Problem with pharmacy. Argh

[DammitJanet]

I went to the doctor yesterday and he prescribed me a nebulizer, advair and albuteral.

I have Medicare (Part A and B), Medicaid and Medicare Part D Drug coverage. You really need a college degree in all this to understand it but basically Medicare Part A is hospital, Medicare Part B is doctors and Medicaid is what picks up my copays for my medicare premiums and the deductible's for Medicare and all the copays, plus it covers my donut hole in the Part D.

Well. I go yesterday and turn in the scripts for the albuteral and the advair to the pharmacy. I also asked them where to get the nebulizer. They told me where to go. Then they looked at the albuteral script and told me that it wouldnt be covered by my Part D, I had to get it from the place I got my nebulizer. HUH? Ok...so I take it and go to that place...thoroughly confused.

I get there and they are confused because they only do nebulizers and no drugs. Just what I thought. So I get the nebulizer and go back.

They say,...oh we cant do the albuteral because there is no diagnosis code on the script. HUH? The diagnosis is written on the script! My doctor is now closed! No way to reach him. They tell me if it was being filled through my Part D or medicaid they wouldnt need the diagnosis code but since my Part D or Medicaid dont pay for albuteral, it has to go through my Part B and has to have the code. Makes no sense. Part B is Doctor...also they say I have to pay a portion...50 bucks because I havent met my deductible for the year!!!

Excuse me? I dont have to meet a deductible!

Of course, my cellphone is dead. Im sick and cant deal with this. I need this medication. I just got the stupid machine and its worthless without the medication.

I go back to the store I got the machine from and get the code for asthma and write it on the script. Go back and get the medication. Yes illegal. So what.

I end up paying what they want. I get my medications and come home.

I finally open everything up and do my treatments. Feel better.

Look at the Advair box. Read the label. OMG...It is mislabeled. Advair is a maintenance medication which is supposed to be taken twice a day. One puff twice a day. The insert says that. My doctor told me that. The little dohickey is round with only 60 doses.

The label reads : TAKE 1 PUFF EVERY 2 HOURS

I am assuming that would lead to a massive overdose.

I called Medicare last night to try and get to the bottom of why I was charged for my albuteral. I have to say Medicare is so very helpful. They were astounded. They told me that I shouldnt have been. Albuteral is covered on my Part D drug plan. I should have paid a $1.10 copay. No way should a drug store have been filing anything under my Part B coverage. My medicaid does cover me just the way I think it does, I am not out of my mind. I am to go to DSS on Monday and show them this paperwork and they will refund me my money.

I am seriously thinking about changing pharmacy's. I have been with this pharmacy for years now. I have had one other problem with them. This though is rather major.

 

[klmno]

What a pain!! I'm glad you noticed the wrong label though and didn't take so much of the advair. I had one of my or difficult child's rx's filled once and they gave me some kind of medication that is typical for senior citizen's instead. I'm REALLY glad I noticed that- I think it was a new medication for difficult child that I was filling so I would never have known what the ppill was supposed to look like. I was also worried that the senior citizen might accidentally take a MS that his medication got swapped with.

 

[DammitJanet]

Another almost problem happened not too long ago when I went to fill my topamax.

Since I have started on the 200 mg pills, they have been round red/rust colored pills. I have to take 3 of these 200 mg pills to get my 600 mg dose so the fact that they are rather small round pills is in my favor.

Well one day I got home from the drug store and I opened the bag with my pills and there is this bottle with HUGE white football shaped pills in it. Now remember I take 3 of these pills each day so this was alarming. I looked at the bottle. It says topamax. I read the description on the bottle. It said...round red pills. Uh. These arent round red pills! I called the pharmacist...very alarmed. Turns out they were the right medication, just from a different manufacturer. I pointed out they should have changed the description on the label then. She agreed. I also asked her if they were still getting the other type in. She said yes, they just grabbed whatever one they grabbed first. I asked her if I could request the other red ones next time because I take like 15 pills at one time.

Sheesh. And guess what, yesterday, they gave me the stupid huge white footballs again. Im so done with these people!

 

[susiestar]

Glad you did NOT take the advair that way. Have you tried other preventative medications in the past? Advair is a combination of 2 medicines. One of them is not good to take and advair should ONLY be prescribed if you have had other preventative medications not work.

Docs RARELY follow this guideline and pharmacies and insurance companies are very concerned. At least all the pharmacies here and the 2 insurance co's I have used are.

You may want to call the doctor and ask about the safety of advair and if there is another medication you could try first. There is a significant risk of death if you use advair daily for a number of years. So for a couple of months it should be OK, but not for extended periods of time.

I would change to a pharmacy that deals with a higher volume of medicaid/medicare patients. Walgreens is usually good about billing here.

We always get 2 inhalers for the kids. Most insurance won't pay for 2 in a month. Ours will, so I have to remind them to try to run it through before charging us for it.

Charging you $50 for albuterol was crazy and way over-priced. I used to get 3 BOXES of individual dose vials for $30.

My doctor has told me to write the diagnosis code on the scrip just like I have to fill out my address and SSN. I don't see why writing the diagnosis code on the scrip is illegal. I keep a post-it with the diagnosis code in my purse in case the doctor forgets to write it on because we now have to have it on every prescription.

I am glad you got your medications and the nebulizer. Be SURE to wash the mouthpiece and medicine cup out every night.

 

[GoingNorth]

I often wonder how much this has to do with the "pharmacy techs" in use at nearly all pharmacies these days. Basically, they do the counting out and labelling of rx medications.

The pharmacist is supposed to check each and every rx before it goes out to be picked up. Since they are usually the only pharmacist on site, they are usually very harried. I can see where something got "missed" though that doesn't make it any better.

 

[DammitJanet]

Im hoping I wont have to be on Advair long term. I didnt get refills on it so that should be a good sign. If I can actually keep up with my goal of stopping smoking, then maybe I can nip this lung issue in the bud. I dont need anymore health problems...lol.

 

[Hound dog]

I could look it up.....but my gut tells me that

The label reads : TAKE 1 PUFF EVERY 2 HOURS

would kill someone.

Janet you get the wrong looking pills....PM me and I'll look it up for ya. I got the book now.

I had this issue with wallyworld for a while with Nichole's medications. Several major tantrums with the store manager (dept manager was an idiot) and it has gotten better. At least I don't have to stand there, dump the pills out to count and make sure they're the right ones anymore. Unfortunately though it's not just wallyworld. I've had issues at other pharmacies too.

GN that is probably much of the problem. Believe it or not, most pharmacy techs are trained in store. Tells you how much they really know about what they're doing.

Janet, how are you feeling today? You are under orders to spoil thy self as necessary. How good is Tony at chicken soup? I don't want you going into pneumonia like I did. And mine happened so darned fast! I'm finally "well" I think. But dry or cold air will trigger a horrible coughing fit still. And it's going to take several days to build my strength back up.

((hugs))

 

[GoingNorth]

daisy...I didn't realize that pharmacy techs were just given such rudimentary training. If so, they are nothing more than cashiers who package pills.

For some reason, I think because "Pharmacy Technician" was actually a military occupational specialty that required quite a lot of training before licenture, that it was the same with the techs in stores.

I have seen hiring signs but for some reason figured that they would have to go through proper training AND be licensed before actually working.

 

[Hound dog]

Nope. They don't.

Oh, there are college programs for pharmacy techs. Those aren't too bad. At least they get some good solid background courses like medication terminology, anatomy and physiology, pharmacology ect. But it's not required that they be trained from such a program. Many drug stores (I know Rite Aide and CVS) actually train their own pharmacy techs and prefer it that way as they don't have to pay them as much. Store trained they get no background courses, it's a fast easy course lasting only a few weeks. They cram for a test after, then they are certified. (but usually only to work for that store)

I was surprised when I found out, and more than a little perturbed. I'd have never guessed but I go to school with store trained pharmacy techs that have gone back to be pharmacists. Scary. And even more scary when they also don't think they know much about what they're doing. ugh!!

 

[GoingNorth]

I think the military specialty was aimed at getting trained techs into hospitals, clinics, etc. I know that one thing was that one license from the military allowed them to practice in all states.

What scares me is that it is possible that the same so-called "techs" could be working in hospital dispensaries as well.

 

[Hound dog]

No, what is really frightening is that these so called "techs" may be despensing medications to patients in the hospitals very soon instead of nurses. Some hospitals are already doing it. easy child and I've been discussing this. I already told her a tech comes near me with a medication and I'm gonna have a holy cow. ugh!!

It's all about cutting cost. Less training means lower wages.

 

[Mattsmom277]

Wow. All of our pharmacy techs in canada have to be college trained.

If it were me, I'd hit the phone book. Call around and ask for the manager. Explain you are searching for a reliable pharmacy. Ask if they EVER do in house training for pharm techs, or if they are college educated, etc. The idea of a few weeks training and then running amok with medications is frightening to me.

Janet, I'm glad you caught the labelling error. You's a smart cookie!

 

[GoingNorth]

It's especially difficult with generics. WI requires generic substition on all medications where a substitute is available. A doctor has to specify on the RX that name brand must be used.

The generics can come from several different companies. I have many times over the years had to take medications to a pharmacist to find out if I actually got the right medications because size, shapes, and colors vary so much.

At least at WalMart up here, the pharmacists are very good at telling you that your pills might look different.

 

[emotionallybankrupt]

I've had a strict rule for years, that before I leave the pharmacy, I take everything out of the bag, check every label, check each bottle for pill appearance, etc. I usually do this in the car before I drive away so I won't be so obvious. It's been amazing how many times over the years that I've had to go back in due to mistakes ranging from being shorted, given wrong medication., given wrong dosage--you name it. Sometimes it is the change in appearance of the pills that makes me go back in. Almost every time it is the issue of so many manufacturers of the generics, but I never assume.

I've also always told my children what I was doing and why, that people are human and make mistakes. I've shown them what I was looking for. This really paid off when a school nurse mistakenly gave my child someone else's pill one day at school. She refused to take it. She was able to name details--which amounted to little more than a difference in the letters/numbers imprinted on the tablet. She was persistent until the nurse finally listened and took a closer look and realized her mistake. The nurse was apologetic beyond words... I really felt sorry for her. But steps were then taken to prevent anything similar from happening again.

It was difficult child, who was in 2nd grade at the time. I was, for once, proud of her for being gutsy enough to buck authority.

 

[witzend]

It's January. Time for all of the insurance companies to rewrite what they have as your "secondary coverage" so that they can at the very least delay payment for a month or two. Maybe you'll die first. At the very least you'll find a way to pay, or to go without. I have Medicare Part A only. Every year it's the same thing from our primary insurance. "We're not going to pay because you have part B." Every year it takes months to straighten out.

 

[donna723]

I thought pharmacy techs had to undergo testing (like the state boards for nurses) and be licensed by the state? Is that not a requirement everywhere?

 

[Hound dog]

Nope Donna, it's not required in every state. Yet. They're trying to change that.

 

[witzend]

Not techs, usually. But their work is supposed to be reviewed by a pharmacist. Usually a formality, sad to say.

 

[susiestar]

Our pharmacy usually has 2 pharmacists and 2 other employees on duty. NEVER is anyone but a pharmacist to touch a pill. They are a mom and pop store and tehy promise that it will not change. I get a paper for each medication that tells the shape and color and marking that it should have.

The other employees take care of teh rest of the store, ring up all purchases, etc... but they never count pills.

Sadly, they have SOMEONE there who is scamming my pain medications. husband didn't count them and I was, again, 55 pills short on one medication. I am getting very upset. We have 2 other pharmacies that refuse to use techs and are family owned. I may change to one of them. I will not change to a chain except for those medications that are on the $4 list. I hate to do that, but I have enough medications that it makes a big difference.

We have to be hypervigilant these days. Almost any medication is worth money on the black market.

 

[GoingNorth]

Susie, the missing painkillers are a CRIME. You should first go up the pharmacy's chain of command. Report incidences each time they happen and document them as well.

If you get no satisfactions, track down the appllicable laws and take it from there.

The pharmacist is ultimately responsible for what is dispensed from his operation. S/He must be notified immediately.

This is very difficult to resolve with narcotics because they can't really legally issue you more medications.

The medications are going missing after the rx is processed and during dispense processeing. This is so that they don't show up on narcotics inventories as missing.