Monday, January 23, 2012


OK, the end of January is approaching and I can't get over the feeling of just spinnin' my wheels.
Work has been an endless parade of insurance rejects...." patient not covered....ask patient for new ID card..... non-matched cardholder.....refill too soon......we are rejecting this claim because it's a day with an 'r' in it, ha ha !!.....and a million other reasons that I've never even seen before. People who have completely changed insurance plans, did not bring the card, and expect me to figure it out for them. I ask people POINT BLANK when they drop off their prescription, "HAVE YOU CHANGED INSURANCE IN 2012?" They reply, "no, nothing has changed." Fifteen minutes later we finally get to their prescription, it rejects, we ask them about it and they say, "yeah, I have a new card." Honestly, I feel like I'm being punked in a reality show or something. And of course the person's next question is, "Is it ready yet?" Things never change.

The prescription transfers are still plentiful. As usual, people don't understand that this takes extra time. I feel bad about calling the same pharmacies multiple times a day, but what else can I do...

Anyway, the other things on my mind are:

--Staffing. Why do we never have the right amount of people when we need them? One of the busiest times in retail pharmacy is between 4pm and about 6:30 pm, when people are picking up prescriptions on their way home from work. Working people, as well, tend to want to schedule doctor's appointments at the end of the work day so they don't have to miss too much time.
Day after day we get slammed at the same time, we don't have the proper staffing, we rack up overtime and get our hands slapped for it, like we are incompetent or something.

-- Security. I never thought about it much before, but I'm becoming more aware of security lapses in the pharmacy and no one else seems to care. It costs money to beef up security, so it's not something I can do without the company's help. I really don't want us to learn the hard way.
I'm trying to figure out how to approach this without stepping on anyone's toes or sounding alarmist. But I'm going to keep at it.

-- Getting fired. It actually happens! We've had two support staff members get fired in the last couple of months. You would think people want to hang onto their jobs right now, but apparently the mere threat of firing wasn't enough for these two. I'm glad someone in the company actually has the balls to do it, but there are still other people who inexplicably get a pass.


Sunday, January 8, 2012

Happy New Yea------- Oh, wait.

Aw yuck. What a hellish "new year's week" it was.

It included a major software change in the way we submit on-line claims to insurances. The end result, in a nutshell, is that there are approximately 1,000 new and different ways for a claim to reject, and I think we saw every one of them.

It included the usual insurance plan changes for customers, with the associated freak-out when
their new copays were revealed to them at the cash register. "But I've always paid (X) dollars!!"
was #1 on the week's hit parade. #2 was, "I don't have a deductible!!" followed by a grumbling
return later in the day, after they had called their insurance company.

It included one of the major corporations in town switching to a new pharmacy benefits card.
I don't even work for them, and I knew about it months in advance. These employees are educated, white-collar workers -- some are even health care professionals. Do you think even ONE of them had the card with them when they came in? Do you think the majority even understood that the benefits they signed up for during open enrollment screamed "CHANGE" ? Alas, no.

And of course it included the transfers out of Walgreens for Express Scripts customers. Most of the Walgreens I called had a message asking me to leave the information for the transfer and they would fax it to me. However, since no one plans ahead and many people wanted it while they waited, I had to ask to speak to someone right away. To my surprise, all the Walgreens pharmacists I talked to seemed pretty darn nice about it. I can't imagine how they are dealing with all that.

It also included assorted other computer glitches I don't even want to get into.

One of my co-workers said she felt like crying. Me, I had to fire up the ol' cocktail shaker
at the end of the week. Simple, yet effective.

We shall steel ourselves for the week to come.