Saturday, November 15, 2008

The W Word

I made a fatal mistake the other night while explaining a situation to a patient. A mistake that I instantly regretted and, after eight years, should know now to say. I mentioned the dreaded W word to a patient. Let's set the story up a bit:

A guy comes in with a Rx for his girlfriend for Hydrocodone 10/500. We've filled four things for her in eight years, but I decided to give her insurance a shot anyway. Strangely enough it works, but it comes back with a reject of 'Refill Too Soon - Last Filled 11/10/08.' I relay this message to the man and he thanked me for his time and left. I thought that would be the extent of my excitement for the day.

About a half hour later I receive a call from a woman asking why I wouldn't fill her prescription. After a bit of thinking I figure out that this is the same woman who's script was too soon to fill. I tell her that when I ran it through her insurance and it came back saying she just had the same drug filled a few days ago at a different pharmacy. She replied that this didn't matter because it was a different prescription from a different doctor.

I know, I know, y'all are getting the flashing red lights in your head just like I did.

Anywho I explain to her that her insurance won't cover it, so she asks if she can pay cash for it. I tell her no as we have a moral obligation to regulate dispensation of medications for the patient and public's safety. She replies, "Well you have to fill it, it's an ORDER from the doctor." After explaining to her that a prescription is not 'an order' and we are not legally obligated to fill every script that is presented to us. "Well I'm going out of town," she states. "Isn't there away you can just fill it or get an insurance override?"

More red lights... and it was next that I stated the word which I avoid using the most out of any other word at work...

"Ma'am when your under insurance through Welfare, they do not allow any overrides"

Note: Part of the reason I used that dreaded word is how our insurances are named in our system. Medicaid is split up through several different processors and each billcode is named for that processor. One of them, what is called straight Medicaid, is called 'Welfare' in our system. Thus, had it said "Purple Dildo", I would have used that term instead of Welfare.

After hearing this she went ballistic, screaming at me that I just said I wouldn't fill her script because she was on welfare. Furthermore she stated she was going to sue my ass and bring the police down to the store to force me to fill it. She continued to scream obscenities at me (while I held the phone about three feet away from my ear) for another two minutes before she hung up.

I then made the obligatory call to my manager to inform her of the situation, just in case she would follow through with her threat, and informed her of my mistake which caused the situation.

I know better than that, but I really wasn't thinking about it in that terms when I stated it. It was funny for a while, but I started to feel like a dumbass for such a simple oversight. Oh well, it was the most interesting phone call I've gotten in weeks and it broke up a relatively slow day.

And George Carlin was wrong, there's not seven dirty words, there's eight. And now you know why.


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