Patient lies about being shorted in pills

[swatchgirl]

If you suspect a patient who paid cash for an expensive medication is lying about her vial being shorted 10 pills, besides checking with the tech who counted the pills and checking the inventory/quantity-on-hand number in the computer system against the actual number of the pills left in the stock bottle, are there other effective and/or quick ways to expose her if she was indeed lying to us?

The 10 pills she claimed that we shorted her cost $77. The medication is usually dispensed as once a day for 30 days at a time. My tech says there is no reason that she would stop at #20 when she was counting by fives, and was certain that 30 tabs was counted out of the stock bottle and poured into the little yellow vial.

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[genesis09]

You can have both the tech and pharmacist initial the bottle after counting it. If it comes in monthly bottles, give it to her with the seal in tact.

 

[swatchgirl]

You can have both the tech and pharmacist initial the bottle after counting it. If it comes in monthly bottles, give it to her with the seal in tact.

Yeah it was premarin 0.625 mg tabs, they come in a 100 count bottle. Ten pills cost $77 cash price, and she wants us to give her the ten for free. Those hot flashes of hers must be real bad, or maybe menopause just brings out the true colors. Thanks for the lesson. I will start doing the double initialing for cash payers from now on.

 

[idatarx]

next time, do a verify count with the patient prior to giving her the medication.

 

[swatchgirl]

next time, do a verify count with the patient prior to giving her the medication.

She usually comes in the drive-thru, I'm afraid that if I tell her to open the bag and count the pills in her car while I watch her do it will upset her and we might lose her future business. I think the safest way is to double initial, my tech counts it and initials it and then I count it again and initial it. Her business is extra work that we'll just have to deal with.

 

[Apotheker2015]

Can you repackage them as unit dose just to be a smart*ss? Lol, it's probably what I would do. Here are your 30 pills. Make'm LAST!!!

 

[6GodPharm]

She usually comes in the drive-thru, I'm afraid that if I tell her to open the bag and count the pills in her car while I watch her do it will upset her and we might lose her future business. I think the safest way is to double initial, my tech counts it and initials it and then I count it again and initial it. Her business is extra work that we'll just have to deal with.

Put a force note to double count and write on the bag confirmed 30 count.

 

[maliciousmotive]

She usually comes in the drive-thru, I'm afraid that if I tell her to open the bag and count the pills in her car while I watch her do it will upset her and we might lose her future business. I think the safest way is to double initial, my tech counts it and initials it and then I count it again and initial it. Her business is extra work that we'll just have to deal with.

Bring that possibility up to her. Let her decide. We had a customer who claimed to always be shorted on stuff. I don't know if you work for a chain or not but being short 10 tabs. provided it's not a CII or something, isn't a huge deal. I would go through everything and check your inventory. If it checks out, tell her it checks out but you are going to give the benefit of the doubt. However, from now on tell her that to avoid this happening in the future we will double (or triple) count it for her (2x by tech, 1x by RPh) or we need to count it in front of her.

 

[ChalupaBatman86]

I would replace them only on the condition that she passes a Polygraph.

 

[npage148]

Ha, I like the blister packing idea. I'll have to remember that

Double count and initial the bottle (and tape over the writing) and/or count it for her at the pick up window and make note that it was counted. If she's not willing to accept that then she can move on

 

[Apotheker2015]

Ha, I like the blister packing idea. I'll have to remember that

Double count and initial the bottle (and tape over the writing) and/or count it for her at the pick up window and make note that it was counted. If she's not willing to accept that then she can move on

Or print 6 labels and give her 6 vials as with 5 pills in each one. Lol, some people. What they'll do to get through a hot flash.

 

[Sine Cura]

Remember there is no good reason to make mistakes, but they happen. I've had a pharmacist somehow pour the stock bottle contents of Norco into the vial (fortunately less than the quantity to dispense) instead of the quantity actually counted out.

If you have good-resolution camera footage of filling stations you can verify that 30 was indeed counted.

 

[owlegrad]

Remember there is no good reason to make mistakes, but they happen. I've had a pharmacist somehow pour the stock bottle contents of Norco into the vial (fortunately less than the quantity to dispense) instead of the quantity actually counted out.

If you have good-resolution camera footage of filling stations you can verify that 30 was indeed counted.

I actually did that once myself. I double counted the amount on the tray and then somehow mixed up what bottle I was pouring what into. The patient got the scraps, the stock bottle got the quantity I double counted. Thankfully it was quickly and easily resolved. Opps!

 

[maliciousmotive]

I would replace them only on the condition that she passes a Polygraph.

That's your decision. For the sake of realizing you're not perfect and that you/your tech could have made a mistake, it's easier to just give her the pills this time and note it in her profile that it's only going to happen once. Same thing with someone picking up meds they didn't need and not noticing until later; technically, we can't return them but for the sake of good business you can do it once and tell them never again. I had a tech count out 15 pills on 2 different scripts when it was supposed to be 30. Mistakes happen.

 

[ChalupaBatman86]

That's your decision. For the sake of realizing you're not perfect and that you/your tech could have made a mistake, it's easier to just give her the pills this time and note it in her profile that it's only going to happen once. Same thing with someone picking up meds they didn't need and not noticing until later; technically, we can't return them but for the sake of good business you can do it once and tell them never again. I had a tech count out 15 pills on 2 different scripts when it was supposed to be 30. Mistakes happen.

If you are giving away pills without a Polygraph you should have your registration revoked. Why not just hand out pills to everybody who "lost" them.

 

[aznkukuboi]

This happens a lot in retail especially those xanax users. I have 2-3 patients who we actually open and count on a tray in front of the cameras and the register that there is the full quantity in the bott.e

 

[zelman]

77 bucks one time isn't a big deal. Just make sure it doesn't become a pattern. I would avoid making the patient get involved proactively ("YOU WATCH ME COUNT!"). Just have a process and make sure it is followed and if it was a genuine error, nothing more will come of it. If it was a scam, she will be exposed.

 

[ldiot]

Since it's not a controlled substance there's not much you can do but give her the extra 10 pills, I know for a fact that our inventory would have been more than 10 pills off to begin with so there's really no way to know. It's not really a big deal just reprint the label and throw 10 in a vial. Just put a forced note in so the pharmacist can double count it or if you really want you can offer to count them in front of here but I've never actually seen anyone do this

 

[PikminOC]

I'm really surprised it's not a controlled substance she is complaining about

 

[maliciousmotive]

If you are giving away pills without a Polygraph you should have your registration revoked. Why not just hand out pills to everybody who "lost" them.

And polygraphs are 100% reliable? Give me a break and get off your high horse. You make mistakes. Your techs make mistakes. If someone says you made a mistake and it's not a controlled substance, the first time it happens you give them the benefit of the doubt. Or don't. I don't give a rat's behind how you run your store.

 

[sosoo]

if her complaint was with a controlled substance, how would u handle it? if you suspect she's lying, tell her u have full faith that it was dispensed correctly. if she keeps making up arguments, repeat the same phrase. tell her to call the cops, report the issue to corporate, do whatever. tell her all her options, but you will not give her extra pills. period. // a few years ago a lady call the cops on this pharmacist guy claiming missing pills etc. the cops came and took side and supported the pharmacist. // flag her profile, and do not accept anymore of her scripts... this is important. you have the right to refuse service.

 

[CountBy5s]

She usually comes in the drive-thru, I'm afraid that if I tell her to open the bag and count the pills in her car while I watch her do it will upset her and we might lose her future business. I think the safest way is to double initial, my tech counts it and initials it and then I count it again and initial it. Her business is extra work that we'll just have to deal with.

Okay. I have had this happen multiple times with controls or expensive meds. We always tell the patient ... we will give you the remainder of "happy pills" this time. In the future, we would like you to come inside for pick up to verify the count before the prescription is sold.... We flag the account "double count everything" and the pharmacist double counts too and initials.. We comment these counts in the system..

Usually patients either agree to come inside or amazingly they no longer question the counts.

 

[Dr Wario]

And polygraphs are 100% reliable? Give me a break and get off your high horse. You make mistakes. Your techs make mistakes. If someone says you made a mistake and it's not a controlled substance, the first time it happens you give them the benefit of the doubt. Or don't. I don't give a rat's behind how you run your store.

Sarcasm is really lost on some people.

 

[ChalupaBatman86]

And polygraphs are 100% reliable? Give me a break and get off your high horse. You make mistakes. Your techs make mistakes. If someone says you made a mistake and it's not a controlled substance, the first time it happens you give them the benefit of the doubt. Or don't. I don't give a rat's behind how you run your store.

It doesn't have to be a real Polygraph. Just tape some wires to your iPhone. Change your ring tone to a buzzer sound. Every time you think they are lying have a tech call your phone. You can even throw in some funny questions.

 

[trailerpark]

We have high resolution cameras that can see a C2 being counted on the C2 counting pod but even if you watch that and the pharmacist verifying it and bagged it how would you know if a tech grabbed some pills when it's waiting for pickup? They could easily find out what pills are in each bag and when they're doing returns they could grab the extra bag they want to steal from.


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[ldiot]

We have high resolution cameras that can see a C2 being counted on the C2 counting pod but even if you watch that and the pharmacist verifying it and bagged it how would you know if a tech grabbed some pills when it's waiting for pickup? They could easily find out what pills are in each bag and when they're doing returns they could grab the extra bag they want to steal from.


Sent from my iPhone using SDN mobile app

Taking pills out of a bottle, putting them in pocket, rebagging it, and putting it back in waiting bin without it going to verification... some if not all of that process is going to be caught on camera... Sure nobody will think much of it if it's one or two patients but once a pattern is established you know you have a problem and LP WILL catch them...

I've heard of nurses switching pills in unit dose blister packs, doctors swapping extra waste dilaudid in the vial with water, dummy scripts on dummy profiles, people taking a single pill off a counting tray, they all get caught, most of them literally within a week or two.

 

[Old Timer]

This is also a simple problem. Run a patient print out for this patient for the last 12 months. How much money do they spend in your store. If they are a good customer, you apologize, give them the pills and then note in their profile you need to double count everything.....

 

[maliciousmotive]

Sarcasm is really lost on some people.

My mistake, I have a hard time telling idiots apart from sarcastic idiots.

 

[zelman]

My mistake, I have a hard time telling idiots apart from sarcastic idiots.

I'm having the same problem....

 

[Rukn]

We have high resolution cameras that can see a C2 being counted on the C2 counting pod but even if you watch that and the pharmacist verifying it and bagged it how would you know if a tech grabbed some pills when it's waiting for pickup? They could easily find out what pills are in each bag and when they're doing returns they could grab the extra bag they want to steal from.


Sent from my iPhone using SDN mobile app

Walmart seems to be the best chain to work for


Lunch breaks, good computer system, also seems like they get plenty of tech help

 

[BidingMyTime]

We have high resolution cameras that can see a C2 being counted on the C2 counting pod but even if you watch that and the pharmacist verifying it and bagged it how would you know if a tech grabbed some pills when it's waiting for pickup? They could easily find out what pills are in each bag and when they're doing returns they could grab the extra bag they want to steal from. Sent from my iPhone using SDN mobile app

I REALLY can't see anyone risking their job and a possible arrest to do this for Premarin. If they are that desperate and criminally minded, they would be more likely to get away with just shoplifting some black cohash, then going to the the trouble of stealing Premarin out of a sealed bag in front of the pharmacy camera.

 

[PikminOC]

Whenever a pt tells me they are short on controlled subs, it's because they are overtaking it

 

[CetiAlphaFive]

I had one patient that wanted to count *every single prescription* in the pick up window.

I refused, because I have too much self respect to dance like a monkey every time someone loses their pills.

Once, I triple counted it, initialed, then when he came back claiming we shorted him, I called the LP manager over and explained the situation.

He explained to the patient that he was attempting to steal, and that he could find another pharmacy if he so pleased

 

[mikejones123]

I doubt the customer is lying over premarin....give her the 10 pills.....And just write a note in the profile.

 

[Rukn]

btw I would just give it to them if it's not controlled

I could care less

it's not my pharmacy so why should I care?

As long as my pay check is right

 

[Deja]

ummm do you guys eye ball the quantities when checking the medications? did the quantity on hand check out? you have no idea how many pharmacists doesn't eyeball the quantities when checking medications, I didn't check when I first graduated but now I can always tell if my tech shorted pills by eyeballing it... I have to keep remind other people to check quantities because it seems like the people who got shorted because pharmacist didn't double check always comes in to complain when i'm working... sometimes its really obvious, like the bottle we gave would be too small to fit the correct quantity

so I doubt she would lie about premarin especially if this is the first time happening... also if she's a cash paying patient, you guys probably already made a killing off of her already, just give her 10 pills lol

 

[Humble Sloth]

This is also a simple problem. Run a patient print out for this patient for the last 12 months. How much money do they spend in your store. If they are a good customer, you apologize, give them the pills and then note in their profile you need to double count everything.....

This is the only correct answer. If their meds aren't that profitable tell them to f off .

 

[Sine Cura]

Medicaid patient where you don't even break even on their **** => definitely tell them to GTFO

 

[Humble Sloth]

Medicaid patient where you don't even break even on their **** => definitely tell them to GTFO

some medicaid patients can be cash cows if you are able to to MTM with them all the time. They have to qualify thou.

 

[CetiAlphaFive]

btw I would just give it to them if it's not controlled

I could care less

it's not my pharmacy so why should I care?

As long as my pay check is right

"Why is retail pharmacy so bad now? What happened?"

Lazy people with no spine like Rukn put on white coats.

 

[swatchgirl]

77 bucks one time isn't a big deal. Just make sure it doesn't become a pattern. I would avoid making the patient get involved proactively ("YOU WATCH ME COUNT!"). Just have a process and make sure it is followed and if it was a genuine error, nothing more will come of it. If it was a scam, she will be exposed.

We checked our inventory against what the computer says we should have and the numbers are correct. My pharmacy manager also checked with the camera's recording of the tech filling the script. We called her and told her that our inventory checks out and that we're confident we didn't short her. She just said okay, and she didn't come back for the pills that she claimed we shorted her. So I guess we saved 77 bucks this time. Go figure.

 

[swatchgirl]

Or print 6 labels and give her 6 vials as with 5 pills in each one. Lol, some people. What they'll do to get through a hot flash.

Ha. I like this one.

 

[sosoo]

My pharmacy manager also checked with the camera's recording of the tech filling the script. We called her and told her that our inventory checks out and that we're confident we didn't short her.

our store manager also checks the video recording. lady claims her birth control pills aren't in the bag, only the case was in the bag. the video recording shows the floater pharmacist was another piece of garbage wasting everyone's time.