Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
OK, sports fans, lets start a list. Both Coaltrain and Christine have written threads about ongoing struggles trying to get meds. A couple of weeks in, neither situation is resolved. So, what stories can we each add? I'll go first.
1) Shortly after I first started Humira I arrived home one evening to find a grey plastic bag hanging off my back doorknob. Inside: a bottle of prednisone and a bottle of leucovorin. I hadn't ever talked to this company, hadn't ordered them, hadn't approved shipment, hadn't agreed to pay, and no one had signed for them. Nice.
2) Enbrel, round one. Set up shipment with the pharmacy. Next day I get a call from their "customer care" staff, wanting to put the wheels in motion to send me the meds. No, it hadn't already been done. No, the pharmacy wouldn't/couldn't have called. they could put Enbrel on the mule train, and it would arrive in 5 to 7 days. Turns out, the pharmacy had shipped as agreed.
3) About three months after I quit taking Humira the pharmacy called to see how I was doing with it and if I had any questions. First question: have you morons noticed I haven't ordered any for 90 days??
4) Orencia. Within a week after my doctor wrote the script, I've had calls from three different pharmacies wanting to send it to me. I ordered from the one associated with my insurance company. Supposed to be here today. We'll see. The third pharmacy to call ONLY fill scripts for patients with one insurance company, one I have never in my life been insured under. I still can't figure out how they got my info. It felt like being "slammed" by a rogue phone company 20 years ago- remember that one?
Next?
1) Shortly after I first started Humira I arrived home one evening to find a grey plastic bag hanging off my back doorknob. Inside: a bottle of prednisone and a bottle of leucovorin. I hadn't ever talked to this company, hadn't ordered them, hadn't approved shipment, hadn't agreed to pay, and no one had signed for them. Nice.
2) Enbrel, round one. Set up shipment with the pharmacy. Next day I get a call from their "customer care" staff, wanting to put the wheels in motion to send me the meds. No, it hadn't already been done. No, the pharmacy wouldn't/couldn't have called. they could put Enbrel on the mule train, and it would arrive in 5 to 7 days. Turns out, the pharmacy had shipped as agreed.
3) About three months after I quit taking Humira the pharmacy called to see how I was doing with it and if I had any questions. First question: have you morons noticed I haven't ordered any for 90 days??
4) Orencia. Within a week after my doctor wrote the script, I've had calls from three different pharmacies wanting to send it to me. I ordered from the one associated with my insurance company. Supposed to be here today. We'll see. The third pharmacy to call ONLY fill scripts for patients with one insurance company, one I have never in my life been insured under. I still can't figure out how they got my info. It felt like being "slammed" by a rogue phone company 20 years ago- remember that one?
Next?
altoclef - as a quick summary of this latest situation -
doctor handed me printed Rx.
I called the same afternoon to ask for the pre-authorization to be started (Feb 21).
Received insurance approval Feb 25 (dr. office did their part). I actually received the approval in the mail Feb 28.
Feb 29 I called insurance to find out how to fill Rx. My call was transferred directly to Accredo rep who told me to mail Rx in with cover letter.
Mailed Rx to Acreedo March 1.
Hearing nothing, I called Acreedo March 12. 1st rep told me my Rx could not be filled via mail order. After being disconnected and calling back, next rep said there is no record of my Rx but also said that if my Rx was sent to their fulfillment center it can't be filled.
Call insurance also March 12 after the above with Acreedo. I am once again told that Acreedo has to fulfill Rx and once again connected directly to Acreedo.
This time rep who called herself a patient advocate read back to me everything that was said earlier. Was asked for my Docs phone number so she could get a new Rx sent to her. Said I should receive a call from them within 48 hours to arrange delivery.
So the doctors office did their part this time. It all lies in the hands of Acreedo now.
I am very doubtful of the docs office doing anything for me. They didn't do anything at the beginning of all this for 3 months when all that was needed was a pre-auth for the Enbrel after denial for Humira.
I remember hanging out on the phone with acreedo.
what is the reason acreedo is giving for not being able to fill it? they don't fulfill this med, or they don't have a participating agreement with your insurer? do you know which?
sometimes the insurance companies don't know which specialty pharmacies stock which injectable drugs.
Ros
Reason is when I've had to contact Human Resources or the Local Union office about an issue I almost always get swift action. I make sure I have all the details as you have spelled out so they know I
have exhausted what I can do. Looking at your list Ros's suggestion to get ahold of a senior person is probably a good idea before going higher but you know your situation
the best.
I hope you get a call and even better your meds soon!
Once I get my second cup of coffee in me I am getting on the phone again. RASAlly - I did keep notes from my last phone call extravaganza so I can start with the same people hopefully.
Ros - what you said is ringing a bell - I remember some mumbling from the reps last time about mail order vs. retail from the specialty pharmacy. That is why I went back to the insurance company to verify.
I'll update my other thread with any results from today - I don't want to derail this thread any more with my ongoing problem.