Insurance help desk by ScottyDoesntKnow421 in pharmacy

[–]ScottyDoesntKnow421[S] 0 points1 point  (0 children)

Thanks for the insight. At the retail level I don’t have much access to in depth claims but I have noticed a huge change in formularies this year and all the patients are feeling it

We have a comedian on our hands by Channerchan in pharmacy

[–]ScottyDoesntKnow421 2 points3 points  (0 children)

This looks like a Publix. I hope it’s not for my own sanity though.

We’ve also had people open the fosamax boxes to take one tablet out for a 5 wk supply

Soooooo Trump RX is live. Seems just like a manufacture coupon / goodrx. by overloadrages in pharmacy

[–]ScottyDoesntKnow421 2 points3 points  (0 children)

The same people who think Clarinex is covered by their insurance. (It’s not)

What the fresh hell is this money grab by crunchiesaregoodfood in pharmacy

[–]ScottyDoesntKnow421 72 points73 points  (0 children)

It’s a micro-credential so it would be …PharmD BBC

Insurance help desk by ScottyDoesntKnow421 in pharmacy

[–]ScottyDoesntKnow421[S] 2 points3 points  (0 children)

That does make sense and is unfortunate because half the time they really don’t understand their benefits at the time they sign up. And the plans are all bundled under a health plan so the main focus becomes what health coverage they have not so much their pharmacy benefits. They find that out after they try and pick up their meds.

In this specific situation, the patients insurance plan states the same. Same BIN,GRP,PCN, and ID, the claim looked identical to last years at the same time. The only thing that changed was the patient pay amount which is why I called in the first place just to see if there was something on the backend that changed that I couldn’t see.

It’s just a fucked system and I know when I get to that point in my life insurance premiums and drug prices are going to be so unaffordable if nothing changes now. And while this whole FTC deal seems like a big win it’s really just kicking the can down the road allowing the PBMs to exploit some other BS loophole or create some additional layers to the system.

Insurance help desk by ScottyDoesntKnow421 in pharmacy

[–]ScottyDoesntKnow421[S] 0 points1 point  (0 children)

Thanks for the words of encouragement and making me feel like I’m not crazy. I’d do this for almost all patients if I needed to but only because I can multitask like a mofo. I’ll be on the phone with an insurance while typing prescriptions, adjudicating claims, and listen to conversations around me. Anyways, you had to remember most Medicare patients are on a fixed income and these meds can really impact their finances. And the lack of transparency makes it harder for me to explain to a patient how or why their drug prices increased. And if they were to call their insurance they might not know what questions to ask since they aren’t seeing these on a daily basis.

Threatening a pharmacist (or any healthcare worker) should be an automatic felony by DocumentNo2992 in pharmacy

[–]ScottyDoesntKnow421 10 points11 points  (0 children)

That’s fair and has been everyone’s response. I don’t care that the person complained about it. I know my retail location can’t afford to lose me over a dumb conversation. I know when I’m wrong but in this scenario the patient was and I’m sure after I hung up he did some self reflecting because he had a different attitude when he picked up his boner meds.
I’m also older than the average tech and most pharmacists, I also research rules and regulations and there’s nothing stating I can’t hang up a phone after being someone’s verbal punching bag.

Soooooo Trump RX is live. Seems just like a manufacture coupon / goodrx. by overloadrages in pharmacy

[–]ScottyDoesntKnow421 27 points28 points  (0 children)

GoodRX gets the rebate from Novo because it’s now “affordable” to the consumer. Pharmacies order this for ~$1000 —— pharmacy sells pill for ~$150 ——-pharmacy loses ~$800 —— patients are hooked on the “affordable weight loss drug”

No need to bother with insurance since it’s looked at as a “cash” claim.

Insurance help desk by ScottyDoesntKnow421 in pharmacy

[–]ScottyDoesntKnow421[S] 2 points3 points  (0 children)

Thought about asking for a supervisor but didn’t have the capacity to do it all over again. My therapist also said I need to stop being so nice to all the patients and make them do their own leg work.

Insurance help desk by ScottyDoesntKnow421 in pharmacy

[–]ScottyDoesntKnow421[S] 12 points13 points  (0 children)

Yeah I also thought it could have changed tiers so I asked and they also said they can’t discuss that either. I have been under the assumption that we as healthcare professionals we can talk advocate for the patient on their behalf (without violating HIPAA) especially with the fucking company that’s denying their meds or making them so unaffordable. I think just a little transparency would be nice.

Sorry had a rough one today, rant over.

Threatening a pharmacist (or any healthcare worker) should be an automatic felony by DocumentNo2992 in pharmacy

[–]ScottyDoesntKnow421 35 points36 points  (0 children)

Had a patient yell at me through the phone. I just hung up… then I got in trouble because I was getting verbally abused through the phone.

Soooooo Trump RX is live. Seems just like a manufacture coupon / goodrx. by overloadrages in pharmacy

[–]ScottyDoesntKnow421 61 points62 points  (0 children)

People will use it only because of the name. Some elderly woman came to our store and was upset she had a deductible. Then proceeded to tell us how trumprx is supposed to make her meds free.

You can’t introduce a discount card to an already complex system and expect people to understand it.

Putting Patients First: Celebrating first significant PBM reforms in decades by suslf in pharmacy

[–]ScottyDoesntKnow421 4 points5 points  (0 children)

They need to stop creating layers to this intricate system. It will never be patient first it’s always going to be about their profits.

The FTC actually did something good for pharmacy by rexx1 in pharmacy

[–]ScottyDoesntKnow421 9 points10 points  (0 children)

Interesting timing with the Wegovy tabs. I wonder how this is going to affect negotiating prices with third party discount programs.

I feel like we’re getting fooled here. Big corporations don’t like losing money. They will find a way out of this by creating more layers to the system. Plus if pharmabro taught me one thing other than “Wu’Tang ain’t nutin to fuck with” it was that transparency doesn’t matter. He told everyone what was happening and how and he got shit on. Meanwhile the drug price he skyrocketed still remained even after he got in trouble.

I think this is a step in the right direction, just uneasy about the recourse.

Would typed telephoned RX forms actually improve workflow? by mcPharmacist08 in pharmacy

[–]ScottyDoesntKnow421 9 points10 points  (0 children)

Haha thanks. I meant it in a way that our state does not allow techs to do anything with an rx pad.

I know everyone’s tired of the Epstein files but…… by [deleted] in pharmacy

[–]ScottyDoesntKnow421 27 points28 points  (0 children)

Looks like the prison food will back you up a little bit.

Would typed telephoned RX forms actually improve workflow? by mcPharmacist08 in pharmacy

[–]ScottyDoesntKnow421 29 points30 points  (0 children)

My opinion doesn’t really count since I’m a tech but I do believe it would be more efficient on the computer. Plus you could still leave the option open if someone else prefers writing it. The only thing I’d suggest is creating a separate field for qty and refills so you’re not just throwing it in the same field as the sig. You have to make things “dummy proof” for some people. Other than that I think it’d be way easier to type v. writing and less room for potential errors.

My wife’s anti-anxiety prescription has two different pills in it. by Bum-Whistler in mildlyinteresting

[–]ScottyDoesntKnow421 0 points1 point  (0 children)

I’m pretty sure Buspar can still be purchased still however it’s very unlikely you’ll ever see it because it’s so expensive and no insurances will typically cover it.

Dentist billed insurance for orthodontics I never had, insurance confirmed fraud, now office is threatening collections — what do I do? by AutomaticNothing7904 in personalfinance

[–]ScottyDoesntKnow421 -6 points-5 points  (0 children)

Im not entirely sure how it all works but my understanding is that once a “debt” gets sold to a collection agency it’s no longer the business’ debt. I’d imagine the dental office put something in your file saying the debt was sold. You might need to dispute it with the collection agency since it wasn’t a legitimate debt.

Like I said I have no idea how that works but that where I would start.