Kaneadsha
COLUMBUS,#2UPDATE Employee
Wed, July 23, 2008
I sincerely apologize for any inconvience we caused. Let me fill you in on the process because a lot of insureds do not know their benefits and how they work. You stated you have been in medical billing for 20 years, well medical billing has nothing to do with your order pf medication per say. I am also a medical biller and medical assistant not as many years as you. I will go through the process step by step. 1. you get an rx from the dr. written DAW 2.you have the dr fax, call it in or you mail it in. 3. we get it and if YOUR health plan dictates " THIS IS S NON PREFERRED DRUG CONTACT PT DR FOR INTERCHANGE" 4.a rep from Medco will call YOUR DR OFC SPEAK TO A MEMBER OF YOUR DR STAFF WHO AUTHORIZES THE CHANGE THAT MEDCO IS ASKING FOR AT THE REQUEST OF YOUE INSURANC PLAN 5. IF YOUR DR OFC STAFF WHOM EVER WAS SPOKEN TO AND TOLD MEDCO THEY HAVE AUTHORITY TO AUTHORIZE CHANGES TH RX'S THAT THE DR WRITES THEN THEY AUTH THE CHANGE. PLEASE REMEMBER IT IS AGAINST THE LAW TO CHANGE A RX THAT A PHYSICIAN HAS WRITTEN . THR RX IS A LEGAL DOCUMENT 6. the pt is then sent what the dr has authorizd for Medco to send the pt 7. there are thourough notes taken by our rph to document who they spoke to , time and date, you also can request that call be pulled for verification and a mbr of management will pull the call and listen to exactly what trasnpired. 8. in some cases a appeal is in order if your plan dictates . 9. To prevent this from happening in the future when you mail in rx also include directions to the rph NO GENERICS if you do not want generics and specify which drug youare speaking about and advise your dr to advise all of his staff they are not to auth generics if Medco calls to try and change your med to generic. 10. The CSR should have also gone an extra mile to see if we could compensate you on the medication for at least a 7d wotrth of meds, this may not have been an option because Medco filled what your dr authorized us to fill therefore you would have to get a local 7d supply at the pharmacy. I understand this is all no concern to you-but I just wanted to shed some light on how the process works. Also the plans that have this feature where they want us to call their insureds dr if they are prescribing an expensive med they do not want to pay for rationale is " the cost of the medication (meaning generics) helps keep premiums at a low for all of their customers/insureds" I would not give a rats hinny if I heard that but this is what we are told to explain to the pt when things like this happens. I hope your experience will not stop you from using our services, it really is not thsi hard to get meds I live in a city where we have a Medco pharmacy and it still wait a while for my meds to arrive but remember once it leaves our pharmacy we have no control over how fast the USPS gets it to you that's why our tutn around/delivery timeframes are so long to allow "sufficient time" for the USPS to get it to you. I apologize for the paragraph of CAPS I pressed it by mistake and by the time I realized it I had writen a lot I was not yelling please do not think I am yelling at any point where there is CAPS I just wanted those worde to jump out at you
Kaneadsha
COLUMBUS,#3UPDATE Employee
Wed, July 23, 2008
I sincerely apologize for any inconvience we caused. Let me fill you in on the process because a lot of insureds do not know their benefits and how they work. You stated you have been in medical billing for 20 years, well medical billing has nothing to do with your order pf medication per say. I am also a medical biller and medical assistant not as many years as you. I will go through the process step by step. 1. you get an rx from the dr. written DAW 2.you have the dr fax, call it in or you mail it in. 3. we get it and if YOUR health plan dictates " THIS IS S NON PREFERRED DRUG CONTACT PT DR FOR INTERCHANGE" 4.a rep from Medco will call YOUR DR OFC SPEAK TO A MEMBER OF YOUR DR STAFF WHO AUTHORIZES THE CHANGE THAT MEDCO IS ASKING FOR AT THE REQUEST OF YOUE INSURANC PLAN 5. IF YOUR DR OFC STAFF WHOM EVER WAS SPOKEN TO AND TOLD MEDCO THEY HAVE AUTHORITY TO AUTHORIZE CHANGES TH RX'S THAT THE DR WRITES THEN THEY AUTH THE CHANGE. PLEASE REMEMBER IT IS AGAINST THE LAW TO CHANGE A RX THAT A PHYSICIAN HAS WRITTEN . THR RX IS A LEGAL DOCUMENT 6. the pt is then sent what the dr has authorizd for Medco to send the pt 7. there are thourough notes taken by our rph to document who they spoke to , time and date, you also can request that call be pulled for verification and a mbr of management will pull the call and listen to exactly what trasnpired. 8. in some cases a appeal is in order if your plan dictates . 9. To prevent this from happening in the future when you mail in rx also include directions to the rph NO GENERICS if you do not want generics and specify which drug youare speaking about and advise your dr to advise all of his staff they are not to auth generics if Medco calls to try and change your med to generic. 10. The CSR should have also gone an extra mile to see if we could compensate you on the medication for at least a 7d wotrth of meds, this may not have been an option because Medco filled what your dr authorized us to fill therefore you would have to get a local 7d supply at the pharmacy. I understand this is all no concern to you-but I just wanted to shed some light on how the process works. Also the plans that have this feature where they want us to call their insureds dr if they are prescribing an expensive med they do not want to pay for rationale is " the cost of the medication (meaning generics) helps keep premiums at a low for all of their customers/insureds" I would not give a rats hinny if I heard that but this is what we are told to explain to the pt when things like this happens. I hope your experience will not stop you from using our services, it really is not thsi hard to get meds I live in a city where we have a Medco pharmacy and it still wait a while for my meds to arrive but remember once it leaves our pharmacy we have no control over how fast the USPS gets it to you that's why our tutn around/delivery timeframes are so long to allow "sufficient time" for the USPS to get it to you. I apologize for the paragraph of CAPS I pressed it by mistake and by the time I realized it I had writen a lot I was not yelling please do not think I am yelling at any point where there is CAPS I just wanted those worde to jump out at you
Kaneadsha
COLUMBUS,#4UPDATE Employee
Wed, July 23, 2008
I sincerely apologize for any inconvience we caused. Let me fill you in on the process because a lot of insureds do not know their benefits and how they work. You stated you have been in medical billing for 20 years, well medical billing has nothing to do with your order pf medication per say. I am also a medical biller and medical assistant not as many years as you. I will go through the process step by step. 1. you get an rx from the dr. written DAW 2.you have the dr fax, call it in or you mail it in. 3. we get it and if YOUR health plan dictates " THIS IS S NON PREFERRED DRUG CONTACT PT DR FOR INTERCHANGE" 4.a rep from Medco will call YOUR DR OFC SPEAK TO A MEMBER OF YOUR DR STAFF WHO AUTHORIZES THE CHANGE THAT MEDCO IS ASKING FOR AT THE REQUEST OF YOUE INSURANC PLAN 5. IF YOUR DR OFC STAFF WHOM EVER WAS SPOKEN TO AND TOLD MEDCO THEY HAVE AUTHORITY TO AUTHORIZE CHANGES TH RX'S THAT THE DR WRITES THEN THEY AUTH THE CHANGE. PLEASE REMEMBER IT IS AGAINST THE LAW TO CHANGE A RX THAT A PHYSICIAN HAS WRITTEN . THR RX IS A LEGAL DOCUMENT 6. the pt is then sent what the dr has authorizd for Medco to send the pt 7. there are thourough notes taken by our rph to document who they spoke to , time and date, you also can request that call be pulled for verification and a mbr of management will pull the call and listen to exactly what trasnpired. 8. in some cases a appeal is in order if your plan dictates . 9. To prevent this from happening in the future when you mail in rx also include directions to the rph NO GENERICS if you do not want generics and specify which drug youare speaking about and advise your dr to advise all of his staff they are not to auth generics if Medco calls to try and change your med to generic. 10. The CSR should have also gone an extra mile to see if we could compensate you on the medication for at least a 7d wotrth of meds, this may not have been an option because Medco filled what your dr authorized us to fill therefore you would have to get a local 7d supply at the pharmacy. I understand this is all no concern to you-but I just wanted to shed some light on how the process works. Also the plans that have this feature where they want us to call their insureds dr if they are prescribing an expensive med they do not want to pay for rationale is " the cost of the medication (meaning generics) helps keep premiums at a low for all of their customers/insureds" I would not give a rats hinny if I heard that but this is what we are told to explain to the pt when things like this happens. I hope your experience will not stop you from using our services, it really is not thsi hard to get meds I live in a city where we have a Medco pharmacy and it still wait a while for my meds to arrive but remember once it leaves our pharmacy we have no control over how fast the USPS gets it to you that's why our tutn around/delivery timeframes are so long to allow "sufficient time" for the USPS to get it to you. I apologize for the paragraph of CAPS I pressed it by mistake and by the time I realized it I had writen a lot I was not yelling please do not think I am yelling at any point where there is CAPS I just wanted those worde to jump out at you