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Background: I work in a grocery/pharmacy in a village in New York State, in which the population is 100% comprised of members of a particular ethnic group (I'm not exactly from this group, but my family originated in the same part of the world, if that gives you a hint). Residents of this village, as well as other members of the same group from other cities, often send their kids for a few weeks in the summer to camps up in the mountains. We deliver around the village several times daily (many residents don't drive) and during the summer months, one delivery to the mountains.
If the kids get sick at the camp, they take them to a local health center, who then fax us the prescriptions. If we have the child in our system already, well and good; we fill and deliver them. If not, then I have to start doing detective work. Sometimes the doctor has the insurance info; sometimes they have only the Medicaid number, which at least I can look up on the state Medicaid website to find out which HMO they have, or if they're straight Medicaid. Armed with that info, I at least know who to call to get the info necessary to process the Rx.
So last week we get a fax from this doctor's office for an antibiotic. No idea who this kid is; we have the HMO membership number and a home phone number, and that's it. No address, no date of birth, nothing. We call the number, and get an answering machine, so we leave a message and leave it at that. Delivery left at 4:30; I get there at 5.
So I start researching. Googling the phone number only tells me that it's unlisted. From the HMO's third party processor's website I can at least get the D/O/B (not to mention the correct spelling of the last name, which turned out to have been wrong on the fax), so that's a start, but the doctor's office thinks they also have Medicaid, meaning they're not going to be charged a copay. Unfortunately they have no idea what ID number that is, and Medicaid won't give me that info without a SSN, which we also can't get.
Boss (Mr. W) goes home at 6:30 as usual. He's been there since the morning, and has a family.
Later that evening, I get a phone call. Woman is screaming at me, why hasn't her daughter gotten her medicine? The ensuing conversation went something like this, though the order of the questions might have been a little different (thank $DEITY the memory has faded):
Me: We had no information on the child beyond her primary insurance. We needed the Medicaid number so we could bill it.
She: Why didn't you call me? I'd have given it to you!
Me: We did call you, we got the answering machine.
She: I know, I wasn't home all day, I just now got the message. Why didn't you call my cell phone?
Me: (thinking: How the
was I supposed . . . ) Because I didn't have your cell phone number. All I have is what the doctor sent me, which is your home number and primary HMO ID. If I had the cell number I certainly would have called it.
Her: Why did they even send the prescription to you anyway? We go to [Our Competition] pharmacy!
Me: (thinking: maybe because we deliver to the mountains and they don't?)
Her: You should have called [Our Competition] pharmacy, they have our information on file! They'd have given it to you, no problem!
Me: (thinking: Right, I'm really going to call my competition across town and ask them for one of their patient's insurance info. They do in a day what we do in a week, I'm sure they've got nothing better to do than stop work and look up information for their competition. And besides . . . ) How was I supposed to know you were a patient at that pharmacy, ma'am? I had no idea who you were; I didn't even know if you lived here or in [Town 1 a half hour away], or [Megalopolis II, an hour and a half away], or what.
Her: So why did they send you the script? We never use your pharmacy!
Me: (thinking: and you can go right on not using us, I have no problem with that) Dunno, you'd have to ask the doctor's office. We don't have any control over where they send prescriptions. Do you have the Medicaid number?
Her: Wait, I'm getting it . . . (reads off number. I put it in the computer and it works.)
Me: OK, it went through.
Her: So you're gonna send it up there?
Me: We only have one delivery a day to the mountains. Next one is tomorrow at 4.
Her: Well why didn't you just send the medicine anyway and get the insurance later?
Me: (thinking: because every time we've done that, we have to go running after the parent for the information, and since the kid has the medicine already there's no rush on their part. Maybe the insurance they gave us is terminated, or there's a copay, and go run after these people who half the time live in a totally different city (and once we had a home phone number in Montreal, which isn't even the same country!) We have prescriptions from 3 weeks ago that we're trying to get paid on.) I don't know, ma'am, you'd have to speak to Mr W. tomorrow morning about that.
Her: So how's she gonna get the medicine?
Me: I can call around and see if there's anybody going up there tonight, but I can't promise I'll be able to find someone. If you know anyone going up to the mountains, maybe you could send it with them.
Her: I'll call you back.
Few minutes later, she calls back.
Her: Can you deliver it to my house?
Me: You never gave me your address . . .
She did calm down somewhat by the end of the conversation. We sent the stuff out, what she did with it after is her business.
As an aside, maybe that heading should say "Suckbay"...
If the kids get sick at the camp, they take them to a local health center, who then fax us the prescriptions. If we have the child in our system already, well and good; we fill and deliver them. If not, then I have to start doing detective work. Sometimes the doctor has the insurance info; sometimes they have only the Medicaid number, which at least I can look up on the state Medicaid website to find out which HMO they have, or if they're straight Medicaid. Armed with that info, I at least know who to call to get the info necessary to process the Rx.
So last week we get a fax from this doctor's office for an antibiotic. No idea who this kid is; we have the HMO membership number and a home phone number, and that's it. No address, no date of birth, nothing. We call the number, and get an answering machine, so we leave a message and leave it at that. Delivery left at 4:30; I get there at 5.
So I start researching. Googling the phone number only tells me that it's unlisted. From the HMO's third party processor's website I can at least get the D/O/B (not to mention the correct spelling of the last name, which turned out to have been wrong on the fax), so that's a start, but the doctor's office thinks they also have Medicaid, meaning they're not going to be charged a copay. Unfortunately they have no idea what ID number that is, and Medicaid won't give me that info without a SSN, which we also can't get.
Boss (Mr. W) goes home at 6:30 as usual. He's been there since the morning, and has a family.
Later that evening, I get a phone call. Woman is screaming at me, why hasn't her daughter gotten her medicine? The ensuing conversation went something like this, though the order of the questions might have been a little different (thank $DEITY the memory has faded):
Me: We had no information on the child beyond her primary insurance. We needed the Medicaid number so we could bill it.
She: Why didn't you call me? I'd have given it to you!
Me: We did call you, we got the answering machine.
She: I know, I wasn't home all day, I just now got the message. Why didn't you call my cell phone?
Me: (thinking: How the
was I supposed . . . ) Because I didn't have your cell phone number. All I have is what the doctor sent me, which is your home number and primary HMO ID. If I had the cell number I certainly would have called it.Her: Why did they even send the prescription to you anyway? We go to [Our Competition] pharmacy!
Me: (thinking: maybe because we deliver to the mountains and they don't?)
Her: You should have called [Our Competition] pharmacy, they have our information on file! They'd have given it to you, no problem!
Me: (thinking: Right, I'm really going to call my competition across town and ask them for one of their patient's insurance info. They do in a day what we do in a week, I'm sure they've got nothing better to do than stop work and look up information for their competition. And besides . . . ) How was I supposed to know you were a patient at that pharmacy, ma'am? I had no idea who you were; I didn't even know if you lived here or in [Town 1 a half hour away], or [Megalopolis II, an hour and a half away], or what.
Her: So why did they send you the script? We never use your pharmacy!
Me: (thinking: and you can go right on not using us, I have no problem with that) Dunno, you'd have to ask the doctor's office. We don't have any control over where they send prescriptions. Do you have the Medicaid number?
Her: Wait, I'm getting it . . . (reads off number. I put it in the computer and it works.)
Me: OK, it went through.
Her: So you're gonna send it up there?
Me: We only have one delivery a day to the mountains. Next one is tomorrow at 4.
Her: Well why didn't you just send the medicine anyway and get the insurance later?
Me: (thinking: because every time we've done that, we have to go running after the parent for the information, and since the kid has the medicine already there's no rush on their part. Maybe the insurance they gave us is terminated, or there's a copay, and go run after these people who half the time live in a totally different city (and once we had a home phone number in Montreal, which isn't even the same country!) We have prescriptions from 3 weeks ago that we're trying to get paid on.) I don't know, ma'am, you'd have to speak to Mr W. tomorrow morning about that.
Her: So how's she gonna get the medicine?
Me: I can call around and see if there's anybody going up there tonight, but I can't promise I'll be able to find someone. If you know anyone going up to the mountains, maybe you could send it with them.
Her: I'll call you back.
Few minutes later, she calls back.
Her: Can you deliver it to my house?
Me: You never gave me your address . . .
She did calm down somewhat by the end of the conversation. We sent the stuff out, what she did with it after is her business.
As an aside, maybe that heading should say "Suckbay"...
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