said...

I work for a PBM and would never argue a copay or coverage issue at a retail level. I know as well as the pharmacy that all claims are billed online. If a copay is incorrect that is great for me, I just identified a system issue.