One time, about two years ago, we tried to get a prescription filled at a pharmacy that we didn’t usually use. (It was late at night and ours was closed.) Luckily, the prescription was cheap, because they insisted that the insurance company was indicating that Molly wasn’t on our insurance. They even appeared to call someone “from our insurance company” and they said that she wasn’t in the records. (Mind you, we went over our insurance information with them, they had the card, and at least one of the boys was also getting a prescription that DID get approved.) I thought it was odd, since I was pretty sure nobody was at our insurance company at that time (at that time, I was working for the clinic portion of the same company, so I knew their hours were typical business hours). So…the pharmacy makes it out to be the bad insurance company’s fault.
On Monday when I called the HMO, they say there is no way they could have talked to anyone, because nobody would have been there, AND they have Molly on the insurance, of course. They then told me that I should go march into that pharmacy with my pharmacy receipt and insist that they re-run the claim properly. I will admit, I wanted to, but then didn’t. I figured the $6 – $8 wasn’t worth how irritated it would make me to go in there.
So, why am I thinking this right now? It’s because we have had another experience of a pharmacy (our regular pharmacy) being at fault but blaming the insurance company. For a week, we have been trying to get a prescription for Noah that the pharmacy said needed HMO approval to get first. They said it would be 3 – 5 business days. So, I finally called today to check again. They said they keep filing it, but the HMO is denying the claim each time. So, I called to the doctor’s office to check on it (they had been called by the pharmacy last week to get the insurance approval through them). The nurse said the approval had gone through just fine. Then, she asked me a few questions (it’s a long story-ish), that made me realize it was because of something the pharmacy was doing wrong. So, she apologize that we hadn’t gotten the medicine sooner, but sounded annoyed (with the pharmacy) and said she would be calling them.
Well…what a coincidence (not!) — just about five minutes later, I get a call from the pharmacy, “Hi — it’s Mark from (pharmacy) that you spoke to earlier. The insurance company just finally approved the prescription, so we’re filling it now and it should be ready in 15 minutes.” Like all the sudden out of the blue the insurance company had come to their senses and approved it. I refrained from saying, “Oh, thanks, Mark. I’m sure it has nothing to do with me calling the doctor’s office and then probably actually filing it correctly this time.”
I seriously feel like I need a rolling eyes icon here!
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