If you work in a pharmacy, the words “Prior Authorization” can run chills down your spine. Normally, when a medication requires a PA, we just fax a form that we print out to the doctor’s office that has all the pertinent information:
- Patient’s name and DOB
- name of the medication and why it’s rejecting (if we know)
- Insurance ID# and phone#
In the rare case when a doctor doesn’t have a fax number, I get to call and leave all of this information on their voicemail (god forbid they should actually answer the phone, yet they still complain when I pick up the phone and they have to wait 30 seconds to speak to the pharmacist.)
An hour or so after I called in one particular PA today (well, yesterday now; man I hate it when I can’t sleep all night) the doctor himself called back.
MD: “Hi The is Dr. Highandmighty. I need to speak to the person who called in this Prior Authorization for my patient Mrs. Outofluck.” (Don’t you just love my nicknames for patient?)
RPh: “Hold on one second that was my Tech.”
Me: “This is Andrew; How can I help you?”
MD: “Hi, Andrew. I just wanted to let you know that you did a better job than most when you called in the Prior Authorization; you gave me the ID# and insurance phone#” (at this point I’m expecting that he got it through quickly and was just letting us know) “but you forgot one thing.”
Me: “Oh, what was that?” (puzzled, since I was sure I had left all of the information)
MD: (in a very condescending tone) “Well, don’t you think I could’ve used the patient’s date of birth?”
Me: (doh!) “Oh, sorry about that, it’s 1/5/62.”
MD: “Well, next time just make sure you don’t forget it so I don’t have to waste my time calling you back.”
Here’s the response I gave:
Me: “I’ll be sure to do that. Thanks, uh huh, bye.”
Here’s the response I wanted to give:
Me: “First of all, how many times have you called in a script without a DOB, and we had to look it up” (he does this a lot, actually) “or forgotten to write the date or your signature or a strength (etc.) and we had to call your staff to verify it. Plus, if we had had a valid fax number or if your voicemail had listed it, I could have just faxed you over this nice clean form we have with all of the information you need laid out very nicely, instead of having to leave it on your voicemail while trying to count out a script and tell someone where the toothpaste is (something you don’t have to deal with because you at least get to hide in your office and actually schedule when patients are allowed to come in).
“Second of all, you’re going to have to pull the chart anyway (unless, of course, you have it memorized, which I seriously doubt) to be able to document for the insurance company what other medication’s the patient has tried and the medical reasons the patient has to be on this medication, so unless your charts are organized by DOB or date seen by the doctor (which again, I seriously doubt) you could’ve kept from wasting both our time and just gotten her DOB from her file. Thanks, bye.”
So instead of wasting 5 minutes calling us, he could have just looked at the file he was going to have to pull (or have his staff pull, since most MD’s farm PA’s out to their nursing staff anyway). I wish I could make that much money for being such a moron.
