PHARMACIST STEVE

Interacting with the most lethal industry

Last week I blogged about my interaction with our healthcare system..  Because I am tired of #Silverscripts controlling my refills.. especially when they are not paying the first penny on the cost of the medications.

I had previously called 800-MEDICARE to file a complaint against #SilverScripts for the same issue… causing me to make trips to the pharmacy every couple of days to get refills… that first complaint took them several weeks for them respond to my complaint… with admission that the CS person didn’t know the rules or lied about the rules and that the CS person would get “coached” as to the proper procedures. Suppose to be refills are allowed when 80% of the previous fill would have been used.

Last week I tried to get refill on a 5 day supply of antibiotics – first filled on Wednesday – on Friday.. there was authorized refills on the Rx.. the Pharmacist had not problem refilling it… but not so much with #SILVERSCRIPTS. I was told on Saturday that I could not refill it until Sunday.. and another 10 mile round trip to the pharmacy.. again .. they were paying $0.00 towards the cost of this Rx.

So I called 800-MEDICARE on Monday and filed another complaint of them discouraging me being compliant with my medication. They tried to tell me that they had the right to do this because of the discount from normal cash price… I guess the monthly premium that I pay them.. is just considered a gratuity to  have access to their discounting pricing ?

This time, it only took them TWO DAYS to call back from this complaint… and I was told that their computer said that the 80% rule would not be satisfied until SUNDAY…  keep in mind I got the 5 day Rx on Wednesday…

Apparently whatever “DUNCE” the programmed that part of their software.. DID NOT COUNT THE DAY YOU HAD THE RX FILLED AS THE FIRST DAY THAT YOU WOULD BE TAKING THE MEDICATION…

#SILVERSCRIPT is part of CVS HEALTH… who has a stock

market value of 105 BILLION and annual sales of 153 BILLION… and they can’t hire programmers that understand the basics of taking medications and apparently their front end CS people are granted no authority… decision making is all handled by a poorly programmed/mindless computer.

Again CVS HEALTH’S corporate motto is “HEALTH IS EVERYTHING”. One has to wonder if there is a disconnect between those that come up with such corporate mission statement and those that are expected to implement and follow that mission statement.

#SILVERSCRIPT is the SECOND OR THIRD largest Part D provider.. reportedly having some FOUR MILLION people who they are helping to manage their prescriptions… my experiences with #SILVERSCRIPT is their assistance is more like MANGLED CARE than managed care.  Interference rather than assistance in me being compliant with my medication(s).

Of course, any costs of a pt not being compliance and ending up with additional healthcare costs will probably end up being borne by Medicare A/B and little/nothing out of #SILVERSCRIPT’S coffers.

Complaints filed with CMS (800 MEDICARE) are suppose to cause a healthcare provider – like #SILVERSCRIPTS to lower their STAR RATING… which if enough are filed are suppose to reduce their reimbursements. All healthcare providers ( hospitals, insurance companies, physicians, pharmacies ) are suppose to be included in the STAR RATING SYSTEM.

If you are not being treated correctly by a healthcare provider… things will only change if you call CMS (800 MEDICARE) and express your dissatisfaction with the provider. Otherwise, nothing will change and remember it is reported that between 200,000 and 800,000 people die every year from medical errors.  If enough pts file complaints… MAYBE .. that number could be reduced ??

Filed under: General Problems