You’re gonna like this. It’s taken me 6 months of changes between my care giver and the pharmacy getting my prescriptions correct and an ample amount of refills without having to go back to my PA every 30 days for a new ‘script. New policy with my care giver…no new refill ‘scripts without an office visit, that office visit costing $83.
It’s also taken me 6 months to sync all my prescriptions up so that the pharmacy only has to deliver this stuff once a month. There for awhile the delivery kid was out here at least 5 times a month. We were almost on a first-name basis.
So, yesterday morning I called in my prescription. The pharmacy has a call-in option to where you just punch in your Rx number and press 2 for delivery. Usully, if you call in before 10AM the kid gets here early in the afternoon. Not yesterday. In fact, he never came at all. The pharmacy asks that you give them at least 3 days to deliver…in case they’re really busy or something else comes up. I figured, okay, he’ll be here Thursday.
I got off the computer well after dark last night, around 7 o’clock. I wasn’t off the computer more than 5 minutes when the pharmacy called (I only have one phone line and dial-up).
"Mr. Boone?"
"Yes?"
"This is Denise at Crystal Pharmacy, I’ve been trying to get ahold of you all afternoon. In processing your order your Part D carrier, Health Net, has denied your claim. We wanted to inform you that you’ll need a co-pay of $380 when we deliver your prescriptions."
"WHAAAAA? Let me call them and I’ll get back to you, okay?"
Denied my claim? WTF? I didn’t know if Health Net was still open at 7 o’clock at night but I was calling them (they’re in California, as I am). I called and went through the "push-1-for-English-yada-yada-yada" and the voice on the other end said, "We value your call. At the moment all our service representatives are busy. The waiting time for your call will be 180 minutes." NO WAY! 😮
So, I waited. And I waited. And I waited. And both my ears went numb. 2 hours later I got a live voice. It seems that some person at Caremark, Health Net’s claims processor decided to go home early on Monday, marked a glut of files as upgraded for 2010, mine included, and merrily skipped on out the door. That’s why I waited for 2 hours…calls were coming in from everywhere. The fellow on the other end sympathized with my plight of running out of insulin in 2 days and said he was upgrading my account as we spoke–that I should be back in the system by tonight. I thanked him for his efforts and he applauded me for waiting 2 hours on the phone, he could only imagine how many people became frustrated and hung up while waiting.
In retrospect…how fragile this whole thing can become in the twinkle of an eye…:cool: