Back to work after a lovely holiday break. Today is probably going to be the worst day of work all year for me. I predict it will be insanely busy and miserable. Why? Well, it will be busy because it's the first weekday of the month, always a busy day in pharmacy (plus it's a Monday, another busy pharmacy day). And it will be miserable because many people will have new insurance cards, a fact that they will be totally oblivious to. I'll spend my day something like this:
First of the year scenario #1:
Patient: Can I get my Plavix refilled?
Me: Sure. Do you have a new insurance card now that it is 2010?
Me: Your insurance is rejecting the claim, saying coverage ended 12-31-09. Did they send you a new card?
Patient: That is ridiculous! I just got my Lipitor last week and they paid for it!
Me: Yes, that was last year. Your coverage changed for 2010.
Patient: That's it, transfer my rx to CVS, I can't deal with this BS!
First of the year scenario #2:
Patient: I'm here to pick up the refill I dropped off this morning.
Me: Ok, your total is $178.26.
Patient: But I have insurance!
Me: Yes, this was billed to your insurance. It looks like this claim was applied to your annual deductible, which restarted january 1st.
Patient: I don't have a deductible!
Me: (In my mind): Oops, you're right, you don't! I just invented your deductible so I could secretly skim $150 off the top of your rx, hehehehe! (out loud): Well let me call your insurance company and we'll find out. (seething, since this call is so pointless when the company just sent us back this price with deductible, I call - annoyed that I have become an insurance expert rather than pharmacist, and annoyed that no one has a clue about his own insurance plan. I hang up.) Your insurance company confirms that you have a $300 deductible on rx's each year. After this claim you have $122 left on the deductible.
Patient: Well I can't afford that! (throws rx at me, misses, paper-cuts the eye of another customer, we get sued).
First of the year scenario #3:
Patient: I need to pick up my new rx.
Me: Can I see your new insurance card? Your old one expired last year.
Patient: What! I don't have a new one!
Me: Well, Express Scripts says your coverage ended in December. Looks like your company changed prescription insurance for 2010.
Patient: Express Scripts?! What are you talking about, I have Blue Cross!
Me: Yes, that is your health insurance. But they contracted with Express Scripts for your prescription coverage, and now it appears they use a different prescription company.
Patient: What?! What?! I have Blue Cross! I've always had Blue Cross! WHaaa?!
Me: Yes, yes, you do. But they hire another company to handle your prescription insurance, and since that company changed I need your new card.
Patient: I threw out my new card! Because it's still Blue Cross! Blue Cross! Blue Cross!
Yep, happy new year to the health care world!