The Angry Pharmacy Girl?

I hate all people.

Okay, not all. But most.

Especially today.

A woman called me on the phone. Here is a recap of the conversation:

Bitchy Woman: “Hi, my mom has Insurance X and her doctor is going to write her a prescription for Protonix. Is it covered?”

Pharmacy Girl: “I don’t know. I don’t have the formularies for every single insurance plan memorized.” (I might have had a not-so-nice tone there, because I think it pissed the Bitchy Woman off.)

BW: “Well, can’t you just run it through her insurance?”

PG: “No, not without a prescription. I suggest that you call the number on the back of the insurance card and ask them if it’s covered or not. Either that or have your doctor write the prescription stating ‘Protonix OR omeprazole OR Prilosec OTC’ so we can fill it for whichever medicine in that class that is covered.”

BW: “No, it has to be Protonix.”

PG: “Well, I guess you should call Mercy Care and ask them if it is covered.”

BW: hangs up on me.

Seriously, do people expect pharmacists to be insurance experts? There are thousands of insurance plans, and frankly I don’t have the brain power or desire to learn all of their formularies. I think people should feel lucky that I am even able to bill their insurance with the bullshit information I usually have to work with.

For example:

Dumb Patient: “I lost my card. But it’s Blue Cross of Norway or something.”

Pharmacy Girl: “I need a little bit more than that. How about a phone number?”

DP: “Maybe it’s Blue Shield. I don’t know. But I won’t pay more than my prescription is supposed to be with insurance, ten dollars.”

PG: “I can’t bill your insurance without more information than that.”
But magically, I do. I randomly call Express Scripts, Wellpoint, WHI, Medco, Argus, Cigna, Humana, HealthNet and Caremark and have them do a name search. I eventually get the prescription to go through. This isn’t what I went to pharmacy school for. Patients expect me to have infinite knowledge of insurance, not drugs.
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This morning I had a STACK of prescriptions dropped off for a new patient. On Mercy Care. Hospital discharge orders…..urgh. The signature on the prescriptions was illegible, just a squiggle. How the hell do these doctors think I’m supposed to figure out who the prescriber is? There is a reason on those scripts that there is a line that says “PRINT NAME HERE.” Or if you just wrote down your DEA number, I would have a way to find out that the squiggle on this prescription means Dr. Parikh, or whoever.

Anyway, hospital discharge orders are the worst. They are usually written by residents or hospitalists, both of which don’t understand the dilemma that is insurance. Or how to write a complete drug order. Of the 14 prescriptions for this patient, I had to guess on a lot of what the doctor wanted. Dr. didn’t include a quantity on Reglan, I just gave a month supply (all the other prescriptions were written for a month…). Dr. wrote for Aggrenox, which isn’t covered. Good luck getting ahold of the prescriber on a Saturday, so I just sent a fax to the primary care doctor letting them know what the hospital doctor wrote for, and that it wasn’t covered so the primary care doc can change it or do a prior authorization. One of the prescriptions was for Renal Vitamins, which weren’t covered on the insurance. I just am going to make the patient pay for those ($7.99) because I don’t think the doctor can even do a prior authorization on that vitamin.
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I also had a patient drop off two prescriptions and want them both. One for Tylox (oxycodone/APAP 5/500) #60 from a doctor in Phoenix and one for Percocet (oxycodone/APAP) #90 from a doctor in Tucson. The Tucson doctor didn’t include which strength of Percocet to dispense (it comes in 5/325, 7.5/325, 10/325, and 10/650) on the prescription. I told the patient that the prescriptions were virtually for the same medication and I would not fill them both. He wanted the Tylox prescription back, but I didn’t give it back before I wrote “filled #90 Percocet 12/8/07″ on the face of the prescription with my pharmacy name and phone number.

I dispensed #90 Percocet 5/325 to the patient and sent a fax to the Tucson doctor asking them politely to include a strength on future Percocet prescriptions (and told them what I dispensed), and alterted them to the fact that the patient is also seeing a doctor in Phoenix for Tylox prescriptions.

All in all, a frustrating day. After such a rant, you are going to have to start calling me the Angry Pharmacy Girl