Insulin pen, box: open box or not? Rite Aid Old Memo of 2013?

[Lnsean]

Cool story.

what's with the personal attacks tho? you salty? if u had taken the L early...you'd be fine. Move on.

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[josh6718]

what's with the personal attacks tho? you salty? if u had taken the L early...you'd be fine. Move on.

Yup.

 

[Lnsean]

Yup.

that's cute

 

[Rouelle]

This thread turns ugly each time it gets resurrected.

 

[Sine Cura]

In fact some Rite Aid stores in my area seem to break insulin boxes and even pen needle boxes.... yeah...

Obviously there is only one set of instructions per box (stated multiple times previously) so it makes sense to dispense the whole box. But consider the following:

Why can't Lantus Solostar be a 3 pack or 2 pack?

Why can't processors allow billing for day supply greater than 30 for select items?

Why is it a big deal to bill one box for 30 DS if the true day supply exceeds 30 DS? Isn't the pharmacist supposed to monitor over-utilization?

Why does Florida Medicaid suck, possibly even more than California Medicaid...

 

[npage148]

I break boxes. Been instructed to break boxes and have no issues breaking boxes. without that you're going to be billing with fraudulent days supplies
And either the patient or the payor is getting shafted

 

[owlegrad]

Remember to follow the TOS and keep the discussion above the level of kindergartners. Many thanks.

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[Pharmanut]

Why would I be butt hurt...everyone is on my side here. You stand alone. lol. Not even one person defended you. It's when you start making personal attacks that you should realize that you've lost the argument on facts. Don't get emotional or make it personal dude. It's just an online forum.

@Lnsean. You are so wrong that every comment you make encourages me that my job is safe from you ignorant sheeps. Yes, insulin boxes can be open. Call sanofi novo or any other manufacturer and they will tell you the same. (I already have) Make sure you print out the PI and give it with the pens. Just stop your foolishness and your thinking that you actually know what is going on. Single patient use is for the nurses not to use the same pen on all patients. If day supply is wrong, many many insurance companies are auditing. Go back in your hole before I find out what state you work in and have your pharmacist license taken away for being incompetent.

 

[Pharmanut]

Because I know for sure they weren't tampered with. That's on me. If you're comfortable with having opened pens laying around then that's on you. Continue doing what you are doing. Walgreens doesn't break boxes, Rite Aid doesn't break boxes, every pharmacist I know do not break boxes. You continue to do you. There's no reason to come on here and tell lies and make up sht.

Genius reply. How did you even pass your boards? Did you?

 

[Pharmanut]

This.

Giving the patient MORE than they're paying for is the opposite of Waste.
It decreases the predatory profits of insulins by dropping their sales.

Josh needs to take the L

Wrong! In every way. Having Medicare and Medicaid pay more than what the patient is suppose to get is the definition of fraud. Are you even in healthcare?

 

[wagrxm2000]

Wrong! In every way. Having Medicare and Medicaid pay more than what the patient is suppose to get is the definition of fraud. Are you even in healthcare?

Did you really create an account just to attack this guy?

 

[Pharmanut]

Did you really create an account just to attack this guy?

I did. I read through this recent post and cannot believe some of these people can be Pharmacists. To think that they cannot grasp a simple thing like breaking open boxes of pens shows me why these retail chains have made a mockery of our profession. If Pharmacists weren’t sheep, we wouldn’t be in the predicament that we are today.

 

[wagrxm2000]

I did. I read through this recent post and cannot believe some of these people can be Pharmacists. To think that they cannot grasp a simple thing like breaking open boxes of pens shows me why these retail chains have made a mockery of our profession. If Pharmacists weren’t sheep, we wouldn’t be in the predicament that we are today.

Well in that case welcome to SDN!!!

 

[Pharmanut]

One final comment about this insulin pen nonsense. If the refills of the RX are too soon, you will never know unless you check the previous fill in every single insulin prescription. This year alone I have come across three different pbms taking money back due to false days supply. For those who do not see this, it is because corporate is taking care of it internally. By opening the boxes, you can give the right amount of pens per day supply without worrying about the next fills being too early.

 

[owlegrad]

I was a big believer in not breaking the boxes however we have to break the boxes in LTC. I have become so accustomed to breaking the boxes that I wouldn't care now if someone wanted me to do it in retail.

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[CetiAlphaFive]

Wrong! In every way. Having Medicare and Medicaid pay more than what the patient is suppose to get is the definition of fraud. Are you even in healthcare?

Except thousands of prescriptions for TDD < 50 units get approved by Medicare every day.

It is, at this point, common practice and acceptable, and only a complete idiot totally lacking in basic logic would think it's "fraud"

 

[josh6718]

Except thousands of prescriptions for TDD < 50 units get approved by Medicare every day.

It is, at this point, common practice and acceptable, and only a complete idiot totally lacking in basic logic would think it's "fraud"

Get approved? You do realize that just because it goes through your computer system does not mean it is live billing. You can bill Medicare part B for $900 worth of test strips and then have a charge back later even if it 'went through' because the claims are not real-time adjudicated.

 

[josh6718]

For those who do not see this, it is because corporate is taking care of it internally. By opening the boxes, you can give the right amount of pens per day supply without worrying about the next fills being too early.

Exactly- CVS has an entire department(s) dedicated to this which requires them to hire and staff personnel and make up for it somewhere along the line by cutting hours in the pharmacy.

 

[wagrxm2000]

Get approved? You do realize that just because it goes through your computer system does not mean it is live billing. You can bill Medicare part B for $900 worth of test strips and then have a charge back later even if it 'went through' because the claims are not real-time adjudicated.

Doesn't Medicare pay like $10 for test strips?

 

[josh6718]

Doesn't Medicare pay like $10 for test strips?

That I'm not sure, with current reimbursement rates I wouldn't be surprised. It is though another area of fraud/waste with people reselling them online or elsewhere

.

 

[wagrxm2000]

That I'm not sure, with current reimbursement rates I wouldn't be surprised. It is though another area of fraud/waste with people reselling them online or elsewhereView attachment 225311 .

Ha, don't get me worked up on that.

My point though is you are giving bad examples. First with enoxaparin now test strips.

You need to bring your A game and argue your point better with good examples.

 

[Lnsean]

guys he was salty enough to create a whole new account and pretended to defend himself

 

[Lnsean]

Exactly- CVS has an entire department(s) dedicated to this which requires them to hire and staff personnel and make up for it somewhere along the line by cutting hours in the pharmacy.

You created a whole new account to come in here and defend yourself...LMAO...what a loser. It's like you're in middle school...jesus christ.

Attached is CVS/Carkmark Audit Tips telling employees not to break insulin boxes. This is your own company saying that. You're actually breaking your own company's policies and standard procedure. So please...go away.

 

[Lnsean]

@Lnsean. You are so wrong that every comment you make encourages me that my job is safe from you ignorant sheeps. Yes, insulin boxes can be open. Call sanofi novo or any other manufacturer and they will tell you the same. (I already have) Make sure you print out the PI and give it with the pens. Just stop your foolishness and your thinking that you actually know what is going on. Single patient use is for the nurses not to use the same pen on all patients. If day supply is wrong, many many insurance companies are auditing. Go back in your hole before I find out what state you work in and have your pharmacist license taken away for being incompetent.

1 day old account---sure buddy what ever you say. Why would I be wrong if it's standard practice. I have all of Walgreens on my side. Look, I am not here to stop anyone. You can do whatever you want; it's your license. It is not standard of practice to open them and you should not open them.

Also, it's so bad that you created a whole new account to attack me personally. Someone that's truly new wouldn't have that much anger in their first post to another person. It's a 2 year old debate that was settled. Industry practice has settled it as well. I don't know why you take it so personally. Accept that you lost and move on.

 

[Pharmanut]

This is exa

I was a big believer in not breaking the boxes however we have to break the boxes in LTC. I have become so accustomed to breaking the boxes that I wouldn't care now if someone wanted me to do it in retail.

Sent from my SAMSUNG-SM-G920A using

Except thousands of prescriptions for TDD < 50 units get approved by Medicare every day.

It is, at this point, common practice and acceptable, and only a complete idiot totally lacking in basic logic would think it's "fraud"

Only an idiot would make comments and not understand how billing works. They can’t see the sig- only d/s and qty on the claim form. If it were acceptable, why are the insurance companies taking back money now? Sure it took a while to catch on but now it is common practice to not over bill and over supply

 

[Pharmanut]

1 day old account---sure buddy what ever you say. Why would I be wrong if it's standard practice. I have all of Walgreens on my side. Look, I am not here to stop anyone. You can do whatever you want; it's your license. It is not standard of practice to open them and you should not open them.

Also, it's so bad that you created a whole new account to attack me personally. Someone that's truly new wouldn't have that much anger in their first post to another person. It's a 2 year old debate that was settled. Industry practice has settled it as well. I don't know why you take it so personally. Accept that you lost and move on.

The anger stems from Pharmacists like you who cannot give valid arguments and think they are correct because a big corporation sways you into thinking so. Do you not see the problem here? Do you know how much fines these corporations pay for fraud on a yearly basis and keep you in the dark? You follow them like sheep and think its the correct way of doing things. We have made plenty of valid arguements which include insurance policies, Medicaid manuals and actual audits that are currently taking place yet your arguements is “big Walgreens is on my side”. It is lazy Pharmacists such as yourself who do not want to deal with the math and days supply that causes fraud. You just want to slap a label on and move on with your day. I have worked for ltc, hospitals and retail chains. All have the option to open boxes. I have had conversations with novo and sanofi reps at hospitals and they all agreed there was no issue with opening boxes. This is coming straight from the manufacturers.

Those are my arguements and yours is that your big daddy pharmacy allows it. This is why I made an account. To show up sheep Pharmacists such as yourself that have ruined our profession.

 

[Pharmanut]

You created a whole new account to come in here and defend yourself...LMAO...what a loser. It's like you're in middle school...jesus christ.

Attached is CVS/Carkmark Audit Tips telling employees not to break insulin boxes. This is your own company saying that. You're actually breaking your own company's policies and standard procedure. So please...go away.

Wrong again. Corporate came out with a new policy from CVS Caremark that said we have to make sure the day supply is correct or call for a PA. This is old and outdated. I can post the new document when I get a chance. Even they knew they got it wrong so they changed it.

 

[wagrxm2000]

Just to update looks like Medicare pays about $6 to $7 per 50 count.

 

[Lnsean]

The anger stems from Pharmacists like you who cannot give valid arguments and think they are correct because a big corporation sways you into thinking so. Do you not see the problem here? Do you know how much fines these corporations pay for fraud on a yearly basis and keep you in the dark? You follow them like sheep and think its the correct way of doing things. We have made plenty of valid arguements which include insurance policies, Medicaid manuals and actual audits that are currently taking place yet your arguements is “big Walgreens is on my side”. It is lazy Pharmacists such as yourself who do not want to deal with the math and days supply that causes fraud. You just want to slap a label on and move on with your day. I have worked for ltc, hospitals and retail chains. All have the option to open boxes. I have had conversations with novo and sanofi reps at hospitals and they all agreed there was no issue with opening boxes. This is coming straight from the manufacturers.

Those are my arguements and yours is that your big daddy pharmacy allows it. This is why I made an account. To show up sheep Pharmacists such as yourself that have ruined our profession.

There are no fines. It's standard of practice. Walgreens has been doing this for as long as I've worked with them as well as CVS/Rite Aid/ WM. Show me evidence of fines because you didn't break an insulin box. You keep saying things but I haven't seen any evidence. Show me the evidence or stfu. It's a very simple concept.

 

[Pharmanut]

1 day old account---sure buddy what ever you say. Why would I be wrong if it's standard practice. I have all of Walgreens on my side. Look, I am not here to stop anyone. You can do whatever you want; it's your license. It is not standard of practice to open them and you should not open them.

Also, it's so bad that you created a whole new account to attack me personally. Someone that's truly new wouldn't have that much anger in their first post to another person. It's a 2 year old debate that was settled. Industry practice has settled it as well. I don't know why you take it so personally. Accept that you lost and move on.

You are like one those crazy conspiracy theorists who think the whole world is out to get them. Trust me, I am new here and came across this post while reading up on something else. Highly doubt a pharmacist would stoop so low to pretend to be two different people.

 

[Lnsean]

Wrong again. Corporate came out with a new policy from CVS Caremark that said we have to make sure the day supply is correct or call for a PA. This is old and outdated. I can post the new document when I get a chance. Even they knew they got it wrong so they changed it.

Show me.

You are like one those crazy conspiracy theorists who think the whole world is out to get them. Trust me, I am new here and came across this post while reading up on something else. Highly doubt a pharmacist would stoop so low to pretend to be two different people.

Come on dude...we weren't born yesterday. You created a brand new account and then jumped to this thread right away? LOL. Yes, someone would stoop that low because he's salty. Also, the anger stems from the fact that you came in here on your high horse expecting praises and when everyone tells you that you are wrong, you're throwing a tantrum like you are doing now.

 

[Lnsean]

Wrong again. Corporate came out with a new policy from CVS Caremark that said we have to make sure the day supply is correct or call for a PA. This is old and outdated. I can post the new document when I get a chance. Even they knew they got it wrong so they changed it.

shouldn't you be logging into your other account now

 

[Pharmanut]

Show me.


Come on dude...we weren't born yesterday. You created a brand new account and then jumped to this thread right away? LOL. Yes, someone would stoop that low because he's salty. Also, the anger stems from the fact that you came in here on your high horse expecting praises and when everyone tells you that you are wrong, you're throwing a tantrum like you are doing now.

Here. Now you can shut up. Im done wasting my time with corporate monkeys like you.

 

[Pharmanut]

shouldn't you be logging into your other account now

Another outdated garbage you found online. Express scripts just audited us and told us we can’t have early fills on the boxes and we may need to open boxes.

 

[Lnsean]

Here. Now you can shut up. Im done wasting my time with corporate monkeys like you.

Umm that's not for insulin. Clearly says Remicade there. You can't read? Also, you **** is from 2012. Nice try tho...LMAO

 

[Pharmanut]

Here. Now you can shut up. Im done wasting my time with corporate monkeys like you.

Sorry here is the whole document

 

[Pharmanut]

Umm that's not for insulin. Clearly says Remicade there. You can't read? Also, you **** is from 2012. Nice try tho...LMAO

Now you must feel stupid that the whole document is there.

 

[Pharmanut]

Umm that's not for insulin. Clearly says Remicade there. You can't read? Also, you **** is from 2012. Nice try tho...LMAO

Also, would you like to respond to Florida Medicaid and the other PBMs posting you just open boxes? Josh showed you earlier? Are you going to ignore those too?

 

[Lnsean]

Sorry here is the whole document

Again, that doesn't say anything about breaking pens. It just telling you to call. Are you not reading this?

 

[Lnsean]

Also, would you like to respond to Florida Medicaid and the other PBMs posting you just open boxes? Josh showed you earlier? Are you going to ignore those too?

Yea, which PBMs are those? Give me a list and show me their audit guidelines that outlines it as such.

 

[Pharmanut]

Again, that doesn't say anything about breaking pens. It just telling you to call. Are you not reading this?

If you call, they do not do a PA unless Md gets involved. Secondly, you can’t give accurate days supply unless you open it genius. So every time you call at Walgreens ?

 

[Lnsean]

If you call, they do not do a PA unless Md gets involved. Secondly, you can’t give accurate days supply unless you open it genius. So every time you call at Walgreens ?

I mean are you not reading what the note says? It says that previously you could submit it and it goes through. Now you have to call and get it documented. That seems like a workflow issue on your company. Nothing to do with breaking insulin boxes. That's your problem that you have to call and get all that info. At walgreens, we don't call and don't need to call.

 

[Pharmanut]

Yea, which PBMs are those? Give me a list and show me their audit guidelines that outlines it as such.

I think they were already posted above but I don’t need to sit here and go looking for documents bc you are too dumb to understand. My point has been proven over and over.

 

[Lnsean]

I think they were already posted above but I don’t need to sit here and go looking for documents bc you are too dumb to understand. My point has been proven over and over.

They didn't post anything. Enlighten me. You came on here with a mission. The burden of proof is on you.

 

[josh6718]

Show me.
Come on dude...we weren't born yesterday. You created a brand new account and then jumped to this thread right away? LOL. Yes, someone would stoop that low because he's salty. Also, the anger stems from the fact that you came in here on your high horse expecting praises and when everyone tells you that you are wrong, you're throwing a tantrum like you are doing now.

As I've stated before, I do not care if I am in the minority or not. Creating a second profile for the sole purpose of arguing with your level of intelligence or lack thereof would serve no purpose.

 

[Lnsean]

As I've stated before, I do not care if I am in the minority or not. Creating a second profile for the sole purpose of arguing with your level of intelligence or lack thereof would serve no purpose.

Bro we weren't born yesterday. It's clear that you were hurt and salty about the whole thing. No surprised that today, a brand new account was created and he jumped immediately into this thread. LOL. come on. If it looks like a duck and quacks like a duck, it's a duck.

 

[Pharmanut]

I mean are you not reading what the note says? It says that previously you could submit it and it goes through. Now you have to call and get it documented. That seems like a workflow issue on your company. Nothing to do with breaking insulin boxes. That's your problem that you have to call and get all that info. At walgreens, we don't call and don't need to call.

What on earth are you talking about? They are clearly saying you have to have the right day supply or call to try an override. Every time you check something at Walgreens, are you doing that? No the d/s is wrong ! Am I correct? It also says the intervals must be correct. It wont be correct if you keep billing one box for 30 d/s and it is actually 60 days. If the patient comes back at 35 days, you just comitted fraud. Do you understand now?

 

[Pharmanut]

Yeh I am so quick right now jumping from account to account in seconds. *****...

Bro we weren't born yesterday. It's clear that you were hurt and salty about the whole thing. No surprised that today, a brand new account was created and he jumped immediately into this thread. LOL. come on. If it looks like a duck and quacks like a duck, it's a duck.

 

[Lnsean]

Yeh I am so quick right now jumping from account to account in seconds. *****...

Not hard. Phone/Laptop. Its 2017.

 

[josh6718]

They didn't post anything. Enlighten me. You came on here with a mission. The burden of proof is on you.

Bro we weren't born yesterday. It's clear that you were hurt and salty about the whole thing. No surprised that today, a brand new account was created and he jumped immediately into this thread. LOL. come on. If it looks like a duck and quacks like a duck, it's a duck.

I'm amused at how continually ignorant you are. Why would I waste time creating an account when I am not trying to argue with you any further?