You Have Been Rejected!

Rejection Is Never Fun

Boys can be cruel but being rejected by your prescription plan can be wose. There are a few little trick that can help.
 Let's say you call up your local pharmacy and give them your insurance information. The customer service representative usually tells you that they will call you back to let you know if your insurance goes through. And of course when the calls comes, they tell you that your insurance rejected your request for coverage. The customer service representative proceeds to tell you that if you want to pay out of pocket the cost is $100.

There you are thinking of every expletive in your vocabulary that you could possibly fling at the money grubbing companies that put such a hih price on vital medications. They must know you cannot afford to pay it. The pharmacist will get an ear full from you but what will that help? What can he do? It's your insurance company that doesn't care about your well being. How could they?  It's like that costly insurance bill you pay every month doesn't mean anything to them. You were just rejected by them and they don't even know anything about you. All you are is numbers on a page and dollar signs that are too low for them to care.

Pharmacy technicians deal with insurance rejection constantly. Calling that sweet old lady to tell her the $100+ prescription isn't covered is possibly the worst part of the job. As we are a compound pharmacy, sometime insurance companies do not cover compound medications. Our pharmacy does its best to work with the patients and the insurance companies to find the best possible solution. It always helps to understand the full process when there are so many parties involved. Here's what we do in a few easy steps.
Once the pharmacy receive the prescription from the doctor's office we call the patient to get more information. We alway need to have:

• name(confirm spelling)
• phone
• date of birth
• physical address
• allergies to medications (if any) 

 Once the patient tells us we have okay, we get their insurance information. We need different numbers from you prescription insurance card than what you usually give for medical coverage.

• BIN
• PCN
• ID
• GROUP 

Once we enter their insurance information into the system, we will get an acceptance or rejection. Depending on the reason for rejection, we either call the patient or the insurance. If our rejection states it is because it is a compound there is nothing we can do and the medication will have to be paid out of pocket.  Patients often have the misconception that pharmacy technicians do not care if a patient's medication is covered. We know the importance of having the proper medications to treat illnesses and diseases. And it's in our best interest as well as our patients' to try to get the prescription covered. We strive for a good relationship with our patients and we don't want you to pay more than you have to. I know first hand the importance of having the right medications because I have struggled to get my medication covered as well. It's infuriating when the medication to make your life so much better is only accessible at a very high price. One of our pharmacy technicians has explained to me that she never enjoys telling a patient their meds won't be covered.

Karli Klar CPhT

Karli emphasized when I asked her how she deals with rejections

"Every patient's insurance plan is different, it is very difficult to tell whether any particular plan will covered non-formulary drugs or compounds or a lot of our specialty items... I hate to see a customer upset because of a high deductible or difficult insurance representatives."

At our pharmacy, we pride ourselves on serving our patients well and making sure they have the right medications. We do the best we can at working with the insurance companies to ensure our patients they receive the medication they need. Rejection is not an easy task and not something we enjoy here at our pharmacy. So, the next time you get rejected for a pharmacy please know that it is not always easy for the pharmacy technicians to deliver the bad news. 

Jennie-Undercover For Your Everything Pharmacy

Good OR Free; Never Both

In My Experience: Free is Never Better

Have you ever had to deel with bad healthcare customer servicae whether it was from a pharmacy. free healthcare or healthcare at a private company? I currently have the terible free healthcare, but I am in the proces of switching over to a private company. A few medications that I currently take need refills. I called up my county clinic to make an appointment and they warned me they are booked up to June.  I asked to speak to someone who could help me get my prescriptions because at this point I had no refills left. The customer service representative tells me to call back the next morning and to speak with a specific person.

The next day, I call back, they transfer me... no one answer. I repeat this process three more times with the same outcome. Fed up, I call back and tell them I need to talk to someone. I get transferred. I tell this technician what prescriptions I need and she puts me on hold for ten minutes. After a few more transfers and explaining my dilemma to a few more snarky receptionist and waiting on hold for 10 minutes, someone answers and says,"Is this Suzanne?"

For the fifth time, I told her my name and briefly described why I was calling. She asked what prescriptions I needed and that she'll have to call the pharmacy. How many more people will I have to deal with just to get a refill? This is a nightmare. But that's what I get for signing up for free healthcare. Finally, after another ten minutes on hold she tells me that I can pick up my prescriptions at the pharmacy. After spending an hour and half on the phone, I was irate and outraged by the horrible customer service this clinic had.

 No one should be treated this way no matter how free the services are. I have seen incredible technicians help customers and meet their needs without being rude or placing customers on hold endlessly. 

Technicians ought to be there to help the patients, and find the best price for them. It's not only good manners, it's good for business relations. As I work, I hear the technicians typing away behind me and chattering pleasantly on the phone. They are always helpful, cheery and incredibly patient. They always seem to go the extra mile to see that the customer is taken care of. I respect and admire that they all maintain the same sweet, understanding manner on every level from pharmacists to clerks.  Our head technician, Ren overheard how long I was put on hold. She was shocked and told me she would never treat patients the way my free health center was treating me.

This experience has taught me that not every company believes in helping their customers or providing superb customer service. I don't know about you but I think I would rather pay through the nose, if I had to, for a company that actually cares. I won't be giving them my time or my business. As a marketing director for a pharmacy, I know the importance of customer service. How can you be proud to work for a company that doesn't do it's very best to help it's customers and make a difference in people's lives?

Jennie-Your Undercover For Everything Pharmacy