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I have 1 customer who simply won't believe me as far as her insurance goes.
She came in again tonight, for the first time in several months. I thought I'd managed to successfully pawn her off on Rite Aid, but it was not to be. We are not contracted with her insurance. She's on public aid, and I have gotten claims to go for a few of her kids, but not for her or the rest of her brood.
The first time, I told her she had the option of paying out of pocket at that time, and that she needed to call the insurance carrier to get the problem fixed. If she got it done in 5 business days, I could rebill and refund her some money back. She took that to mean that if she paid now, that magically things would happen and she could get money back with no effort on her part.
The second time, she was hassling another tech who was also unsuccessful at getting a claim to go through, and he called me in to help since I'm very good at adjudicating claims. I should be, I've been doing this for 3 years and we do about 500-600 prescriptions a day these days. I know what I'm doing.
I called support for her, and they confirmed that we were no longer a provider for this particular plan (it's a pretty stinky PPO, but hey, you get what you pay for, which is to say, she's hardly paying anything.)
I told her this AGAIN, and told her to call insurance AGAIN as well as her caseworker AGAIN if she thought this was incorrect. She ranted for awhile, and finally went to Rite Aid.
Tonight, she got a script to them, and they were unable to fill because they were too close to closing. Guess what? Same problem. This time, she told me that she'd never had this problem at other stores in my chain (sure, if you're filling for that one kid who I've also gotten claims to go through for, numbnut), and that the people at Rite Aid "couldn't understand" why I was having trouble with the claim, and that it must be that "I need more training". Um, no. Why do you think other techs and pharmacists at the other stores call me if they have issues? They know that I know how to get things to work! She didn't want to go to the 24 hour Rite Aid because it was tooooo faaaar. *cue very small violin*.
She asked ME when Rite Aid would be open again. I don't know, you fill there, I don't, lady, I'm assuming 8AM like everyone else.
She finally went away after I gave her the supervisor's name and when she'd be back in, and I also printed off the reject I was getting from her insurance, as well as the complaint line.
But seriously, she could have avoided ALL of this if she'd just bloody called the insurance company like I told her to many, many times. Seriously, how hard would that be, rather than deal with this crap for 6 months or more? Even if I was wrong, which I'm not, they could then call me and we could get the problem fixed. Gah, I hate people who simply won't listen to anything that comes out of my mouth.
She came in again tonight, for the first time in several months. I thought I'd managed to successfully pawn her off on Rite Aid, but it was not to be. We are not contracted with her insurance. She's on public aid, and I have gotten claims to go for a few of her kids, but not for her or the rest of her brood.
The first time, I told her she had the option of paying out of pocket at that time, and that she needed to call the insurance carrier to get the problem fixed. If she got it done in 5 business days, I could rebill and refund her some money back. She took that to mean that if she paid now, that magically things would happen and she could get money back with no effort on her part.
The second time, she was hassling another tech who was also unsuccessful at getting a claim to go through, and he called me in to help since I'm very good at adjudicating claims. I should be, I've been doing this for 3 years and we do about 500-600 prescriptions a day these days. I know what I'm doing.
I called support for her, and they confirmed that we were no longer a provider for this particular plan (it's a pretty stinky PPO, but hey, you get what you pay for, which is to say, she's hardly paying anything.)
I told her this AGAIN, and told her to call insurance AGAIN as well as her caseworker AGAIN if she thought this was incorrect. She ranted for awhile, and finally went to Rite Aid.
Tonight, she got a script to them, and they were unable to fill because they were too close to closing. Guess what? Same problem. This time, she told me that she'd never had this problem at other stores in my chain (sure, if you're filling for that one kid who I've also gotten claims to go through for, numbnut), and that the people at Rite Aid "couldn't understand" why I was having trouble with the claim, and that it must be that "I need more training". Um, no. Why do you think other techs and pharmacists at the other stores call me if they have issues? They know that I know how to get things to work! She didn't want to go to the 24 hour Rite Aid because it was tooooo faaaar. *cue very small violin*.
She asked ME when Rite Aid would be open again. I don't know, you fill there, I don't, lady, I'm assuming 8AM like everyone else.
She finally went away after I gave her the supervisor's name and when she'd be back in, and I also printed off the reject I was getting from her insurance, as well as the complaint line.
But seriously, she could have avoided ALL of this if she'd just bloody called the insurance company like I told her to many, many times. Seriously, how hard would that be, rather than deal with this crap for 6 months or more? Even if I was wrong, which I'm not, they could then call me and we could get the problem fixed. Gah, I hate people who simply won't listen to anything that comes out of my mouth.
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