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Wednesday, August 25, 2010

We Need to Work on Our Communication

One of the important players in my D-management team is the pharmacy.  I see these folks more often than I see my endocrinologist.  I'm on my 3rd pharmacy since my diagnosis, and each one got so used to seeing me that they automatically looked for my name when I walked up.  It's really important to know your pharmacy and how they handle frequent patrons.

And I really like my new pharmacy.  The staff there is always friendly, and if I don't have time to wait around for my prescription, they call me and let me know when my stuff is ready.  And they are willing to call my doctor on my behalf for prescription request; however, my endo has a "the patient must call for all prescription refills" policy.  So I have to do this myself.

Well, this week I had to get a new prescription refilled for my testing strips.  The way my doctor writes my Rx is in terms of number of times per day that I test (he writes it as 5/day, but it's more like 6-8).  It's a lot easier for my pharmacy to fill my Rx in total number per month, which I ask to be 200.  The past few times I've had a new Rx filled for strips there has been some confusion in how many my doctor writes and how many the pharmacy fills.  Inevitably, I have to call my endo's office and tell them, "Just write it for 200 strips, please."  Plus I get a $10 Rx refill charge everytime I have to call and straighten out this confusion.

So, to avoid this confusion, at my last appointment in June I asked the nurse to have my endo just write it for 200 then and there.  "They won't fill that," she retorted.

Me:  "Yes, they will.  I know they will.  They've been filling that for the past 4 months.  And I know my insurance is OK with that."

Nurse:  "OK, but the doctor will have to write a special Rx for that."

Me:  "That's fine.  That's what I want." 

My endo is always happy to oblige my requests if it means more control for my diabetes.  But the reason the nurses are always hesitant is because most insurance companies view 200 strips per month as a too many and can cause issues for refills.  Well, my insurance company never gives me any issues with this request because my insurance is awesome.  The copay is the same for me whether I have 100 or 200 strips per month, and every time I have to remind the nurses of this. 

So, armed with what I thought was my problem-free Rx refill from my endo, I run by the pharmacy after work on Monday.  I needed to get a refill on strips before our anniversary dinner.  Well, the pharmacy gives me the same song and dance about how they can't refill something based on number of times per day, so they'll need to have my doctor call.  The problem with this is that it was already 4:30 PM and my doctor's office is closed.  "Ummm, well I'm out, like completely out.  Can you guys give me a loaner vial and take it out of my future refill?"  "Sure, we can do that."  "Thanks."  Like I said, I really like my pharmacy.

We go to dinner with 2 loaner vials on hand, and yesterday I called my doctor's office and told them what was what.  "Just tell them 200.  They've already given me 50."  "OK, I'll call that in right now," the nurse said.  "Thank you so much!"  "You're welcome, hun."  A few hours later I call the pharmacy and make sure the Rx went through and the tech told me, "Yes, we have that ready."  "Awesome, can I also get my insulin refilled while I'm there?"  "Sure, we'll do that."  "Thanks."  *click*

Unfortunately, my day got worse after that phone call.  I went to my softball game at 6:15 PM and played like a schmuck.  We were in the playoffs and one game away from the championship.  I missed 3 throws at first base, and made 2 stellar pop-ups in the infield at my only two at bat.  We lost the game 18-11, and I felt the whole weight of the loss on my shoulders.  Then, I still had to stop by my pharmacy before heading home.

Sweaty, down, and sore, I drag myself to the counter and said my name.  "Here you go, 100 strips in addition to the 50 we've given you makes 150 strips."  "It's suppose to be 200."  "Your doctor's office said you requested 150."  "No!  I said 200!  Is the copay the same?"  "Yep, do you wanna wait until tomorrow?"  "Yeah, I guess so.  *on the verge of tears*  This is so frustrating . . . "  I drove home wiping tears from my face.  It's really nothing worth crying over, but the constant frustration with this seemingly simple Rx request combined with my less-than-stellar softball game had just pushed me pass my breaking point. 

I walked in the door, crying, and said to Trey, "What is so confusing about the number 200?!  It's a two with two zeros behind it!"  "Same issue?" he asked.  "Yes."  "I don't know why they can't get this right."  "Me neither, it's so frustrating."  I sulked off to take a shower, beaten with the idea of having to call my doctor, again, and going by the pharmacy, again. 

*fast forward to this morning*

I just got off the phone with my endo's office, and she said, "Well, I thought giving you 150 would be enough of a cushion?  There's 30 days in a month, and if you're testing 4 times a day . . . "  I cut her off, "No, the actual prescription refill was written for 5/day but it's more like 6 times, and if I have a low or a high I need to correct then I'd rather it just be 200 . . . please."

Nurse:  "And your insurance will refill that?"

Me:  "Yes, they've never given me an issue."

Nurse:  *clicking on her computer*  "OK, 200 strips per month for 6 months.  Will that work?"

Me:  "Yes, that would be great!"

Nurse:  "Alright, I'm sending that in and let me know if you have any more issues."

Oh, this whole situation has been an "issue".

4 comments:

  1. I so hear where you are coming from.Refilling strips is always a pain in the rear for me too. For me the Dr.'s office is great, it is the insurance that thinks I should only test 3/day. So annoying. I hope they get it worked out for you and that you won't go through this again.

    ReplyDelete
  2. Ugh. This is exactly why I went on mail order.

    Oh! And, I thought you should know that Constance is about to become a Mom. :) (i.e. my Dexcom shipped today.)

    ReplyDelete
  3. @Fiona: Yay yay!!! I hope you enjoy yours and find it as beneficial as I am. How do you get on mail order? Because since this shenanigan happens everytime I need strips, I think it would be worth it. Either reply back or email me at arnoldandme at gmail dot com. =)

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  4. That's really weird with your pharmacy. I now have my strips refilled with my pump supplies from Minimed, but I've never had a problem with a pharmacy just "working the math" - script says X number of tests per day, that works out to X number of tests per month, which means X number of strips per month. We have really good insurance, too - THANK GOD.

    ReplyDelete

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.