annoying pharmacy- kinda long

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merrygirl
Veteran Member


Date Joined Jun 2007
Total Posts : 702
   Posted 2/20/2010 4:42 PM (GMT -7)   
I have been going to a large chain pharmacy for many years. they do recognize me, but I never feel like they "know" me.

I have had the same major insurance for about 5 years. My meds cost me 25% of their value.

so as an example my fentanyl 50mcg patches copay is 63$ every month.

I was eligible for medicare last fall. I accepted and pay for that every month. I became eligible for medco medicare rx coverage in January. I did not have to pay for that as I qualified for assistance.
So when I got my card for medco, I brought it to the pharmacy to get the info entered in the computer so that when I had an rx it would be all set.I knew it wasnt normal when at the time, the associate acted like my secondary insurance was from Zimbabwe. She was like "I guess I will enter it in" and well see what happens... well I kept filling rx's and they were all the same usual price. I am pretty broke, so I was bummed out that this secondary insurance was not helping. Finally today I went to pick up m y patches and they were again the usual price. I pulled the pharmacist aside and asked her what the deal was, and she said she had no idea and call my main insurance carrier for questions.

I was a little peeved and disapointed that this person could not help me nor attempted to dig deeper for me. I payed the 65$ and went home. I called medco and the operator told me that they havent been submitting claims to them at all!!!! not even attempting to put it through! She said my patches should have cost $2.50!!!!!!!!!! What a huge difference. I called the pharmacy and spoke with the pharmacist again. She said she would try to put it through and it did. It came up as FREE, no copay.

So this pharmacy refunded my money. I asked her to try to put another one through that I had picked up the same day and she said it wouldnt, but I dont think she even tried hard. The pharmacist said that I needed to tell them what ins to bill? I thought t his was really wrong. My problems are that for 2 months I have been paying more than I should have. I am also annoyed that I am the one that had to figure this all out. I know that they have a huge clientel but I want to be treated like the only customer that they have when I am there or need something. I shouldnt get the feeling that I am bothering someone to get help. I spend thousands on rx's alone. So my plan is to call and speak to the head pharmacist on monday and see if I can get this straightened out. I may also change my rx to a small local non chain pharmacy. the problem I see with them is that they do not keep convenient hours, they will have to order a lot of things, and may cost more. But I am thinking it would be worth the extra few dollars. What have other peoples experiences been with pharmacies?
I am also reluctant to change for the shear aggrivation of transferring a million scripts to a new pharmacy.

SO in a way I am relieved that my meds will cost less. but I am super annoyed. Unless they offer me something
I think I am going to a new pharmacy. thanks for reading if you made it this far!

melissa
Chronic Lyme Disease,Fibromyalgia, CFS, PCOS, sleep apnea, hypothyroidism, type 2 diabetes, bulging discs to name a few


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 2/20/2010 5:00 PM (GMT -7)   
Melissa,
I had a similar problem with a large pharmacy -- though in my case the first error was committed by my evil drug insurance company. I learned that the people who work on evenings & weekends have no idea how to reprocess a claim for payment. I was totally given the run around & they called my PM after hours to report that I was trying to fill a second prescription of Actiq. That was totally untrue. All I was trying to do was get the refund that was owed me due to the problem with them not getting all the money from my insurance company that they should have.
The person who processed claims only works M-F 7AM-3PM. I don't know, but they told me that was standard practice for their chain. You might try calling again on a weekday late morning/early afternoon to ask who can reprocess your claim with the insurance company. If they can't get you the refund you are owed for the past 2 months, call your insurance company while you are at the pharmacy & ask for their help. Sometimes they are better at explaining things.

Personally, I've had really bad luck with the smaller pharmacies. There aren't a lot that are in-network for me & those that are have on multiple occasions given me products that were on the verge of expiring (for example, I filled a script on 31 May 2009 & the expiration date on the package said May 2009). The last straw was when the compounding pharmacy I went to was closed down by the DEA because they were filling C2 medications after the 7 day state limit & were back-dating their records. Sure, the people there were nice & they remembered my name, but it just wasn't worth it to me. But every area is different & maybe the smaller pharmacies are better out by you.

Still, you are absolutely right to demand a refund & better service going forward. I feel really bad that you've had such horrible service from them. It's such a hassle to have to spend precious energy chasing down insurance & billing people & doctors & everyone else because of mistakes that should never have happened in the first place.

wishing you luck with everything,
frances :)

merrygirl
Veteran Member


Date Joined Jun 2007
Total Posts : 702
   Posted 2/20/2010 5:04 PM (GMT -7)   
thanks so much! GOsh I am sorry that happened to you! I never thought about a pharmacy being in network. that may really affect my decision.

thanks for bringing it up!

so much to think about

hugs,
melissa
Chronic Lyme Disease,Fibromyalgia, CFS, PCOS, sleep apnea, hypothyroidism, type 2 diabetes, bulging discs to name a few


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13478
   Posted 2/20/2010 5:29 PM (GMT -7)   
Merrygirl I use a large chain and have for years because it is in network too. But the scripts are done electronically and rarely do they ever have to call the company unless something is kicked back that shouldn't have been. What I don't understand is when your name was put in the computer both companies should have popped up at the same time. I use discount cards with some of my medications that come from the drug companies and it reduces my co-pays. These cards are entered into the system like a secondary ins. If you remember what the clerks looked like that waited on you during these times they need to be reported for not doing their job.

I would be hacked over this like you say money is tight. So, lesson learned here every time you get a script you will have to ask if they billed the 2nd company as well it sounds like. Makes you wonder where they find some of these people.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/20/2010 5:36 PM (GMT -7)   
Hi Merrygirl,

Sorry to hear about the mixup with them...very frustrating I am sure!!!

I think that our Pharmacist is a big member of our pain management team along with our Dr...whether it be a large chain or small store...it's very important to speak the head Pharmacist...ask their name, how long they have worked there..just some friendly chit chat..introducing yourself...

Then I usually call the day before I go in to pick up my medicine..since sometimes they have to order it, or they will hold it out for me..and say that I am coming in next day...

Each month I go in..I always talk to them..ask how their weekend was...holiday plans...vacation..etc...develop a true friendship with them...it truly can go a long way if their is ever a glitch or you need help..not pretending to be nice..I truly do think highly of my Pharmacist..he is a sweetie!

One thing I have learned from my years mission work is to always use their first name..."Hi Bob...how are the kids?"...

I know this can't take back your issue that you just had and I guess you can find out when you speak to the head Pharmacist whether you'll decide to stay or not...just some suggestions for next time around...

Also..please be sure to notify your Dr. as lots of people..like myself..have PM contracts where we can only go to one pharmacy...just notify them of the change if it happens...

Again..sorry you had that trouble and hope that you can recoup your money!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Dec 2006
 
PM since 2006


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 2/20/2010 5:57 PM (GMT -7)   
Hi, Merrygirl,
You've already been given some good advice, and I think your plan to speak to the head pharmacist is a good one. I think doing it in person, especially the first time, would also be good so they can put your name and face together.

Be sure they participate fully with this secondary carrier. That can be an issue, although it sounds like they do if the billing did get straightened out. If they're a participating provider with both your insurances, and they keep doing this, you can call your insurance company (the secondary carrier) and talk with them about it. The head pharmacist should also know how often they use this secondary carrier, and if it's infrequent they may not have it in their computer system accurately, so that both insurances are billed together. This stuff happens all the time, so I'd be sure you can't fix it before switching pharmacies. If you do switch, like others have said make sure the other pharmacy regularly bills both of your carriers, so you don't run into the same problems.

Good luck!

PaLady

bsjaguar
Veteran Member


Date Joined Jun 2009
Total Posts : 974
   Posted 2/22/2010 4:48 AM (GMT -7)   
Merrygirl, I have medco insurance and also my father has medco. For non-narcotic meds we use the mail-in to save money. I would think this would be available for you too. Do check it out before trying, they have a website for this. All you need to do is have your doctor write your prescriptions for 90 days with 4 refills for a years supply. Then you can go to their website when you are ready for a refill click on the appropriate box and your pills are delivered within a week normally. I use the mail-in for my Neurontin, my husbands BP & sinus meds, and for all of my fathers 5 prescriptions. It is so much easier than going to the pharmacy. Once you get logged into their website you can even print out a fax sheet to take to your doctors office to alleviate sending in a script, the doctors office can just fax it in.

This won't help with narcotic meds because most docs won't write more than a 30 day supply for those but this could be something for you to check out.

I quit using the chain pharmacies because it seemed like they either didn't have my meds in stock or Wal-mart said they had to call the doctors office before filling my script so if it was after 12pm on Friday or the weekend I couldn't get a refill until Monday. Good Luck!!!
---Jag---
 
DDD, osteoarthritis, facet syndrome, fusion surgeries C-5/7 & L-4/5 both in 2006, torn meniscus surgeries left knee 2000 & 2002, buldging disc L-2/3


MIKEL99
Veteran Member


Date Joined Feb 2010
Total Posts : 914
   Posted 2/22/2010 5:15 AM (GMT -7)   
merrygirl , its always a pleasure to read anything you write because you are a great person , besides this site isabout telling it like it is so others can benefit from our difficulties sometimes , so don't worry . I'll just say I hope its straightened out and you get your meds promptly and at a cheaper price .Good luck merry !
HIV+ also Hep c , need hip replacement surgery on hold because of cellulitus  .most pain from hip condition and cellulitus .hands numb may have carpal tunnel syndrome now .             .Medecines - Oxycontin , percocet , Oxycondone , Celelbrex ,Avalox , lasix .


Pommom
Regular Member


Date Joined Mar 2008
Total Posts : 155
   Posted 2/23/2010 8:19 PM (GMT -7)   
I was using a large chain pharmacy. but they were making so many mistakes. so i switched to an  independent pharmacy. the pharmacist is the owner. and he and his staff are super great. i had a lot of prescriptions to transfer. all i had to do was give the new pharmacy a list and they did all the work.of transferring. i asked the pharmacist one time if he knew of anybody who had luck getting ins. to pay for a blood pressure monitor. he measured my arm and said come back the next day.i did, he gave me a monitor free. it was 75.00 at walmart. another time he gave me a travel kit for insulin. it has the ice packs and 2 slots to put insulin bottles in it. the only one of my meds they have to order is the humira and it always comes in the next day.  i couldnt be happier with their service.
best of luck to you.
Julie
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