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	<title>Psychotomy &#187; insurance yahoos</title>
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	<description>Breaking Down</description>
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		<title>Prescription FAIL</title>
		<link>http://attriel.psychotomy.net/wp/2011/11/prescription-fail/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=prescription-fail</link>
		<comments>http://attriel.psychotomy.net/wp/2011/11/prescription-fail/#comments</comments>
		<pubDate>Tue, 29 Nov 2011 01:14:01 +0000</pubDate>
		<dc:creator>attriel</dc:creator>
				<category><![CDATA[Kitty]]></category>
		<category><![CDATA[insurance yahoos]]></category>

		<guid isPermaLink="false">http://attriel.psychotomy.net/wp/?p=700</guid>
		<description><![CDATA[So, to continue our tale from Fun with Prescriptions &#8230; When I  checked the mail from last week (we were out of town) &#8230; Note from CVS/Caremark. After carefully reviewing the case, blah blah blah, according to our records, yadda yadda, we are DENYING your request for an exception for this medication because: After two months, you [...]]]></description>
				<content:encoded><![CDATA[<p>So, to continue our tale from <a title="Fun with Prescriptions" href="http://attriel.psychotomy.net/wp/2011/11/fun-with-prescriptions/">Fun with Prescriptions</a> &#8230;</p>
<p>When I  checked the mail from last week (we were out of town) &#8230; Note from CVS/Caremark.</p>
<p>After carefully reviewing the case, blah blah blah, according to our records, yadda yadda, we are DENYING your request for an exception for this medication because:</p>
<ul>
<li>After two months, you are expected to switch to a 90-day supply</li>
<li>You can get a 90-day supply via the mail-order</li>
<li>You can also get a 90-day supply at your local CVS/Pharmacy and pay the mail order price</li>
</ul>
<p>Because this prescription does not fulfill these requirements (90-day prescription required for all maintenance medications), we cannot grant you an exception to the 90-day maintenance rule requirement.</p>
<p>I&#8217;m going to try to scan it and post it, because seriously?  I can&#8217;t make this stuff up.</p>
<p>They can&#8217;t give me an exception to the rule requiring a 90-day prescription, because I need a 90-day prescription, and I don&#8217;t have a 90-day presecription, and I should have a 90-day prescription, so we can&#8217;t let you not have a 90-day prescription because you don&#8217;t have a 90-day prescription.</p>
<p>REALLY?  Clearly they don&#8217;t employ actual people, just scripts that are, SOMEHOW, incapable of performing simple logic?</p>
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		<title>Fun with Prescriptions</title>
		<link>http://attriel.psychotomy.net/wp/2011/11/fun-with-prescriptions/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=fun-with-prescriptions</link>
		<comments>http://attriel.psychotomy.net/wp/2011/11/fun-with-prescriptions/#comments</comments>
		<pubDate>Tue, 08 Nov 2011 02:07:49 +0000</pubDate>
		<dc:creator>attriel</dc:creator>
				<category><![CDATA[Kitty]]></category>
		<category><![CDATA[insurance yahoos]]></category>

		<guid isPermaLink="false">http://attriel.psychotomy.net/wp/?p=693</guid>
		<description><![CDATA[So, Kitty (our third) is on medication for reflux.  It&#8217;s a compounded admixture.  So it has a shelf life of 12 days.  Can stretch to double when refrigerated. Insurance demands a 90-day scrip for any &#8220;maintenance medication&#8221;, which is anything you need more than one refill of :o  Since it&#8217;s only good for so short a [...]]]></description>
				<content:encoded><![CDATA[<p>So, Kitty (our third) is on medication for reflux.  It&#8217;s a compounded admixture.  So it has a shelf life of 12 days.  Can stretch to double when refrigerated.</p>
<p>Insurance <strong>demands</strong> a 90-day scrip for any &#8220;maintenance medication&#8221;, which is anything you need more than one refill of :o  Since it&#8217;s only good for so short a period it hit &#8220;maintenance&#8221; within a month.</p>
<p>After arguing the point with the insurance, we kinda were giving up but had the doc submit the justification (uh, she prescribed it?  how&#8217;s that for a justification, bitches?) and, I don&#8217;t know if it had an effect or not, since we still can&#8217;t get a one-month supply.  BUT!  After three months of paying for it out of pocket, the pharmacy suddenly said &#8220;hey!  What if we filed it as a 90-day prescription, but we&#8217;ll give it to you one month at a time?  eh? eh? clever, right?&#8221;</p>
<p>OK.  Point the first.</p>
<ol>
<li>How is 90 days, in 3 30-day segments, noticeably different from 30-days with 2 refills?  seriously?</li>
<li>How can you insist on a 90-day scrip when it&#8217;s not good for 90-days?</li>
<li>While we&#8217;re on the subject, those of you good at math might have figured out &#8230; 30 days &gt; 12*2, yah?</li>
<li>Dude when I was calling to argue was flabbergasted it was compounded and not in pill form, &#8220;Is that really necessary?&#8221;  Kitty was <strong>5 months old</strong> at the time of this conversation!</li>
<li>Seriously, when did the insurance companies become the final arbiters of medication???</li>
<li>Oh, yeah, and didn&#8217;t 90-day start out as a convenience and money-saving thing for people?  How has it become the mandated standard?</li>
</ol>
<p>So, last month we filled the 90-day scrip (yay, less than half the price we were paying for 30-days previously!), and they said they had the other two months of it set aside here and it would be ready each month for me to pick it up.</p>
<p>Well, today I went to pick up month 2.  Lady at the pharmacy asked &#8220;when did you drop off the prescription?&#8221; &#8220;Last month&#8221;  &#8221;I&#8217;m sorry, it sounded like you said last month, haha&#8221; &#8220;I did&#8221;</p>
<p>Well, she looks in the computer and says &#8220;It looks like it was sent back&#8221; Uh, no. &#8220;We only keep them on the shelf for 15 days&#8221; Uh, no.  I explain.  &#8221;Oh, did you get a partial?&#8221; Seriously, like it&#8217;s my problem to know?  And didn&#8217;t you just say the computer said it was filled and returned a couple weeks ago?  Where did that come from?  Oh, right, NOT the computer!</p>
<p>So she looks some more, asks someone else, and comes back. &#8220;I think they put it back in the general supply, I don&#8217;t see anything waiting&#8221; Again, no.  Explain.  &#8221;I don&#8217;t see anything here made, I can put in for it to be filled&#8221; Fine</p>
<p>&#8220;When do you want to pick it up?&#8221; &#8220;Other than now?&#8221; &#8220;I can check with my pharmacist, but I don&#8217;t know if she can fill it tonight&#8221;  Fine, tomorrow.  I wasn&#8217;t coming back tonight anyway.</p>
<p>&nbsp;</p>
<p>Moral of this story?  If you&#8217;re going to quote the computer, try not to have to change your story.  And if you&#8217;re not going to keep it set aside in a folder like you claim, perhaps you shouldn&#8217;t claim it.  Just say that you&#8217;ll pull it at time.</p>
<p>Seriously people.  Can you at least TRY to act like professionals and not the keystone cops?</p>
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