HELP! starting as a pharmacist at CVS this week!

[maria1oh]

Remember I originally stated just deleting the PRN readyfills and not all of them. The PRN meds like creams are unlikely to be picked up and end up on 14 day return to stock list. Also insurance companies will audit and chargeback if they see an 454 g jar of cream being dispensed every 30 days with no affected area documented or if the area is small. Also the day supply on insulin gets messed up if you are dispensing a full box as 30 day supply even though actual day supply is 50 but you don't believe in breaking boxes and insurance limit is 30 days. Or eye drops with day supply of 50 but auto filling every 30 days on readyfill because insurance limit was 30 days.

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[tryingtomakeit]

Is it crazier than this? That's like 1000+ just sitting in the queue. No amount of damage control can fix this..lol

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[BidingMyTime]

thank you guys, I'm already looking for another job. they have thrown me to the sharks. I'm working 50 hours a week 7 days week and obviously no overtime. they put be in a vacation spot with 1 tech and i did not leave until midnight. I had a good cry and realized its not worth the money. how do you send brand new pharmacists and floater to a busy store with no techs??? i was getting the 20 cars in drive thru, 50 pick ups and drops off and all while I heard "5 pharmacy calls 5 pharmacy calls". Not to mention everything was red, OT,QP,QV and 10 voicemails!!!!!! wtf. i have 2 kids that i never get to see bc i sold my soul to cvs and unfortunately have 250,000 in student loans to pay off......should have been a stay at home mom!

Every potential pharmacy student needs to read your post. Because pharmacy students don't believe that they are FAR more likely to get a job like yours, than to get a job working 09:00 - 05:00 M-F doing strictly clinical work.

California is nothing like the rest of the country for pharmacists.

Yeah, CA might as well be another country.

This is so scary...how can they do this to new grad?? I mean, how much would a tech cost compared to getting so much angry patients and increase chances of making error? What are the managers / corporate thinking?

This is many retail jobs. Even many hospital jobs are getting stressed. Pharmacists these days must be able to run non-stop, handle great stress, and multi-task a minimum of 7 or 8 things at the same time.

 

[ldiot]

Remember I originally stated just deleting the PRN readyfills and not all of them. The PRN meds like creams are unlikely to be picked up and end up on 14 day return to stock list. Also insurance companies will audit and chargeback if they see an 454 g jar of cream being dispensed every 30 days with no affected area documented or if the area is small. Also the day supply on insulin gets messed up if you are dispensing a full box as 30 day supply even though actual day supply is 50 but you don't believe in breaking boxes and insurance limit is 30 days. Or eye drops with day supply of 50 but auto filling every 30 days on readyfill because insurance limit was 30 days.

Would they really chargeback on those eye drop/insulin examples? It's their fault the day supply is off in the first place for requiring 30 days!!! This would seem really stupid.

 

[maria1oh]

If you bill an eye drop for 30 day supply due to insurance limits but it's actually a 60 day supply then the insurance will let you run it through but expects the actual day supply to be documented. If you have a pattern of refilling it every 30 days then yes you will get busted in an audit.

 

[ldiot]

If you bill an eye drop for 30 day supply due to insurance limits but it's actually a 60 day supply then the insurance will let you run it through but expects the actual day supply to be documented. If you have a pattern of refilling it every 30 days then yes you will get busted in an audit.

That's bull****. Where the **** am I supposed to document it at? In the sig?

 

[maria1oh]

Document it with a note in the system or document on scanned hard copy.

 

[ldiot]

Document it with a note in the system or document on scanned hard copy.

Do you actually do this at your store? I'd probably just watch for it at verification.

 

[maria1oh]

No I usually do not care or too busy but some techs do it for me. Also got told to by rxsup. She also went on a rampage about making sure we document "affected area" on creams/lotions due to insurance chargeback but again half the time I'm too busy to care unless it's an expensive rx.

 

[farmadiazepine]

I have you all beat. Here you go.

Shout out to CVS in Spring Valley, NY for being a real f*ck up with this one. The only way to fix a store like that, no kidding, is just to delete everything and start from scratch. There were scripts in there that were there for more than 3 months. I can't find that picture.

Still had 114 PCQ calls. LMFAO

 

[farmadiazepine]

Is it crazier than this? That's like 1000+ just sitting in the queue. No amount of damage control can fix this..lol

You are right, there is no fixing that. When things like that happen, everything just needs to get deleted. There is no fixing it, and I am serious.

 

[Rukn]

I have you all beat. Here you go.

View attachment 206891

Shout out to CVS in Spring Valley, NY for being a real f*ck up with this one. The only way to fix a store like that, no kidding, is just to delete everything and start from scratch. There were scripts in there that were there for more than 3 months. I can't find that picture.

Still had 114 PCQ calls. LMFAO

haha what a joke of a company

the DM and Sup both need to be fired for letting things get like that ... the director and VP or whatever they call those *****s should be disciplined as well

 

[ldiot]

haha what a joke of a company

the DM and Sup both need to be fired for letting things get like that ... the director and VP or whatever they call those *****s should be disciplined as well

Office politics; they were probably waiting for the pharmacist(s) to quit before sending in extra help to clean it up.

 

[lane one]

lol did you not see where I said "vacation spot", we are the only pharmacy over the bridge!!! People can't leave and go anywhere else unless they want to drive 30 mins!!!....Why would I exaggerate....i didn't answer the phone for 4 hours and obviously nothing was getting typed, filled, or verified because we are supposed to take care of the customers in front of us right!??? So i ended up filling and verifying as they came to the counter. Everyone "forgot their meds home and just need 2 pills until they go home" Most of them don't even use CVS!!"why can't you just give me 2 pills!!??""" so aside from dealing with the locals who by now should know to just get mail order in the summer i have to write up emergency supplies, called on stacks of transfers, oh and take doctors who come in bc they are on vacation and want to write 10 scripts out for their whole family. I'm not even going to mention the parents who brought their child in having an asthma attach trying to get a refill on their proair, in which there were none.....even if i called 911 he would have died so hey just gave them a proair, maybe ill get fired who knows. But to throw me in something like that is out of control. I filled 405 prescriptions that day (left all the 900pms red in the queue) on top of all that ****. i would not wish that day on my worst enemy.

It's ok...I believe you. Anyone who says it isn't possible has never been thrown to the wolves at CVS

 

[lane one]

I have you all beat. Here you go.

View attachment 206891

Shout out to CVS in Spring Valley, NY for being a real f*ck up with this one. The only way to fix a store like that, no kidding, is just to delete everything and start from scratch. There were scripts in there that were there for more than 3 months. I can't find that picture.

Still had 114 PCQ calls. LMFAO

Whooaaa. Just read farther and that's definitely worse than I've seen. Haha yeah, burn it down. It's the only way.

 

[PikminOC]

Not going to lie, it's tough as a new graduate until you overcome 1) technology/computer system learning curve, 2) knowing how to delegate & who is appropriate to delegate work to (efficiency), & 3) getting over dinguses who think you don't know anything because they expect ALL pharmacists to be 40+yo it seems.

Many of the hard stops will be "high doses" based on pt age, insurance limits, off-label use, etc. When in doubt, just review the pt's Hx (history) & see whether this is a usual dose for them. New drugs with DURs of 1-2 warnings (most severe) should be set aside to contact physician &/or pt; use your judgment. Review DUR comments (DC) & Fill Notes (FN) & History (H, very useful for past billing) to pick up potential clues when verifying.

With enough repetition, you'll become a machine eventually as you will become accustomed to the system. Take some propranolol to not freak out (jokingly) looking like a headless chicken running around all over the place

Ever reported a doc to dea for overprescription

 

[Drugsarefun2350]

Ever reported a doc to dea for overprescription

I do frequently if I think there pill mill operation going on or gross negligence in prescribing

 

[PikminOC]

Ok. What happens then

 

[ldiot]

Ok. What happens then

I've not done it personally but I've seen it happen. A local doctor was running a pill mill and every pharmacist in the area had reported him. It took a solid year before he was shut down. It's a very slow process.

 

[PikminOC]

Ok. Thanks

 

[Drugsarefun2350]

Ok. What happens then

If you report to DEA they may or may not contact you regarding your complaint. I've had them contact me once regarding a complaint I filed, haven't been contacted about others. I've also sent complaints to boards of medicine/departments of health. They request copies of questionable prescriptions sent to them along with the complaint. It's normally a very very slow process. I believe the average time for the department of health here in florida to actually act upon the receipt of a complaint is around 400 days or so.

 

[PikminOC]

That's because the board's are inundated with trivial complaints now that everyone complains about everything.

 

[RxPreceptor]

Ever reported a doc to dea for overprescription

No, have yet to report a physician to the DEA. I'd more than likely tell the patient the physician needs to be contacted to fill & then he/she always seems to back out & take back said suspicious Rx. Like the others have said, it's a very slow process; I have 1 practitioner in my area currently under investigation though.

 

[FarmD711]

I reported a doctor who prescribed a patient 27 methylphenidate 20 mg tabs daily. And then tried to ok early cash fills


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[Van zandt]

A few rules that will really help you through filling

1. Prescriber state license, dea number, and NPI are three totally different numbers. You won't believe how many pharmacists think just because a state license is active the dea will also be active.

2. Please be aware that for all controlled drugs 2-5 there are narcotics and non narcotics. Ex: Adderall is a CII-Non Narcotic. If a prescribers dea registerd is only allowed to prescribe CII Narcotics he has to update his dea to prescribe both narcotics and non.

3. A different DEA and State license number is required for every state the prescriber fills in. If prescriber has location in Florida and Georgia he need a Florida dea and Georgia dea as well as a Florida state license and Georgia state license.

4. If you are back billing a prescription make sure to change the Date Of Service back to the original DOS when the prescription was initially billed for.

5. There is soo much helpful information with genco strongpak return and third party rejection information in RxNet. Its helped me resolve solo many issues with rejections and inventory.

6. Make sure you scan everything for out of stock. It really helps your score.

7. If you need more help reach out to you sup and let them know.
Hope this was helpful and goodluck