What's Da Buzz?

That line is usually followed by….

“because you won’t let me have my meds! I’ll sue you!!”

At my part-time work at home job , that actually is a daily occurrence. The truly sad part is 99% of the time this isn’t for cancer medication or some true life saving pharmaceutical intervention. It is normally those who want their anti-acid reflux (upset tummy), latest ADHD meds for kids, anti-depressants, anti-anxiety, birth control, smoking cessation and even Viagra pills. These are not lethal conditions and sometimes the medication itself may be more prone to creating fatalities (anti-depressants & anti-anxiety).

Those comments are also not always from whom you would normally expect it to be from. We’ve heard that from doctors, nurses, and the pharmacists. All of whom can hand out samples but yell at us because their customer couldn’t read the directions and took too much of the meds too fast before the refill date.

**Note: Any medication that is based on medical necessity will be covered. However, should the medication be an elective like birth control or smoking cessation insurance will not cover it and the bill belongs to the patient. In the cases where a medication can go either way, authorization or a letter from a doctor is needed to prevent fraud and drug abuse.**

Here are a few scenarios which are typical of what I get. I’ll provide you first with the generic answer I have to give (even if I know it is a distortion) by company orders or get fired (CLR). Then I’ll give you what I really want to say (WIRWS).

Pharmacist: You people are killing my patient.

CLR: Sir, I am sorry we cannot override any step therapy reject. Plan has to override this rejection first.

Pharmacist: No, you people are going to get sued. My patient is going to die without her medication. Sir, what was the medication again? I am sorry sir my hands are tied. We are not the plan.

WIRWS: Sir, you have the medication there. Give her freebies for at least 3 days or until Monday or send your patient to the ER or a clinic so she can get samples. It is not my fault if the patient has *whatever* to deal with.

Member Calling : You people are playing doctors. If my doctor prescribed the medication- It should be covered. I can smell a lawsuit here.

CLR: Sir if you don’t agree with me. Please call the right number. We can’t help you here. We are not the decision makers here. I’m sorry but you are calling the wrong number.

WIRWS: What lawsuit? You are better off paying for your own meds than suing us. We are just the software provider hired by your plan. Let me know how much you got charged for attorney fees k?

Member Calling: My son needed the ADHD medication. You just don’t know how awful it is having a child like mine. You people are evil- has no mercy on people like us. He is going to be worse than ever without the meds. He is going to die without this medication. I want you to call the pharmacy now and tell them to release the prescription. You b*tch. I hate people like you!!

CLR: Ma’am, I am sorry. Again, we are not the decision maker here. We are following the guidelines set by your insurance plan. I am giving you the directions we are instructed to give. If you are not satisfied, then please call your insurance plan directly.

WIRWS: ADHD is not fatal you idiot. My Goryo grew up with two kapatid that have it. Stressful, yes. Fatal? Only to your blood pressure. Calling me a b*tch? Mag palipad ka nlang ng saranggola!

For review:

Anti-acid reflux (upset tummy) – Calm down and this will likely go away. Drink tea, don’t yell at me.

Latest ADHD meds for kids – Is the kid a handful? Yup, likely is. Fatal? No. Meds are not as necessary as a highly structured home and sound parenting.

Birth control – If it isn’t for a medical condition, pay for it. If not married, there is a sure fired solution.

Anti-depressants, anti-anxiety – I dare you to spend a year in the Philippines in the province. You’ll grow up or die. Depressed ka dahil heart broken; please grow up- it’s not the end of the world. There are legit reasons why people  are suffering from depression. Drug may work for them- I respect that and it’s their choice.  But in my own opinion, prayers and the support from our family and the people around us can help us cure depression. 

Smoking cessation – You chose to start. You can choose to quit. The cold turkey option has been around a lot longer than the med version is.

Viagra pills – 30 pills in 30 days is a bit too much. I feel sorry for your wife. Hopefully she went past menopause or those 120 hours a month might get a bit messy.

Okay, tapos na ako mag vent. Sorry po – napahaba ulit ang ranting ko.

Thank you,

Anah

Photo credits from http://mentalhealthhumor.today.com

Let me reword that title a bit. Is the following conduct a demonstration of being an American? I would venture a guess to say no but my experience is saying yes. On my job, I get to take 120 calls a day in an 8 hour time-frame. Of those calls, 10% or about 12 are from nice people. Another 10% or 12 calls are neutral from people doing what they need to do or just getting information. That leaves 80% of the calls or 96 of them that are not nice or neutral.

These 96 callers are flat out nasty, rude, mean or cruel. It does not matter if it is a pharmacist, a nurse, a doctor, or your neighbor calling in. My job is simply a pharmacy help desk. We give answers on data issues and computer procedures. But we are accused of changing insurance plan regulations, step therapy decisions, and not doing things the caller thinks we should do as opposed to what we can do. Just because a phone number is on a card doesn’t mean you can dial it for all insurance, pharmaceutical, and whatever else crosses one’s fancy.

Understand all of the aspects that impact your life!! It is your life so pay attention to what is going on that directly or indirectly impacts you. That line alone makes this in the Vested Wisdom category.

What you shouldn’t do is be hostile and demeaning. It will never help you. It will not make me want to help you at all on the phone. If you called the wrong number, you called the wrong number. I will tell you that and redirect you to the right number. But instead, I get showered with terms like the ones below 96 times a day because I can’t do the job that belongs in a different company.

The *s included below stand for the following vowels in this order i, o, and a. I’m not going to fully type out the words here but you figure it out.

Dip Sh*t – This phrase means the individual is completely stupid, a total moron, and has no idea what the right answer is. I get called this when I let them know they called the wrong number or recite the decisions of their insurance plan. So of course, I’m the idiot when they called the wrong place.

G*d D*mn whore – When they do not hear the answer they want, that obviously makes me a cursed woman who sleeps around with every guy. Naturally some jerk throwing a toddler temper tantrum can make up whatever they want because they do not know I’m a happily married faithful wife who follows Jesus.

Moronic slut – This is a combination of the above two. In this case, I’m not cursed but just a total idiot who sleeps around. Let’s see those geniuses handle these calls, troubleshoot computers while designing websites and speaking multiple languages.

Inbred hick – I had no idea what this one was at all so I had to ask my co-workers to define it. They apologized for the rudeness of the callers because I’m considered one of the nicest on the phone. This insult means my parents were brother and sister. The hick part means I have no social skills because of living in the wilderness of southern USA looking forward to getting married to my brother. I might have been more insulted if the stupidity of the insult wasn’t so funny. An inbred hick wouldn’t be answering pharmaceutical phone calls and computer troubleshooting calls.

Is it enjoyable being a college educated, multi-lingual immigrant being treated this way? Uh, no. I am proud to be a Filipino because respect is far more common in my culture. I now live in the USA but I have a problem.

I really do try to believe this line, but dealing with this everyday really strains the credibility of the line.

“Proud to be an American”

Ano sa tingin nyo? hehe!

Anah

Photo credits: http://blog.evaria.com