- Joined
- Jun 13, 2004
- Messages
- 846
- Reaction score
- 3
So, I thought I would send in a prescription to Tricare mail order pharmacy to try it out during one of my ADT's this year.
I made sure DEERS had me listed as active duty for the correct time period.
Got my prescription. Filled out the mail order form correctly and mailed it in.
Didn't check to see if the medicine was "preferred" or not. Oops. It wasn't.
Did Express-Scripts bother to notify me??? Nope. I figured it out on my own and called them.
Express Scripts operator: "Oh yeah, you need a medical necessity form for that med. Otherwise, your doc has to prescribe one of the listed alternatives."
Called doc and had him fill out the medical necessity form and write a new prescription. Done. Mailed it in to Express Scripts.
Noted on their website that it had been received and was in processing.
Then it disappeared from their website today. Again, they didn't bother to notify me. I called them again.
Express Scripts operator: "We didn't get a medical necessity form with your prescription."
Me: Yes you did. It was in the same envelope as the prescription.
Express Scripts operator: "I'll put in a search order to the pharmacy."
Me: thinking this will take weeks..."Can I talk to your supervisor?"
Supervisor: "Oh, I found your medical necessity form but it isn't filled out correctly. Your doc did not list a reason why you need this non-preferred med."
Me: "But he circled #5 which had printed next to it:
'Pt is currently on this medicine and would likely have an adverse reaction if switched to another medicine.'"
Supervisor: "I know, but he needed to write in a comment."
Me: "You mean he needed to circle #5 which had printed right next to it that I was stable on this med and could not switch to another AND he had to write down the exact same statement even though it was already printed on the form???
Supervisor: Yes.
Me: Isn't that redundant?
Supervisor: Yes.
..........................................I go off AD tomorrow, so even if I got the form filled out correctly and faxed to them today, they won't fill it because I'm no longer AD, even though the prescription was written and received by them last week.
Welcome to Tricare 😀
I made sure DEERS had me listed as active duty for the correct time period.
Got my prescription. Filled out the mail order form correctly and mailed it in.
Didn't check to see if the medicine was "preferred" or not. Oops. It wasn't.
Did Express-Scripts bother to notify me??? Nope. I figured it out on my own and called them.
Express Scripts operator: "Oh yeah, you need a medical necessity form for that med. Otherwise, your doc has to prescribe one of the listed alternatives."
Called doc and had him fill out the medical necessity form and write a new prescription. Done. Mailed it in to Express Scripts.
Noted on their website that it had been received and was in processing.
Then it disappeared from their website today. Again, they didn't bother to notify me. I called them again.
Express Scripts operator: "We didn't get a medical necessity form with your prescription."
Me: Yes you did. It was in the same envelope as the prescription.
Express Scripts operator: "I'll put in a search order to the pharmacy."
Me: thinking this will take weeks..."Can I talk to your supervisor?"
Supervisor: "Oh, I found your medical necessity form but it isn't filled out correctly. Your doc did not list a reason why you need this non-preferred med."
Me: "But he circled #5 which had printed next to it:
'Pt is currently on this medicine and would likely have an adverse reaction if switched to another medicine.'"
Supervisor: "I know, but he needed to write in a comment."
Me: "You mean he needed to circle #5 which had printed right next to it that I was stable on this med and could not switch to another AND he had to write down the exact same statement even though it was already printed on the form???
Supervisor: Yes.
Me: Isn't that redundant?
Supervisor: Yes.
..........................................I go off AD tomorrow, so even if I got the form filled out correctly and faxed to them today, they won't fill it because I'm no longer AD, even though the prescription was written and received by them last week.
Welcome to Tricare 😀
