Sunday, February 23, 2014

DEALING WITH IDIOTS...My Blood Pressure Is Rising!

Warning!  This is a rant!  If today you happen to be dealing with your own difficulties, you may want to avoid this post!

IDIOTS!  When my son was young he used to listen to some punk rock group that sang a song about the world being taken over by idiots.  SO TRUE!  Back in December I called to set up an appointment for my MRI.  The girl on the phone told me I had a $25 copay.  I told her that I had already verified with our insurance company that we do not have a copay.  Quite nastily she informed me that the computer said I did...therefore I would owe $25 at the time of service.  I informed her again, more loudly I admit, that we do NOT pay copays on MRIs and I would NOT be paying $25 at the time of service.  She said, "We will see when you get here".  Long story, short...we don't have copays for MRIs and I did not pay. 

Fast forward a little less than two months and Dear Hubby went to have his MRI.  When I scheduled his appointment the girl on the phone did not mention a copay, so I figured the "computer" picked up correctly that our policy did not have copays for that service.  Idiot.  ME, that is.  I should have figured there would be a problem.  Computers and their GIGO (Garbage In, Garbage Out)!  This morning Dear Hubby hands me a receipt for his $25 copay at the MRI place.  Grrrrr.....  Now I will have to fight to get the hospital to refund the money to our Benny card.  I can't have it sent to me, or I will have to send a check to our Benny card administrator.  This should be fun, NOT!

On January 10th I asked our Endocrinologist for new prescriptions for four of Dear Hubby's medications.  A week or so later there was no record of the prescriptions on our mail away prescription website, so I called the mail away pharmacy.  No, they had no record of the prescriptions...but when you talk to the doctor's office have them fax it to XXX-XXX-XXXX.  Fine.  I called the doctor's office and, YES, they faxed it.  They even had a confirmation.  I asked them if they would please fax it the number the pharmacy had provided.  About 30 minutes later I got a call from the doctor's office confirming they had faxed it to the new number and they had a confirmation! 

Fast forward to this morning.  Dear Hubby informs me that he has less than two weeks of one of his medications left.  Shouldn't we have gotten the prescriptions by now?  So I go online to look at when they were shipped.  NO RECORD OF THEM IN OUR ACCOUNT!  I called the mail away pharmacy and they have no record of the prescriptions.  AGAIN!  How in the heck can these IDIOTS lose a prescription that was faxed to them?  TWICE!  I told them I will contact the doctor's office tomorrow and have them call in the prescriptions (AGAIN)...and that at they had better be over-nighted to our home because my husband is so low on meds.  And I'm not paying for the over-nighting as these prescriptions should have been filled weeks ago!  The customer service rep tells me to get the doctor to call a small prescription to our local pharmacy and pick it up there.  Okay.  I REALLY lost it with her.  Why on God's Green Earth should I have to get over to the pharmacy to pick up a prescription because they screwed up TWICE?  We are supposed to be getting more snow and if I'm not feeling well I'm not going out in it!  I informed them that they had BETTER over-night it free of charge...OR ELSE! 

I will be making several phone calls tomorrow:
  1. Telling the hospital they need to credit our Benny Card with $25 and fax me proof of the credit...
  2. To the doctor to BEG them to put up with this "happy horse shit" (as my dad would say) one more time and CALL Express Scripts... and ask them to fax ME a copy of the paperwork from the last two prescription attempts so I can take this further...
  3. To the Better Business Bureau to file a formal complaint against Express Scripts...
  4. To the Attorney General to file a formal complaint against Express Scripts...
  5. To my husband's employer to file a formal complaint against Express Scripts... 
For the first four years we have had mail away coverage through Medco.  In all of that time we never had so much as one glitch.  Then Express Scripts bought out Medco.  When I informed our physicians' offices of the change, the office staff people wished us luck.  I guess they knew from experience just how BAD Express Scripts can be.  Me?  I have no understanding of, or acceptance of, such shoddy practices.  These medications are what are keeping people ALIVE!  Between Dear Hubby and I we are on over 20 medications.  The amount of money our insurance company pays Express Scripts in primary coverage and the amount of money WE pay in copays is astronomical.  Two of my medications alone have $100 copays, and it would probably be more except our policy has a cap at $100 a copay!  Now multiply that by tens of thousands of people in my husband's company alone.  And Express Scripts, since buying Medco,  is probably one of the largest mail order pharmacies in the US.   They are "making BANK" as J would say!  For that reason ALONE we deserve better service! 

Okay.  My rant is least for today.  I think it is time to sit in my rocker with my cup of hazelnut coffee and attempt to "chill".  Breathe deep...breathe deep...


  1. Girl, You Rant because you have a reason. I have worked in the medical office, I am a certified billing coder and medical asst. Many times I was put in positions to do task I was not qualified for. This office probably didnt use an actually fax machine, it was a computer fax.. Lots of space for error. My favorite one is when my doctor office told me to have the pharmacy to call for refills, Ok, this is a RX he has never wrote, ( thats against the law) , I have Caremark, which is CVS so I dont have to get mail order anymore, but they will argue about that, that is a technician will. Always ask for the Pharmacist, The Doctor, or the office mgr and take names. Your right about reporting, The Govt is pushing on Drug Companies, which effects us, Office staff is paying for cheap inexperienced help because they have to pay for electronic medical records, and insurance and etc.. which in turn makes us a patient sicker, I have become disable and I love listening to some of the offices tell me what is right and then I tell them what their going to do. I wish I could tell you in so many words about the stupidity I ran into last week, well it had to do with Labs, No one could find them, I stood in front of the office and solved the problem for them, They looked like asses..... The doctors need our business to pay their bills dont be afraid to ask to speak with the Office Mgr or the Doctor . Everyone one has a Customer Service #. Take names and No shit..

    1. You and I have very similar backgrounds! I worked in the medical field from 1979 to 2011 when I went out on disability. In that time I was an office manager, did medical billing for 12 years, a medical records manager and ran my own medical transcription business! Unfortunately, you are correct...many physicians cannot afford to hire really qualified help because they must spend so much on malpractice and electronic medical billing, etc. Plus, insurance reimbursements continue to go down. Our medical in this country is being controlled by administrative people who don't know the difference between a stethoscope and a speculum...and our government is allowing them to determine pt care...without a license! I am SO tired of fighting the errors, oversights and stupidity. But, we are entitled to those husband needs them...and by golly I'm going to GET them!

  2. I'm sorry ... I went round and round with my doctors office and the insurance company last year over proof of some stupid mandated "wellness program" ... ended up finding a supervisor at the insurance company who helped me straighten the mess out. My advice, after the first round, go directly to a supervisor.

    1. I'm HOPING it is all straightened out. I have to call Express scripts today to make sure they have record of the prescriptions the doctor's office called in yesterday. Then I have to call the doctor's office because I asked them to fax over the prescription and confirmation from January 19th so I can follow up on the problem at Express (this is NOT over). Between the prescriptions, the overpay in co-pay, and setting up appointments for my yearly GYN appt and mammo...I spent FOUR HOURS on the phone yesterday. Yes, FOUR HOURS. Why does everything take more than one phone call? Transverse through four different departments by pushing buttons before you finally get to right place, leave a message stating the patient's name, DOB, telephone number, etc, then a person calls and you review everything you left on the answering machine, they hang up to "check into it", they call you back for more clarification of what you said previously TWICE now, they say they will call you back when they have an answer, they don't, you call back and get someone DIFFERENT and the whole process starts over again! And I am so SICK of being "pre-registered" for my mammo, my appointment with my gynecologist who has just joined another practice, etc., etc., I swear I will leave my WILL to a company who still uses a human being to answer the phone and doesn't need to enter your entire demographic history into the computer before they can help you, lol.

  3. Were you able to get things all sorted out?

    1. Yes, Yesterday my husband's prescriptions were listed online and scheduled for delivery today and just about 30 minutes ago I got a call from the hospital billing department that they were posting the $25 refund to our "benny card". Two more things I can cross off of my "handle" list!