The Pharmacy Chick

Flying the coup in retail

“It’s covered” doesn’t mean ” It’s free”

Filed under: Uncategorized — pharmacychick at 9:05 am on Tuesday, June 25, 2013

Effective communication is probably one of the most important attributes to being a good pharmacist.  You HAVE to be able to convey a message that your patient understands properly and in the proper context.  Time and time again I have said X to a patient who will immediately hop on a cell phone and convey Y to the person on the other end with a message that not only is inconsistent with what I had just said but often completely inaccurate.  Doctors have called me unable to understand what a patient was telling them because they managed to mangle a message.  Its amazing really.  Therefore I will often speak in first grade English and ask them to verify understanding on things that really matter.

ONE of those things is the cost of their copays.  to many, “covered” means “free” and that is never ( or seldom) the case.  Nothing expensive is ever labeled, opened or otherwise adulterated until the patient fully knows what the cost is, has agreed to pay for it, and is standing at the counter asking for it.  I am done with being stuck with drugs I cannot use because somebody taped a label to it.  Thankfully with the advent of integrated main frames I can see what other stores use and can sell it to somebody who can actually use it. Never the less, Id rather not have to do that.

Recently I got bit by the “covered but not free” bug myself.  Mr Chick had been having some dental problems and finally went to the dentist who delivered the grim news.  ” You need a crown”.  Lovely.  We had the dentist do all the appropriate things by having it pre approved and by all intents and purposes, we did everything by the book.  The receptionist called me a week later and said ” we have everything pre approved.  Its covered and you have a 50.00 deductible.”.   Now had I had my rph thinking cap on, I might have said…” Covered…as in 100%?” but something in my brain was turned off and I took her words at face value…so did Mr chick, also a pretty smart insurance savvy guy. So we went into it thinking we had to pay 50.o0.

The big day comes and lo and behold he needs two crowns because the tooth that was cracked was hiding a crack exactly opposite it in the adjoining tooth. so both needed to be done.  My heavily sedated sweetie hardly knew what happened because he was so out of it.

A couple of weeks later the ” explanation of  benefits” came in the mail.  “AMOUNT BILLABLE TO PATIENT: $ 1150.00”.

Yessiree. Crown was covered….at 50%  and 50.00 deductible…a little fact that the receptionist failed to mention.  But nevertheless, still my responsibility.

Now, thankfully, we have the resources to pay this kind of bill.  Not everybody does and it served as a timely ( if not costly) reminder that even the intelligent and relatively informed can be misled.  Would it have changed things for us? Probably not, he needed that crown…both of them.  But there are a lot of people who might have had a bill like that be a life changing mess.

Yes, communication is important.  Remember that!


Filed under: Uncategorized — pharmacychick at 9:42 pm on Wednesday, June 5, 2013

If people who hacked into other’s accounts  spend half their efforts into legit careers we’d probably be all better off.  To any of you who have received a spammy email from Pharmacy Chick, my apologies.  I was hacked.  And to those of you who took the time to notify me, THANK YOU!  Iappreciated every one of them.

My best wishes to all!