Refusing

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So, today was a relatively busy day in the pharmacy. It was pretty much non-stop action all day. It wasn’t a bad busy, just busy. The day flew by pretty quickly, and most people were in good moods. I’m sure the sunny weather helped with that. =)

There was one man who came in today who had both a Medicare part B and Medicare part D plan. Both will cover diabetes equipment and drugs, but with varying copays. We had originally billed his prescriptions through Medicare part B just over a month ago. He received a letter in the mail the other day telling him that he has had Part D coverage for those prescriptions for a few years without realizing it. He asked me to rebill it through the Part D plan. I willingly obliged.

Well, it turns out one of the prescriptions was the same price either way, but the other was cheaper through Part B. I tell him this, and he asks me to undo the second one. Unfortunately, once it’s been over 30 days, you can’t undo things like that in our store. You can only bill under new plans. You cannot rebill and then undo it because it was cheaper the other way. That is technically fraudulent behavior. You, as the patient, are responsible for knowing which billing option you want to use beforehand. The pharmacy can only rebill and refund under very certain conditions, especially with government funded insurance (Medicare, Medicaid, Tricare, etc.).

So, because the price difference wasn’t that much, I was just going to absorb the cost, since he wasn’t previously aware of the price difference, but he wanted to hear nothing about it. Before I could tell him that I wouldn’t be charging him extra for it, he walked away and out of the store. That left me with an interesting story for my store manager tomorrow morning when the register is all totaled.

Listen, if you are ever in a situation where rebilling something makes it more expensive for you, most retail pharmacies will absorb the difference and not charge you. But never EVER just leave without completing the refund transaction. We need you to sign receipts verifying you were present for the transaction. Otherwise, the store can get in trouble. This is mostly for chain store pharmacies, but even for independents…it’s just plain courtesy to stay until any transaction is finished.

 

Image courtesy of http://i784.photobucket.com/albums/yy123/Pokeman14/IREFUSE.jpg

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