I work in the pharmacy benefits industry. One of the plans we handle is a state benefits plan - like Tenncare - welfare folks, can't afford regular insurance, etc. I was handling an issue for a patient - we had her order for her various medications, and couldn't ship it until we received some form of payment, a credit card or a check number. I called the number we had listed for her home phone, and got her daughter on the phone. I explained who I was, asked if her mother was there - mom wasn't there. Asked her "when do you expect her home, I'm calling from the Pharmacy Benefits Company and we need payment for her medication. Daughter wasn't sure when she'd be home. I told her that we were going to have to cancel the order then, unless mom called us in 24 hours and asked if she could call on her cell phone, kid tells me "I don't think she gets cell phone coverage in Hawaii." She's on a three week vacation in Hawaii...and she's on state benefits. I'm working for the pharmacy benefits company, and I can't afford to go to Hawaii...I ask if she knows what hotel her mother is staying in - it's the Hilton. "Well, I'm pretty sure the Hilton has telephones - you need to call your mom and let her know that if she doesn't call back in 24 hours, we're going to cancel her order." We were filling scripts for her oral contraceptives, her oxycontin, hydrocodones, oxycodones. Birth control and pain meds, and she's on vacation in Hawaii. Oh, but these people need these plans, and our money.
Majority of the meds we're filling for the state welfare plans are oral contraceptives, and a potluck of pain meds. Had one today call and complain because we denied her oxycontins - she had them filled 3 days ago for a 30 day supply of 90 - and somehow, she lost them. Went and looked at the history - she would fill an oxy script, then lose it 3-4 days later, and get another one filled, wait a month, get a regular refill, and 3-4 days later, lose the medication. I took great pleasure in saying, "Ma'am, your benefits plan has asked us to have you contact them the next time you lose an oxycontin script. If you'll hold on for a moment, I'll connect you to them." She disconnected while I was calling the plan - but I still got to tell them what was going on - and watched in my system as they locked her out of benefits until she called in.
Sorry for the rambling rant -
A lot of these folks are selling the oxycontins. Not a rant, great info.
It's freaking ridiculous.
Great stuff, Bob. I'd be happy to read your real-life stuff anytime!
If I remember right, wasn't Tenn Care offered to all State employees???????