Wednesday, February 20, 2008

Tonight A Customer Cracks The Secret Code Needed To Obtain Coverage In The American Health Care System.

One of the great joys of my profession is the fact that while other healthcare professionals may have a little sign in front of the receptionist saying that payment is expected at the time services are rendered, few have the ability to file and adjudicate your health insurance claim on the spot, instantly determining your eligibility and financial liability. Customers appreciate this, and it never fails to lead to many a lively discussion during the workday regarding the scope and amount of their coverage.

What I just said in that last sentence is that customers bitch about their insurance coverage. A lot. Many times at high volume.

The conversations are usually very predictable, and over the general din of pharmacy sounds this afternoon I hear one going on in the background, It's kind of like the pharmacy equivalent to crickets chirping outside a country cabin late in a summer's evening, just part of the expected background noise:

"Sir your insurance company says your coverage has expired."


"Blue Cross says you're no longer covered. Do you have a new card?"

"No" The customer usually then will just stand there, expecting that that answer will still get them their meds at their usual co-pay. It must be explained again to them at this point that without a valid insurance card, they are liable for the entire cost of their prescription.

This is what today's customer said next, complete and unedited. I double checked with my keytstone tech to make sure I heard him correctly:

"There was a senior citizen behind me last time, would that have made any difference?"

I had no choice. I instantly stepped in and reinstated the man's insurance coverage. He had a senior citizen behind him last time. He had figured out the Da Vinci code of health care. What every insurance company employee and health care professional knows and is sworn never to tell. Senior Citizen behind you = full coverage. Having an old geezer stand behind every American was actually the cornerstone of presidential candidate John Edward's health care plan.

I still don't know exactly what point the customer was trying to make, and I haven't had any scotch in a week.

That streak will end tonight.


Pharmer Mike said...

LOL .. I thought everyone knew that secret! That's why I carry a Ronco "pocket senior" with me at all times. When I'm not having my healthcare issues magically resolved, I'm getting a discount on my purchases. I never leave home without one. (announcer: Warning! Pocket senior is not to be used during telemarketing transactions as permanent loss of life savings may occur).

Romius T. said...

that's all i need to get me some pills? yehaw! And go get some scotch!

Mother Jones RN said...

Thank you for giving me an idea. I'm going to place this ad on Craig's List:

Retired nurse with gray hair and wrinkles will work to help you get health care coverage. Will stand behind you in line at your pharmacy to ensure enrollment in the health care plan of your choice. Reasonable rates. Contact Mother Jones, RN at


Bariatric Brat said...

Have you seen the OxyClinton ad spoof?

Tyler said...


You are too funny, do you need a new pharmacist? Sounds like working with you would be a blast!! You have to have humor to deal with some of these patients and the way they fricking act. Last time I worked I had some guy bitching at me cause his Juice didn't ring up on sale like it was supposed to. I was like "I don't really deal with that" I wanted to say "do you have any fucking drug related questions for me, or do you want to continue to waste my time" but anyway, dumb ass grabbed the wrong brand, wah wah.

Jennie said...

Wow, that customer is just full of fail. I wonder what would have happened if a drug rep was stood behind him at the time. That one might earn him a share in the company... :p

jens said...

My wife works as an outpatient pharmacist in a hospital, where the unionized employees (not, of course, the pharmacists) have a prescription plan that allows them - for the life of the prescription to have one fill and one refill locally, and for the rest of their life they have to use mail-order.

This gives rise to some interesting discussions when the patient needs the drug NOW, but has to send away for it.