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Saturday, September 14, 2013

5 Days Til 30 - An Incident At Work

I don't post often about work these days. Why would I? Most of it wouldn't be worth reading if I'm being honest. But this is something I just feel I needed to share.

Brief bit of background for those who don't know; I work as a tech at a pharmacy. One of the aspects of that job is we call insurance companies if there is an issue with a prescription that is causing it to not be covered. Today, we were working on a prescription for a patient and this issue popped up; the insurance company was claiming it was too soon to fill the medication citing it was filled earlier that day by our pharmacy. What likely happened was we had filled the same medication for another patient in the family and both profiles had the same birthday in our system. The patients, however, were not twins. The profile that was rejecting had a note highlighting what the actual birthday was, the incorrect birthday was in our system because it was possible that the insurance company may have had that date in their records and if the date was changed, the insurance wouldn't cover as a result. I know, it sounds stupid but I've run into that situation more times than I care to recall.

Anyway, I call the insurance provider's help desk number and after initially speaking to a customer service representative, I am told they need to transfer me to another department in order to resolve the issue and the hold time should be about 1 to 2 minutes. I say fine and wait to be transferred. 20 minutes pass and I'm still on hold. Nothing has happened. I hang up. Not long after that, the patient's mother returned looking to pick up the order. I explained the situation to her and said I would attempt to call again. Thankfully, the lady was very understanding about everything. I hate to say it, but that reaction is something of a rarity. So very often people become upset and confrontational when told their medications are not ready. And that gets very old after a while.

So after some time passed, I attempted to call again. Same exact thing happened; Initial representative tells me I need to be transferred, it should take 1-2 minutes, and it was once again a 20 minute hold time. I was less than thrilled, to say the least.

The pharmacist then suggested trying to change the patient's date of birth to what was noted as the correct date. Neither of us figured it would work since we were under the impression that the insurance company had the wrong date on file and it would continue to reject. But I went ahead and made the change anyway. Guess what happened. Go on, guess. Yeah, we got a paid claim. Again, I was kinda pissed. Don't get me wrong, I was glad we had finally resolved the issue. But I just wish we thought to try that earlier so I wouldn't have wasted close to 40 minutes on hold! 5 minutes later, the patient's mother called and I explained the situation to her but ultimately culminated in telling her we got everything resolved. She was thrilled.

So, yeah, that was the "big thrill" for today. Yeah, I got nothing. I don't really know how to end this post. See you tomorrow.

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