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Medicare Part D makes me want to kill.
Started by WVUPharm2007
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That is just ridiculous. 👎
Yes. Friday night we were on hold from 6 p.m. until 9:15 p.m. with Humana. Never even spoke with a human.
Half of the time when we call one of the TP providers we get a message that says, in effect: We are too busy to take your call right now. Please try your call later. Niiiiiice.
On Thursday we held on forever with Anthem to try to find out why a patient's card didn't work. When we finally got a person, they told us that they had been too busy to load the patient into their computer system, even though they sent a letter of confirmation of coverage to the patient in early December!
Half of the time when we call one of the TP providers we get a message that says, in effect: We are too busy to take your call right now. Please try your call later. Niiiiiice.
On Thursday we held on forever with Anthem to try to find out why a patient's card didn't work. When we finally got a person, they told us that they had been too busy to load the patient into their computer system, even though they sent a letter of confirmation of coverage to the patient in early December!
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I had one today who was unprofessional and bitchy to the point that I felt like calling and talking to her supervisor. 👎
bananaface said:I had one today who was unprofessional and bitchy to the point that I felt like calling and talking to her supervisor. 👎
The patients are quite annoying too! They all seem to forget they have deductibles and will not accept that as the reason why their copays are so much more than "usual". If I hear "that's not what I paid last time" one more time, I might reach over and strangle someone.
I'm also slightly disappointed that I can not know exactly how much every single persons deductible is.....geez, what is wrong with me; i should be better than that.
My technicians have told more than a couple of people that they need to call the companies themselves so we don't waste tech hours being on hold with the insurance companies. 👍
Of course, I work in an area without a lot of elderly. I would never work in Sun City or Sun City West.
Of course, I work in an area without a lot of elderly. I would never work in Sun City or Sun City West.
ForgetMeNot said:Of course, I work in an area without a lot of elderly. I would never work in Sun City or Sun City West.
Well, up until 9 days ago, my store was a gem... low volume during the hotter months when the snowbirds retreat back east, and no drive-through.
Can someone please explain exactly what Medicare Part D is to an innocent pre-pharm? I've heard the term so often but still don't really know why it is different! I thought they were trying to make medications more affordable to seniors but is it not achieving its purpose??
It is different because until Jan. 1 there was no coverage for drugs under the Medicare program. If the patient had other coverage through a pension plan or something like that, then they might have had prescription coverage before. So, basically you have a large population, most of whom have no idea how Rx coverage works in the first place. On top of that, you have what in my observation is a lot of providers who were not ready for Jan. 1. So, we have a majority of patients who don't have cards or adequate ID information, yet they all want us to fill their prescriptions. And, as other posters note, it is IMPOSSIBLE this week to get any insurance company on the phone for anything!!starsweet said:Can someone please explain exactly what Medicare Part D is to an innocent pre-pharm? I've heard the term so often but still don't really know why it is different! I thought they were trying to make medications more affordable to seniors but is it not achieving its purpose??
Plus we have to convert all of our state Medicaid patients over to Medicare Part D provider since the federal government is taking over that program as well. So you have Medicaid patients who don't bother telling you that they have a new letter/card with their new prescription plan even when you ask. The copays vary a little with each plan, but the worst is that the formulary is different for each plan so people who didn't apply ahead of time and got automatically switched over might not have the best plan that covers all of their current medications.
rxlynn said:It is different because until Jan. 1 there was no coverage for drugs under the Medicare program. If the patient had other coverage through a pension plan or something like that, then they might have had prescription coverage before. So, basically you have a large population, most of whom have no idea how Rx coverage works in the first place. On top of that, you have what in my observation is a lot of providers who were not ready for Jan. 1. So, we have a majority of patients who don't have cards or adequate ID information, yet they all want us to fill their prescriptions. And, as other posters note, it is IMPOSSIBLE this week to get any insurance company on the phone for anything!!
Thanks rxlynn and Sosumi, this really helped. 🙂
We're getting a lot of Medicaid patients that think their $1 copays are "ridiculous". 🙄
Hey WVUPharm2007, 2.5 hours? Wow! At least they were entertaining your calls. I dealt with a particular TP that completely stopped taking provider calls last week. It's been a bit crazy lately.
Hey WVUPharm2007, 2.5 hours? Wow! At least they were entertaining your calls. I dealt with a particular TP that completely stopped taking provider calls last week. It's been a bit crazy lately.

Haha I love the Medicaid patients with $50 dollar deductibles and such now. Surprise! You're not special anymore with your free drugs!ICA said:We're getting a lot of Medicaid patients that think their $1 copays are "ridiculous". 🙄
Hey WVUPharm2007, 2.5 hours? Wow! At least they were entertaining your calls. I dealt with a particular TP that completely stopped taking provider calls last week. It's been a bit crazy lately.![]()
"What?! $3 dollars?! That's ridiculous!"
Kill me.
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I blame the govenment. If you're gonna socialize medicine for a portion of the population, bloody freakin' socialize it. Don't farm it out to 100 different third party payers. Save the taxpayers some money that right now is going into the insurance company's pockets and just do it yourself. Imagine if every Part D person was billed to the SAME third party and all we needed to know was their ID number. The capitalists have to look capitalist to all of their capitalist buddies while they start a new socialist program. Gah.
WVUPharm2007 said:I blame the govenment. If you're gonna socialize medicine for a portion of the population, bloody freakin' socialize it. Don't farm it out to 100 different third party payers. Save the taxpayers some money that right now is going into the insurance company's pockets and just do it yourself. Imagine if every Part D person was billed to the SAME third party and all we needed to know was their ID number. The capitalists have to look capitalist to all of their capitalist buddies while they start a new socialist program. Gah.
I could NOT have said it better myself.

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