Friday, August 08, 2008

Of course there is an update!

Finally my med was called in around 11 a.m. DH and I got off work at noon so he could pick up the rental car, pick up our meds and get back home so he could pack for his trip. I had been contacting the pharmacy every so often to see if the doc's office had called in our Rx's. I know the docs and staff go to lunch from noon to 1:15 but I called and called and called for an hour and a half past 1:15 and nobody answered. I finally got smart and started dialing random extensions till I began noticing a pattern of extensions for the doctors and their staff. I finally got the billing office and explained to them the situation. She checked DH's record and there was nothing there. I also asked why nobody answered the phone and she said the telephone operators leave at noon on Friday because the staff and docs pretty much close up shop and it goes to the after hours message.

Well uh--the practice isn't closed so why do they quit answering the phone at noon? The patients don't know it is shut down after 12. A person could call and call and call and think they just forgot to take off the after hours message. Anyway, I called the pharmacy again and still no prevacid.

We got to the pharmacy and they recommended the generic for Prilosec which is OTC so we bought that for $20 (DH's prevacid only costs us $5!) When we got home FINALLY there was a message on the machine by the nurse saying that she had some samples of Protonix at the front desk for him, which would last him past his trip and until this matter with the insurance was resolved. I called her and let her know that we were already home and she lived near us so she brough them with her and we met her near home to get them. It was so nice of her to do that! She also told us that it is better that he take the Protonix than the generic Prilosec because it was just stronger. Apparently the doc was adamant about DH staying on Prevacid which is why she faxed the authorization through to AvMed.

So, let's see, where are my beefs here?

First---that AvMed never mailed anything to their patients notifying them that as of August 1st the PPI's (Proton Pump Inhibitors) Prevacid, Protonix and Prilosec would be affected by this change and that even if someone had open refills remaining, if they tried getting it refilled after August 1st they would have difficulty. Had they notified their patients oh--back in June or early July, people could have taken precautions and gotten with their doctors to fax through the appropriate paperwork EARLY so as not to miss a prescription.

Second---that it takes FOURTEEN days for AvMed to get back to the doctor's office with the approval.

Third---that the doctor's office does not leave an outgoing message stating that their office hours are actually Monday through Thursday 8:30 - 5:00 and Friday 8:30 to noon. At least people wouldn't keep trying to call on Fridays thinking that they are taking a long lunch or just not answering the phonel. I wasted at least 20 minutes on my cell phone redialing and trying to get someone.

3 comments:

  1. Jess,
    I'm with ya' about these doctors that close up on Fri early without notice. We used to have a doc with the same deal and it was murder getting anything done, even when they were in. Our current doc, (pediatrician) is so awesome. She accepts calls on weekends and ANSWERS HER OWN PHONE! Imagine that. As for insurance companies, that's a whole other matter. Kudos to your nurse for the personal attention on getting the meds to your hub. Hope your trip is a good one!

    Take care,
    FMD

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  2. Last month when I was in NFRMC they gave me Protonix instead of the Nexium that I've been taking for several years. The reason was because it's supposedly just as good, but it didn't work half as well for me as the Nexium does.

    As much as I complain about health costs, insurance etc, I have to say that our relationship with BC/BS over the years has been excellent. As you know, we've had this same coverage since 1968 (when Dad started with BS) and I really can't remember ever having a problem with them. In our case, the problems usually come from the some of the physicians we've had.

    Hope to see you while V is away!

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  3. Anonymous8/09/2008

    I'm glad Vinny got the meds. What a wonderful nurse. I hope it works for him. Robert has had the same experience as sma with protonix and nexium.

    We have had both avmed and bcbs. I have to say, bcbs is much easier to work with. Far less hoops to jump through.

    I hope Vinny has a safe trip and a wonderful time.--ST

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