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Old 03-03-2009, 05:02 AM   #1
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Pharmacy or insurance issue ?

Went yesterday to get monthly meds. Same day of the month as it has been ( 2,3 etc). There was a slight change in my meds ( only the daily total ). Pharmacy says " we can't fill the Endocet for 11 days".. SHOCKER.. Not wanting to be rude and demanding, I asked WHY the insurance was denying as I use only that pharmacy so they had my records, no other fills on Endocet at all ANYWHERE, They looked at my history Jan 2 Feb 3rd and then Mar 2. Pharmacist did an over ride since there was a change but this should NOT have happened

 
Old 03-03-2009, 09:45 AM   #2
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Re: Pharmacy or insurance issue ?

Sounds like whatever pharmacist filled your Rx the previous month entered in the "days supply" incorrectly. Therefore, the insurance company thought that you had meds remaining. It sounds as if the pharmacist went in and changed it.

It's good that you questioned them. Some would not and simply walk away.

Regards,

Ex

 
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Old 03-04-2009, 05:31 AM   #3
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Re: Pharmacy or insurance issue ?

I just hope the next month there isn't going to be an issue again. 11 days is WAY off when insurance has allowed me to fill a few days early before

 
Old 03-04-2009, 05:47 AM   #4
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Re: Pharmacy or insurance issue ?

Um, Feb only has 28 days rather than 30 or 31. If you previously filled on Feb 3, it would not have been due until Mar. 5. Depending on how many days early you had done the Feb refill you could have been beyond what your insurance allowed. Usually the absolute max for any med is 7 days.

Tigg.

 
Old 03-04-2009, 05:55 AM   #5
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Re: Pharmacy or insurance issue ?

Yep. It was last filled Feb 3. March 2nd was 2 days off not 11...That is what threw me off... 11 days...Plus there was a CHANGE so it should have been allowed. When I had gotten the script filled early before ( like in November or October LAST year ) it was less than a week early,, never more than that. I am going to call insurance co to make sure that doesn't happen again

 
Old 03-04-2009, 08:26 AM   #6
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Re: Pharmacy or insurance issue ?

Quote:
Originally Posted by katlovesdogs View Post
I am going to call insurance co to make sure that doesn't happen again
With all due respect, this probably won't do anything. The issue is more than likely @ the pharmacy...Probably just a simple clerical error.

For example, 1-2 every 5-6 hours is 6 per day or a 25 day supply. If the pharmacist enters it in as a 25 day supply, then all will be fine on day 26. However, if a pharmacist used the exact same instructions, and entered in 4 pills per day, then it comes out to a 36 day supply, or 11 days difference. Pharmacists make mistakes and as soon as you pointed it out to them, they corrected it.

Hope this helps.

Regards,

Ex

 
Old 03-04-2009, 12:44 PM   #7
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Re: Pharmacy or insurance issue ?

THAT explains it. The script was for 90 pills,,,, I tablet every 4 hrs max of THREE a day so 3x 26 days ( the # days between fills ) = 78 pills leaving 12 pills but that would have accounted for 4 days NOT eleven. ( 3 a day x 4 days). And I know my insurance allows for a 7 day early ( or they have before ).. The pharmacist says they have it all as 30 day supply going back to January so I am still puzzled... Oh well.. No need to beat a dead horse as she was able to fill since there was a change in the script itself anyway. I just have never had that happen before and was shocked at the 11 days

 
Old 03-04-2009, 06:09 PM   #8
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Re: Pharmacy or insurance issue ?

Also, just to let you know Kat...If all else fails, you can pay "cash" for a script, if it's denied by insurance. Just because one's insurance won't pay for it, doesn't mean the script isn't valid...Even on controlled meds.

So, hypothetically speaking, if your insurance denies, saying it's a couple of day early, you could tell the pharmacist you'd like to pay "cash." Granted, a pharmacist can deny any script for any reason, but as long as the script is valid, most will fill it. You could also take it somewhere else if needed.

Just wanted to let you know what your options are...Some don't realize they can still fill the script anyway, and end up in WDs.

Regards,

Ex

 
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