Tuesday, October 5, 2010

Ed's adventures in prescriptions fills

As most of my loyal readers know by now I've since left the east coast and the world of PCs for the open air of California and a Mac loving industry (for the record I lasted 12 hours on a Mac!)  With the big move came switching pharmacies and transferring my prescriptions from VA to NY to CA.  I've also switched insurance and pharmacies so the idea that all of that would have gone smoothly for someone who has encountered more problems with prescription re-fills than NASA does testing flight equipment was probably a stupid thought.

For the past couple weeks I have been getting everything set for my first insulin pick up at Kaiser Permanente (KP).  I contacted my new PCP to let him know I would need insulin for October 1st, contacted the KP pharmacy to ask what the protocol was and followed up with CVS to initiate the transfer.  Through a series of e-mails, phone calls and follow ups I was assured that I would have a 1 month supply of insulin by September 25th and that not seeing my doctor for the first time until the second week in October was not a problem. 

So I hopped on the 38L from work last night and anxiously awaited to hop off the bus at Divisaderio and Geary.  An aside, it is really hard to tell what street you're on while riding the bus in SF; I constantly have to look at google maps on my Droid because the street signs aren't consistent and have names, not numbers so I can't just "count."  I'm sure eventually I'll know landmarks and stuff or figure out the mystical language other SFers use to know when to get off the bus but for now I rely on technology. 

Once off the bus I walked into the KP building, found the pharmacy and got into line.  The pharmacy is freaking huge and feels more like a DMV than a CVS, there were about a dozen people waiting in chairs staring at some screen that apparently tells you when your script is ready for pick up and there are windows of tellers - not a nice open desk for you to drop off your script, pick up or pay for stuff I guess.  This pharmacy also had the most robust section of contraceptives I've ever seen - no problem with that, KP just offers quite the variety!

Finally I got to window 5, handed the clerk my drivers license and KP insurance card and then I saw her inquisitively looking at the screen.  Uhoh, the trouble begins.  "What medicine do you need?" I respond insulin - Novolog.  "Hmmm, ok there is a note from your doctor but CVS hasn't transferred the scripts yet."  I responded, I confirmed everything with my Doc and CVS and have e-mails following up with each, yes those scripts have been transfered.  The really nice (seriously) clerk then said "ok let me talk to the pharmacist."

After a couple minutes the clerk came back and said "we would send you up to emergency care to get a script but they are closed."  I responded ok, I'm just about out of insulin and will be by tomorrow morning, this is kind of a necessity right now.  For the record this was the first time I could actually go to KP to get my script filled, I didn't intentionally wait until I only had 30 units of insulin left - all in my pump.  "Ok let me get the pharmacist to talk to you."

Evil pharmacist comes to greet me.  "We can't refill your script, it doesn't exist."  I responded in a non-elevated tone, that of course it exists, I have e-mails saying so, can pull my old scripts on CVS.com and have an e-mail from my doctor.  Evil pharmacist of course doesn't budge so I then get a little agrivated but didn't raise my voice (I'm learning!).  So I asked her this; KP is supposed to be all about patient centered care, right?  she responds "Yes," and I am the patient, right?  again she says, "Yes", so then if in the morning I'm in the hospital because I don't have insulin how does that possibly equate to patient centered care?, she looks slightly annoyed so I close with; I'm pretty sure a dead patient doesn't equal patient centered care.  At that she replied "we can't fill your prescription you have to talk to your doctor," and walked away.

My clerk in shining lab coat was way more empathetic and tried to help me out; she asked me what the CVS phone # who held my scripts was, and if I had the RX number in the e-mails from my Doc.  I then brought up the e-mail from my Doc on my trusty Droid and showed her the CVS script on the same gift of technology.  My CVS script said refills "transferred out," proving they did their job and the e-mail from my Doc said "you are fine to pick up your one month script before seeing me, the endo nurse will follow up and confirm," which she did.

The clerk in a stroke of genius then went to talk to a different pharmacist, this one with a brain, who understood the importance of insulin for a T1 and who realized that this was a system mistake and not some dude on the street trying to score some insulin (because nothing says a fun night like going hypo).   After 45 minutes everything was resolved and I did in fact receive the goodness that is synthetic insulin that keeps me going day after day.  Sampson hadn't lost his hair.  Welcome to a new pharmacy - my adventures continue.


Anne said...

man what a pain! the good thing is that once you are in the system, you can just have your refills mailed to your house; and you can order those refills online.

AmyT said...

OMG, hilarious and sad too. F the system,right?! Next time you're desperate in SF contact me - I live here too and have some great resources ;)

btw, the streets of SF are easy to navigate! It's just big grid poking out into the water is all.

Anonymous said...

OMG that made me laugh and cry at the same time. I miss you man!

MAO said...

Get used to it just wait till everyone gets health care. I to have burned a few bridges at the pharmacy. the funny thing about it is I still think you can buy it over the counter.

Just wait till the 3rd party vender sends you to collections over a 100 copay for soft sets that should be covered 100% by the insurance and oh by the way we are sorry its a software issue....fun fun fun.

Alison said...

Great post, Ed! Lately, I've been scoping out insurance options, so it's insightful reading about your experiences with KP.