I DID THE WORK; THEY GET THE PAY

I order my prescriptions on line from Walgreens. They usually send me an email when the prescriptions are ready for pick-up.

I ordered my diuretic Saturday to be picked up today by 1:00 pm. As of that time, I had not received the email so I went to their site to check on the status of my order and the prescription was not even on my list of medications; it had disappeared! I called the pharmacy.

Apparently, there were no more refills authorized so they called the doctor listed on the last refill authorization (a pitch-hitter for Dr. T) and she refused to authorize the refill! So, instead of calling me (yes they have my new phone number), they just put it aside and went about their business. My order fell through the proverbial crack.

I ended up telling them how to operate their pharmacy by asking them to call the doctor listed on previous refills (Dr. T) to get the danged authorization. Thank goodness my last pill was not to be taken until tomorrow morning so we still had time to get the refill completed.

I did the work; they get the pay.

I kept getting these “we are waiting for your insurance company to pay this claim” on a bill that was for lab work in March of this year. In addition this time, they had a footnote that I should call my insurance company to help get the payment expedited. What, their dialing finger broken?

I called Anthem to see why they had denied the claim and they told me they were waiting for an explanation of benefits from Medicare. Apparently, the service provider had not filed the claim with Medicare first (Medicare is primary) but filed it with Anthem only (my secondary carrier).

I then called the billing department at the service provider and after being in queue for 25 minutes, I finally got a human to look into my claim. Sure enough, they had not filed with Medicare and “will do so immediately”. Once again, my claim had fallen through the crack. And they wonder why they aren’t getting their invoices paid? If I had not worked with insurance claims when I was employed, I would still be going around in circles!

I did the work; they get the pay.