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The “s” word got someone arrested

In my pharmacy we are (or at least I am) very superstitious about the dreaded “S” word–no, not that one; “slow.”

Well, today being the day before a holiday, the pharmacist had the (mistaken) impression that today would be, umm, s**w, since everybody should be travelling out of the area. I told her not to say that word, and she just said I was being superstitious.

Around 10am, a “nurse” called in a script for Vicodin ES, #30, 1-2 twice daily. All in all, not a weird script, except for the following:

  1. She had a very (very, very, very) fake “briddish” accent, making it obvious she was trying to disguise her voice.
  2. She was calling from an emergency room. In this area, at least, ER’s don’t call in scripts.
  3. There was no background noise; if she were really in an ER, there would have been the usual sounds of an ER

So, the pharmacist called the ER, and the nurse who answered quickly said, “Well, we don’t even have a nurse by that name.”

RPh: Well, I need to speak with the doctor to confirm that it really is fake.

RN: Dr Soandso is busy right now.

Rph: Well, I’m sure Dr. Soandso would like to know if someone is calling fake scripts in under his name.

RN: Ok, I see your point.

Well, the doctor confirmed that it was fake as well, so we called security, who then called the police. A really nice policeman came and took a report of what had happened. He waited in our back area where he couldn’t be seen for about half an hour before deciding to leave his cell number (something he said he doesn’t give out to just anyone) with instructions to call if she came.

I said as he was leaving, “Of course, she’ll be here in ten minutes.” (and of course, I was right; an early-20-something very-pregnant woman wearing daisy dukes, a tank-top, and flip-flops came strutting in.)

To stall her, we had her fill out a new patient profile. “We haven’t filled anything for you since 2005 (which was true) so we need to update your information (which was pure baloney). Meanwhile, the pharmacist got on the phone and called the officer.

As the “patient” finished filling out the profile, a different officer came in behind her and yelled at her to drop her backpack. He then proceeded to cuff her and lead her to the bench by the bath room. Evidently he loosened his grip just enough, because she decided to make a run for it; not easy to do when you’re very pregnant and wearing flip flops, not to mention hand cuffs behind your back.

By this point, the first officer had come in, the assistant managers on duty came back to the pharmacy, and half the employees were wondering what was going on. We also had one patient waiting for about an hour in the store while this was going on; thankfully she was nice, and it was an otherwise sl…er…not not not busy day. (Hopefully that will keep me from jinxing myself for the next time I work.)

I was sent to make copies of the “script” that she called in and the profile she filled out. When I came back, one officer was asking her name (“I don’t have one,” being her response; gotta love stupid criminals) while the other officer pulled out 4-5 prescription bottles and half a dozen presumably fake scripts from her back pack.

When it was all over, I turned to the pharmacist and said, “See, I told you not to say the “s” word. It gets us in trouble every time. (of course, I meant we’d get a lot of scripts, not a nearly nude pregnant girl running from the police.)”

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Hope everyone has a happy 4th.

A new look

Well, I’ve been meaning to do it for a while, but I finally have a new theme for PharmCountry. It’s a heavily modified version of Festival by dirflux.com. The title graphic is just the old one except on black instead of white. (The procedure used to change the colors made the pill logo look really cool, didn’t it?)

I added a reflection to the header because that sort of thing seems to be in nowadays (and I thought the header looked to short without it.)

So, do you like it? hate it? don’t care? Post a comment.

More real posts to come tonight after work (hopefully.)

See-too day

(aka, C-II day)

After the 3rd perco script in a row, I started calling today a C-II day. After the fourth, I jokingly said we just just keep the percocet out on the counter, and after the 5th, we started keeping it out.

And it wasn’t just percocet; there was also metadate, focalin, and Daytrana (more on that later). There was even one really spooky, “Scary Door” moment. A man came in with a script for 120 tabs of Percocet 10/650. The pharmacist, however, knew that it was about time for some of our regular patients, a husband and wife, to get their monthly supply (he gets 80, she gets 200.) If we had filled the 120 script, we wouldn’t have had enough to fill the 200+80, so we turned the script down (well, that, and the guy looked kind of shady.)

Not 30 seconds later, the wife brings in their scripts.

I told you it was spooky.

Then there was the Daytrana (ritalin in a patch) script. Monday, we had a mom call to see if we have Daytrana 10mg patches, #60 (the kid was to use 2 patches daily). Of course we didn’t have it, so we told her we’d have to order it. Long story short, we eventually agreed to order it without the script (our first mistake); the mom wanted to try a few more places before bringing the script to us.

When the Daytrana finally came in, the lady’s husband brought the script in, but he had a coupon card that is good for 40 free patches. Since the kid had never used the patches before, we asked him if he would like to just get 40 patches for free (and lose the rest) to see if they even work for the kid before they had to pay any money for it. Well, he thought that was a great idea, so we ran the script through and sent him on his way.

About 10 minutes later, I get a call from an angry lady (guess who) demanding to speak to the pharmacist, who was helping a patient out in the aisle. I put her on hold, but before the pharmacist had a chance to pick up, the lady had hung up and called back, screaming (and I quote): “Don’t you dare put me on hold again! I’ve been trying to get this straightened out for a week!” (Yeah, lady, 2 days equals a week in this country.)

She demanded to know why she would lose the remaining 20 patches, and we explained to her that on schedule II medications, we can’t give refills. We promised to contact the doctor’s office and let them know the situation (in fact, we already had), but she wouldn’t have it; she demanded (her word) to get the rest of them, even if she had to pay the $45 copay.

My response would have been, “Sorry, the medicine has already left the pharmacy.” The pharmacist’s response was, “Fine, whatever, just as long as I don’t have to deal with it anymore.” (to me, not to the mom.)

The husband was very apologetic when he came back. He gave us back the 10-pack, and we gave him another 30-pack (thankfully Daytrana is sealled with ultra-hi-tech holographic seal thingies) The situation left me wondering who the medicine was really for; the kid or the mom.

Caremark making me crazy

I usually love processing claims for Caremark. (About 20-25% of our claims are processed through them, thanks to the number of Federal government employees and State Medicaid beneficiaries we serve.)

They have easy to remember override codes for Vacation and Dosage Increase rejections, and if that doesn’t resolve the issue, they have a very easy to use voice activated IVR system.

I don’t love them so much when their computers go down. I was working a rare Saturday today, but nearly 20% of our prescriptions could not be processed because Caremark was down. About 12:30 I called and was told that they expected their systems to be up in about 2 hours.

At 2:30, I tried again and still no go. At 4:00, I called again and was told that they didn’t expect the systems to come back up until at least tomorrow (my emphasis on “at least”). I can only hope they come up by Monday, or we’re going to be in trouble.

Yes, generics are the same medicine

Edit: sorry, the picture was lost during a site upgrade.

More evidence that a generic is the same medication as its brand equivalent. The capsule on the left is cefdinir 300mg made by DAVA Pharmaceuticals, and the capsule on the right is brand Omnicef by Abbot.

The pills are IDENTICAL, from the indigo and aqua coloring right down to the Abbot logo and the word OMNICEF printed

Adipex cheater

Edit: sorry, the pic was lost during a site upgrade.

Look closely at this prescription (finger added to protect the, ahem, not-so-innocent). I finally understand why this doctor always writes the quantity twice on controls.

It’s not so obvious in this RAZRized picture, but if you look at the second line, “Disp: 30 tabs” was changed to “Disp: 80 tabs.”

Well, we of course called the doctor’s office to verify that the script was valid. The nurse told us to go ahead and fill the prescription (for 3o with no refills, as it was originally written) but to fax them a copy of the rx.

Well, the next day, the nurse called and I picked up. She wanted to know if the patient had picked the prescription up, and unfortunately they had. The nurse told me, “Well, just so you know, he is no longer going to be our patient.”

Sting. And the thing is, the patient isn’t even fat.

Wall of Contraception

Edit: sorry, the pic was lost during a site upgrade.

Because of the long holiday weekend, we had to do a big order of our top 200 drugs, a large percentage of which are birth controls. The above is a picture of all the birth control we got in on Friday. (can you tell my pharmacy prefers Barr generics?)

Ping Pong: UnitedHealthCare edition

I already hate UHC because they manage my insurance (which is why my Advair script is $140 a month, and why I don’t take it anymore). Now, I have a new reason to hate them:

Last week on Thursday, we had a patient, (call her Ms. Goodman) call in her prescription for zonisamide #150 capsules. Of course, we didn’t have enough, so I asked her if she’d be willing to wait until Friday to pick it up. She was fine with it, so I processed the script and placed it on order.

When it came in, though, our supplier had switched us to a different manufacturer, so I had to back out the script, and rebill it for the corrected NDC.

A week rolls by, and we get a call from a frantic Ms. Goodman because she got a letter from UHC stating that we had billed them twice for the same medication, and if she actually got two fills, she owed them $139.

So, I called Medco, the company that processes prescriptions for UHC, where the nice Indian lady, after saying “Thank you for patiently waiting,” confirmed that the first claim was reversed.

So, I called UHC itself to see what was going on, and all they could tell me was that I had to call Medco.

So I hung up and called the patient to tell her what was going on. She told me she had called UHC and they told her that their system showed two claims.

Well, I called UHC again, and finally got someone to confirm that, but they told me I had to call Medco to have them retransmit the reversal. At this point I was ready to pull my hair out.

So, I called Medco again, and all I could get them to do was “document” the situation in their system, because “UHC should be able to see it in their system if I can see it in mine.” But he told me he would see if he could get someone to fix it.

I was at least able to get the rep’s name (Richard, if I were to actually believe him) and ID number, which I then gave to Ms. Goodman. She thanked me for everything I did, but I’m afraid it wasn’t enough.

Perco-Hell

I’m going to call yesterday Perco-hell. We must have done five or six percocet rx’s within a 2-hour period. Two of them came at almost the same time.

One of them didn’t have a DEA number (and we didn’t even have it on file) so I had to call the doctor’s office. The “nurse” that answered the phone told me she wasn’t authorized to give that information out, but to go ahead and fill the script because it was valid. (What school did she go to where they think that’s acceptable?)

The other one had the date 5/22 without a year. It was from the hospital, where the patient had given birth. So, we asked to speak to the ob/gyn who had seen her (since we couldn’t read the doctor’s name, of course). He said she had been discharged on 5/22/07, but he didn’t remember writing a script for percocet. “But I’ll ok it anyway. Here’s my DEA number…”

After those and a few other perco scripts, our supply for the long holiday weekend was brought perilously low. I hope there aren’t a lot of car accidents.

All you need is love

Yesterday at work I had Beatles’ songs stuck in my head all day, from Hey Jude, to Yesterday, to the afore mentioned All You Need is Love.

And after the disaster that work was yesterday, I agree with that particular song: we need more love in this world.

Let’s see, I got yelled at (I don’t just mean they were annoyed, they actually raised their voice) at least twice. One time was because a druggie insisted that the last time he got his lorazepam rx filled, it cost him $22, and was angry that this time it cost $73. (I checked the computer; he paid the same price last month.)

The next time was when I was ringing a lady out for her 3 antidepressants, Cymbalta 30mg, Effexor XR 75mg, and brand Wellbutrin SR 200mg, which, of course, we had had to order (the reason she picked them up on Friday and not Thursday).

As soon as I told her the total was $105, she went ballistic: “IT”S ONLY SUPPOSED TO BE $15! I WANTED GENERICS ON EVERYTHING!”

After calmly explaining that the first two drugs don’t come as generic, I explained to her that we had a note that said she wanted brand on the Wellbutrin, and that was the only reason she had to wait until Friday to pick it up, since (at the time) we had generic in stock.

Well, she calmed down somewhat, but got angry again when I had to tell her that we had already dispensed our supply of the generic Wellbutrin, and we wouldn’t have more until Tuesday (due to the Memorial Day weekend). So I offered to see if another store had it, which they did.

Me: Ok, Ma’am, the [Capital City] store has it.

Lady: So when will it be here?

Me: Umm, that’s not how it works. You have to go there to pick it up or wait until Tuesday for me to order it.

I thought, Yeah, some magical fairy is going to whisk the drug away from the other store and make it appear on my shelf. She, of course, wasn’t happy to have to drive to the other store. I, on the other hand, was just happy to get her out of my store.

Can’t I get a little more love?

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