Walgreens Emergency Supply question

[DH1987]

Today I just got yelled at because the patient's insurance required a 90 day supply for coverage, but she only had 60 days supply remaining on her Rx and I wouldn't give an emergency supply to hold her over until we get the 90 day Rx. I tried to offer selling a few capsules with a discount card at $16, but it wasn't good enough for her.

Yes, she was being overly entitled, and I'm very tempted to use foul and inappropriate language to describe her, but let's put that aside. I've always been told, we can't give emergency supplies if we have any refills remaining on file and we have to sell them first. Yet we can give pills for free if there are no refills? It doesn't make sense to me. Anyone have an explanation for this? What would stop me from dispensing a few capsules off the Rx and price modifying it to 0? Would really appreciate any input.

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[Sine Cura]

Nothing would stop you really (who would care about some cheap non-control), but this isn't an emergency.

 

[DH1987]

Well...I guarantee that most of the time they're given, they're not emergencies either, lol. Most of the time they're given so they don't miss a day or two of their medication while we wait for doc to give us a new Rx.

 

[Sine Cura]

Yeah nothing in retail is an actual emergency. Not a few times where the customer doesn't even know the concept of follow-up, i.e., the PCP just magically knows what you got when you were admitted 6 months ago

 

[DH1987]

Yup. They should probably rename it, maybe call it "temporary supply", "adherence supply", or something...

 

[thecoolpharmboi]

Today I just got yelled at because the patient's insurance required a 90 day supply for coverage, but she only had 60 days supply remaining on her Rx and I wouldn't give an emergency supply to hold her over until we get the 90 day Rx. I tried to offer selling a few capsules with a discount card at $16, but it wasn't good enough for her.

Yes, she was being overly entitled, and I'm very tempted to use foul and inappropriate language to describe her, but let's put that aside. I've always been told, we can't give emergency supplies if we have any refills remaining on file and we have to sell them first. Yet we can give pills for free if there are no refills? It doesn't make sense to me. Anyone have an explanation for this? What would stop me from dispensing a few capsules off the Rx and price modifying it to 0? Would really appreciate any input.

You can provide emergency supply on a 90 day WCB only based on your judgment whether that’s appropriate for that drug or not. There’s no policy or rule that says if there’s refills left that you can’t give emergency fill if it’s waiting on a 90-day exception. I don’t recommend adjusting price to 0.

 

[johnpharm01]

You can provide emergency supply on a 90 day WCB only based on your judgment whether that’s appropriate for that drug or not. There’s no policy or rule that says if there’s refills left that you can’t give emergency fill if it’s waiting on a 90-day exception. I don’t recommend adjusting price to 0.

Try again. Some states define "emergency supply" as when a prescrition runs out of refills. A prescription with 60 days left clearly has refills. Remember its their insurance which requires 90 days so they are angry with you because they have lousy insurance. Dont cave in. At Walgreens customers get angry about everything because they get rewarded for it. You have to know where to draw the line.

 

[Pronounce Doxazosin]

Today I just got yelled at because the patient's insurance required a 90 day supply for coverage, but she only had 60 days supply remaining on her Rx and I wouldn't give an emergency supply to hold her over until we get the 90 day Rx. I tried to offer selling a few capsules with a discount card at $16, but it wasn't good enough for her.

Yes, she was being overly entitled, and I'm very tempted to use foul and inappropriate language to describe her, but let's put that aside. I've always been told, we can't give emergency supplies if we have any refills remaining on file and we have to sell them first. Yet we can give pills for free if there are no refills? It doesn't make sense to me. Anyone have an explanation for this? What would stop me from dispensing a few capsules off the Rx and price modifying it to 0? Would really appreciate any input.

FWIW, in a case like this, you can generate a 90 day WCB exception, which will allow you to give them a e-supply

but at the end of the day, we are not required to do e-supplies. I’ve refused e-supplies in the past for multiple reasons.

 

[grumpyRph]

customer should call their insurance and ask to opt out or for an override. but of course one of your techs is going to offer up making that phone call and then argue with an insurance representative on customer's behalf, wasting all of our time lol.

 

[DH1987]

Thanks all. The 90 day WCB exception sounded like it might have been appropriate in this case, but I was also wondering if the patient could have opted out of that, sounds like one of you confirmed that.

I feel a little stupid for this, but I actually do not know how to create 90 day WCB exceptions. Anyone willing to educate me on how to do that?

 

[Pronounce Doxazosin]

Thanks all. The 90 day WCB exception sounded like it might have been appropriate in this case, but I was also wondering if the patient could have opted out of that, sounds like one of you confirmed that.

I feel a little stupid for this, but I actually do not know how to create 90 day WCB exceptions. Anyone willing to educate me on how to do that?

Go to the fill screen and then under options, there should be a column that says create 90 day exception, and just put a Y for yes there

 

[DH1987]

Go to the fill screen and then under options, there should be a column that says create 90 day exception, and just put a Y for yes there

Thank you!

 

[thecoolpharmboi]

Try again. Some states define "emergency supply" as when a prescrition runs out of refills. A prescription with 60 days left clearly has refills. Remember its their insurance which requires 90 days so they are angry with you because they have lousy insurance. Dont cave in. At Walgreens customers get angry about everything because they get rewarded for it. You have to know where to draw the line.

Well of course within your states’ laws. I’m just saying Walgreens-wise it can be done but within realm of pharmacists’ judgment

 

[projektreverb]

Unless it’s a control, an easy solution would be to close script by pharmacist, generate a WCB and do the emergency supply that way.

 

[VA77]

God I hope you gave them a gift card

 

[DH1987]

God I hope you gave them a gift card

Nope. She wanted to transfer her prescriptions to a new pharmacy. I happily agreed.

 

[projektreverb]

Here’s my argument in a state where there aren’t any specific laws surrounding emergency supplies: if the patient HAS a legitimate 60 days on file, this boils out to a system flaw if you ask me. They technically have a valid script but it boils down to an insurance flaw. An argument can be made that a reasonable doctor in the normal course of practice would authorize an extra 30 days on a maintenance med. Just close out the 60 days, send a 90DS refill request and give the emergency supply. Patient will definitely pick it up and put the copay. Why give yourself the extra headache. You’re keeping the patient happy, it’s not illegal and you’re avoiding an unnecessary conflict. But that’s me.

Edit: I would highly advise against a price override situation.

 

[Chrish]

Depends if pt has previous rx on the file for the same med with no more refill left and how much I like the pt. If pt is well-behaved then I can consider giving 3 day emergency based on previous rx until they sort stuff out. If they act entitled then screw them.

 

[BidingMyTime]

The idea of an emergency fill under most (if not all) state laws, is to give the pt a few days of medicine, when the physician can't be reached, the medicine is truly necessary for their health, an the expectation is that the physician will give refills once reached.

A patient not wanting to pay for their medicine, doesn't meet the qualifications for an "emergency supply", but as a business, you can always give free medicine away with a valid prescription (although your employer may frown on that. )

 

[wagrxm2000]

Simple answer, they have refills, they don't get an emergency supply.

Have to hold your ground

 

[Deja]

what medication was it, if it was just lisinopril or something just give her 3 tabs and tell her to call the doctor too, then either subtract the 3 tab when you get the script or don't.... save yourself time and the headache lol