Friday, November 17, 2006

"Loop, Endless," see "Endless Loop"

(Tonight's image has been borrowed from; I hope they don't mind too much.)

On most days, I'm pretty even-keeled. I'm hard to offend and I'm even harder to shock.

Still, there are things that push my buttons instantly, things I can't abide, things I will immediately leap to the defense of those wronged in such situations. Such situations include intolerance, injustice (especially towards children), and selfish incompetence.

A couple of days ago, I had to deal with the latter...and believe me, it...well...I'll let you decide.

My doctor and I have been trying to find a medication that manages a primary condition without involving side effects that, um, guys prefer not to live with. ('Nuff said!)

Well, I happen to work for an organization that has a pretty decent health plan. In fact, the health plan is such that they prefer you fill prescriptions through an online provider...if you do, they give you a 90-day supply without a co-pay. (For the record, most health plans in my experience require a co-pay and limit you to a 30-day supply at best.)

So, my doctor gives me a prescription for a certain medication. I dutifully ask him to contact the online provider. He (or someone on his staff) does so. We've been through this before and there have been no issues whatsoever. The pills usually show up in a couple of days.

If you've read my blog over the past couple of months, you know I've recently moved.


My first warning of trouble is an automated phone call from the company that fills the prescriptions. They claim that not only am I *not* covered, but that the contract they had with my insurance provider expired in 2003.

Um...I wasn't covered by this particular health plan in 2003. And they had a contract just a couple of weeks ago when I refilled a different prescription. WTF?

So...I contact my doctor's office to see what's what. They tell that they've filed everything according to instructions and that I need to contact my insurance company to get things straightened out.

After a bit (OK, a lot) of digging on the I dig up the number to contact my insurance company and I call...and I burn cell minutes waiting on hold because I have this inherent idea that one should not use one's employer's phone lines to conduct personal business. (And, for the record, my cell provider stinks.) I get on the phone with the health plan provider and explain the situation.

They tell me they understand, bring the prescription provider online, and then vanish...thinking everything's handled.

I provide the details again. And then am quizzed on the new delivery details.

Yes, they have the right ID's and plan numbers. Yes, they have the right address. Yes, everything's right, good, and proper.

The next day, I learn the prescription had been denied...for very different reasons.

About 10 a.m., a voice mail appears in the Inbox of my cell. It's an automated message that sounds slightly like the 1970's versions of the Cylons. Oh, c'mon. You know the ones I mean, the ones with the 'voder saying "By your command!"

The message claims they've contacted my doctor and that he's failed to respond to their queries within a 48 hour period. So, they can't fill the script.

The implication, of course, is that my doctor is a moron.

So, I call the health plan provider back, just to make sure I have the right subscriber number, address, and other vitals squared away. (I do.)

Now, I've yet to speak to the same person twice in all of this. It's also about ten days after the initial prescription.

Then I call my doctor's office.

I'm also getting kind of frustrated because I'm getting two different stories and no one seems to be willing to step up and talk to another party without using me as a messenger.

There are times I'm a very good messenger, but at this point, I have no idea which computer system has a bug up its assets.

So, I start solving the problem the way Alexander solved the Gordian knot. I tell my doctor what I've been told. I provide my observations about the different stories. They acknowledge the weirdness and promise to deal with it. I begin to breathe a bit easier.

A couple of hours later, I receive a call from my doctor's office, repeating the story of the missing contract and telling me that I'd need to work out the problem between my health plan provider and the company that fills the prescriptions.

The implication, of course, is that my health care provider and the company that fills my prescriptions are both morons.

It's déjà vu all over again.

I get on the phone to my health plan provider. I work really hard to rant without ranting. I lay out the ridiculousness of the situation with an air of aggravated frustration. The woman taking my call responds with the appropriate amount of sympathy. She clearly has been trained in how to deal with frustrated customers. We confirm my numbers and my address. She's open, she's listening, she cares. Yadda, yadda, yadda. (Shut up, Jerry!)

She tried to tell me that I need to call my doctor and tell them they need to call the prescription in,

I'm like...What?!?

I tell her that this is the third time I've been asked to do just that very thing and the lack of progress is why I'm calling now. I explain the stories I've heard. I tell her I have no idea what to do know. I'll call, but I don't have any faith there will be any significant progress. I tell her I need someone to deal with the problem, not frob it off on someone else.

Amazingly, my audio correspondent understands that. She asks me to wait on the phone while she calls my doctor. I don't have a lot of faith, but I agree...and I wait. (Yes, I'm still burning minutes.) A few rounds of Solitaire later, she comes back and tells me my doctor's office has been filing the right paperwork and would I be willing to wait just a few minutes more so she can call the prescription provider to make sure the story's straight on their end?

(What, I'm going to disagree at this point?)

Long and short, she comes back after that conversation and tells me that while she can't tell me they're going to ship the medication, it certainly looks like they have the right information, too.

She promises to keep an eye on things over the next several days.

Today, she called me back and told me that it looks like my meds have been shipped and I should see them in a few days. Frankly, I feel like Chris Kattan in "Night at the Roxbury." Hello, Operator 238...Credit Vixen!

OK, I'm over-stating things. I actually haven't received my meds yet. I hope they show up soon.

Huh? What's the "primary condition?" Um, well,'s high blood pressure, of course.

I wonder what I'll need to go through when they prescribe meds for the cholesterol.


Blogger Jane Poe (aka Deborah) said...

Of course, I got to hear this story before I read it ... but, still I'm reminded of the inefficiencies of "efficient" systems. Hey, let's send them your cell phone bill next month! xxx, JP

11:36 AM  
Blogger Tim ID said...

All I can say is that heatlh insurance companies are a pill.

Oh and I take BP and cholesterol medication. The perscription process doesn't get any better.

9:14 PM  
Blogger paris parfait said...

OMG! This is one reason I'm so glad I'm not in the States at the moment. Hope your meds have arrived and you don't have to suffer a repeat performance the next time you need a prescription.

1:36 PM  

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