I’ve been trying to schedule the delivery of my chemotherapy for a few days now. When I realized I had about four doses left, I called to schedule. I knew I was cutting it close with how few doses I had remaining but my medicine gets over nighted so I didn’t feel there was too much of an issue. Yet, when I called, I was told insurance had rejected it. I’ve been receiving this medicine for a little over a year now and have never had this problem. I was so confused and flustered, insurance rejecting any medication is a big deal, but there’s not really any other medication substitute for this one. That knowledge made me feel even more worried.
So, I inquired more about why and discovered it was simply a miscommunication from the pharmacy to insurance about what was written on the script. Everything was solved, it was being sent back to insurance, and I went on with my day waiting to be called to officially schedule my order.
I hadn’t heard anything after 12 hours, so I called back and explained the situation all over again. I was told insurance hadn’t processed it yet, but they would mark my order as stat and call me in the morning to schedule delivery.
The morning had come and gone, so I called for a third time.
My medicine quantity was getting lower and the weekend was fast approaching, I knew that would only complicate things further. Kindly, they stayed on the phone with me as they tried everything but couldn’t figure out why insurance wouldn’t cover it so they reached out to my NP. I followed up with her as well just to be sure that she knew the whole situation and that the phone call did take place.
My beautiful, beautiful NP solved the whole situation in like an hour and reminded me that it’s people like her that make the medical world wonderful. She took my worries and absolved them all. She made it an easy process for me, the patient. I went into the weekend assured that my medicine was covered by insurance, that it would be delivered, and it would be okay if I ended up missing a single dose.
Now, we arrive 5 days after my initial phone call and 4 days after everything was resolved. Yet, I still haven’t received my medicine. This was the latest date I was told it would be delivered so I called back… for a fourth time. I asked for an update on the shipping status, thinking maybe it’s still out for delivery and I’m just being my usual dramatic self. Then I was told it wasn’t scheduled.
Yes, insurance would cover it but the pharmacy was waiting to be told to schedule it. I was told it had been scheduled and was given a date to receive it. How could it not be scheduled? I spent 20 minutes on the phone figuring out how to get my prescription delivered as soon as possible, and finally, five days later, all my medicine problems are solved.
However, this whole ordeal has left me upset and questioning the medical system. My script was sent in two weeks prior to this entire situation. The pharmacy would have known that insurance denied coverage fairly quickly after that. Why wasn’t I or my doctor contacted and informed that it wasn’t covered? Why weren’t we told that we needed to rewrite the script?
Once that was solved, why wasn’t I contacted as soon as the pharmacy knew it needed to be delivered? My chart had this order marked as stat. They knew that I was running low on medication and needed my refill as soon as possible. Why wasn’t I informed that it hadn’t been scheduled when I was told prior that it would be?
There needs to be more communication and better communication between the pharmacy and prescribing physicians, even between pharmacies and their patients. I respect pharmacists because they hold so much more knowledge about medications than I ever will, but how am I not informed about my own medications? How are my physicians not told that there is a problem?
What if I couldn’t advocate for myself?
I have been managing medications my entire life, but what if I was new to this and didn’t know to call the pharmacy and check? What if I didn’t know how to inquire for more information and question the process? What if I didn’t find it odd that I wasn’t hearing from the pharmacy? How was my physician to know that there was a problem with the script, if she was never told?
The medical community fails when there’s no communication. Medical practitioners needs to be a team. My situation is no one person’s fault, and I don’t blame anyone. It was just a lack of communication and poor timing. It highlighted for me though, all the complications I’ve dealt with in this field already.
Something needs to change because there are patients out there who could be missing doses or medications because they do not know that they can challenge the system and advocate for themselves in this way.
P.S. They were also using masculine pronouns for my NP and my doctor throughout this entire ordeal… they both have very feminine names. Females are doctors too. Society, please do better.