Shameless Mayo Plug

[Matthew74]

There are a couple threads about trouble getting meds from the pharmacy. When that happens, I feel like the Looney Tunes character just after they drink the bottle of hot sauce.

One time I explained to the insurance person that by making it hard for me to get my meds they were running the risk of me ending up in the hospital, which they would then have to pay for. Somebody should do a cost analysis of prior authorizations taking into account all of the time and expenses incurred by the insurance, doctors, pharmacies, and patients in the process, as well as the additional medical costs caused by poor patient outcomes that are a result of patients not getting their meds on time, not getting them at all, or getting less than ideal medication. I think the only reason the insurance companies save money on it (if they do) is because enough people give up and don't follow through with it.

I'm on medicaid, which I am extremely grateful for. However it's a lot like an insurance company. To make a very long story short, the administrator I was with in Red Wing doesn't serve people in Rochester. It covers care in Rochester, but I was supposed to switch providers. For the life of me I couldn't figure out how. I called everybody, who told me to call everyone else.

Well, this week when I phoned in my prescription refill at the Mayo pharmacy like I usually do (because it's awesome), I got a call the same day saying it was rejected by my insurance. I went in and found out I had finally been automatically switched by the state to the local Medicare provider. The tech figured this out in about two minutes. Great, except they wanted a prior authorization (which I already had taken care of with the former provider). I must have looked like I was in agony, despair, or tragic resignation or something. Without my asking, the pharmacy tech called the Mayo business office. I waited about 20 minutes. She told me it was being taken care of, and that they would make sure I had enough pills for the weekend. Later that day I got a personal call from the business office with an update, with a direct phone number and name. The next day the same person called again saying the prior authorization had been denied by the insurance, then appealed and approved. I got another call in the afternoon from the same person letting me me know they didn't have 90 pills, but could do a partial, and if it was ok, the rest of the order would be waiting for me on monday. I'm on a very rare drug, so it was remarkable they had it at all. I picked up the partial. Going back is no problem since it's literally on my walk to work. They took care of everything, in about 24 hours. I was wondering how I could ever move away from here.

 

[Nakamova]

It's nice to hear when things go right. I wonder how much was due to the efforts of the individual you spoke to and how much was due to the insititutional goodwill and efficiency.

 

[Matthew74]

I think it's both. They have a culture and system of taking care of things right. Like I said elsewhere, you have to work within the system, and some of it depends upon your doctor, but it works. One thing I think they teach their people is problem solving, and they back it up with institutional support. For example, the tech knew how to figure out the insurance issue, and had someone to call about getting the prior authorization. Any other pharmacy I've been to I would have had to do both myself. Then, the person taking care of the prior authorization knew what they were doing, and followed through. It would have taken me hours to do the same thing, just getting through the phone menus, leaving messages, and days waiting to hear from people. There were any number of times they could have dropped the ball but didn't. They accomplished the goal, getting me my meds.

I wish that sort of responsibility were more common. I've complained a lot about doctors, etc. When you are sick, you need someone to take care of you. For the most part they do a good job of that here. I'm a mess, I feel like I'll never be the same since I had to move from Virginia and since the thing with my back. I can't afford a place to live. The church here has taken care of me, and so has the Mayo.