Saturday, February 23, 2008

A Quick Question For My Friends In The Insurance Industry

If you can print off a letter that says someone is covered, and that their card containing all the info needed to file a claim on their behalf is on the way, and that while this letter doesn't contain a scrap of information your pharmacist will need to file any claims, you should bring it to the store with you and wave it around like a lunatic anyway.....

Is there some reason.....you couldn't take the time and resources that you used to print and mail this useless letter and do something like.....


......oh I dunno.....maybe......


PRINT THE ACTUAL FUCKING CARD?.......AND MAIL THE ACTUAL FUCKING CARD? THE SAME WAY YOU MAILED THIS GODDAMN LETTER????

Call me crazy, but I'm thinking it could be done. Some nights just lend themselves to big dreams I guess.

15 comments:

Anonymous said...

Why would they do a thing like that? Then they might have to PAY some nominal amount for that person's drugs. I've always seen it as another scam to catch the person offguard. They think they're covered until they get to the pharmacy to find out we have no way to bill whatsoever. Then it's a clusterfuck and the average joe ends up paying and is to lazy (which is his own fault) or plain forgets to submit the receipt and whallah, the payor didn't have to PAY anything

Pharmer Mike said...

I can understand not including the card with the letter IF the card is printed off site, which is probably the case. However, since THEY are sending the info to the printer, shouldn't they just include it IN the fuckin' letter?! It's a simple mail merge, not rocket science. Btw, they're already mail merging the patient's basic info into a form letter to begin with... Just add a few more fuckin' fields and I won't have to call Miss Cleo to process a script!

Anonymous said...

And the insurance company laughs all the way to the bank...

Anonymous said...

Amen to that, brother. My favorite is when the customer says, "They said you can call them if you have any questions."
Yeeaaaaahhhh, riiiiiight...............

Ellie said...

Wow, you're flying high on the Ambien!
Print the card. As if.

Charlie said...

Quote of Friday night:

Me: "Ma'am, your mother's antibiotic wasn't covered as she got a 20 day supply less than a week ago."

Customer: "But she just got out of the hospital! They HAVE to cover it!"

Me: (stunned silence)

Why is it that given the choice of picking up a phone and talking to someone with the power to change something who speaks English as a native language, or yelling at the underpaid bastard at the pharmacy to call some powerless drone who lives in India, customers seem to favor the latter option?

I actually convinced that one to check mom's medicine chest. I'm getting really good at "Please contact your benefits coordinator if you believe this is incorrect."

As for the card info, Mr. Monkey, if the card info was printed on the letter, it still would be missing useful things like "RxGRP" or the almighty "RxBIN" and you know it.

Dustin said...

I would imagine it has something to do with liability or fraud. Warning the subscriber that the card is on the way tells them to watch out for it in an envelope that doesn't obviously have a plastic card in it. Credit card companies do the same thing sometimes, and banks often send PIN and card separately for the same reason.

Anonymous said...

i love it when the drugmonkey loses his cool.

it's my favorite.

Anonymous said...

This has been happening a lot lately. Pharmacy has no minnimum standards in place for billing insurance so we put up with stuff like this. Its our own fault. We're not smart enough as a profession to unite against this nonsense and put an end to it. So we waste time on pointless phone calls and letters like these when we already have more scripts to fill than ever before.

kario said...

Aww, isn't that cute. An idealist!

that rx girl said...

We would be thrilled if they would even just print the information on the letter. If they aren't send the cards out, would it be so hard to just print the BIN, ID number and the group?

My favorite is when the medical insurance is through Blue Cross, so the letter says Blue Cross, but the RX portion is through Wellpoint, or Medco, or PCS, or...you get the point.

Charlie said...

I like that Caremark will send you a reject error like "Verify BIN, PCN, GRP, ID" like they know that the pt. is covered with them, but aren't exactly sure why.

Would it be that hard to oh I don't know, maybe use something like this instead:

"Resubmit claim to BIN:004336 PCN:ADV GRP:MORONRX ID:66666666 PC:01"

Jennifer said...

Only nerds memorize BIN numbers...610014. page down 3 times, arrow key up 3 times....yay medco *sigh*

Anonymous said...

they sure do wave those papers around like lunatics. my real question: why don't all insuances cover 90 day supplies? is it because they think they will have wasted the money if the med is discontinued? i really want to know so I don't sound like a moron making up a reason, when actually i shouldn't have to explain the insurance co's assholish ways for them

Anonymous said...

Because insurance companies are NOT in the business to pay claims. And sending claims through - with the right info on the "card" (which is obviously unavailable) is the first step into having to pay these irritating claims - cutting into their profit.