I'm bipolar. I'm lucky because I only have to take two medicines to stay stable and happy, Lamictal and Cymbalta. I got a new job about a month and a half ago, and so very luckily for me the new insurance kicked in right before the prescriptions I had ran out. I also recently moved to Utah from Virginia, so I needed a new doctor anyway. I go in, go through the whole "new patient" two-step, and with very little fuss and a good feeling about the new doctor I leave with a new script in my hot little hand for a whole year's supply of each of my medicines.
So, I head to the pharmacy. The Lamictal has no problem. It turns out for the Cymbalta I need a pre-authorization. The pharmacy people are absolutely wonderful and have already called the doctor for me. They say it will be a couple of days, but I have about a week left of that med from the old script, so no worries from me. I even called the doctor right after I left the pharmacy to make sure they had gotten the order and to give them the number for my old psychiatrist, in case they needed it.
The next day the doctor's office calls. The insurance needs to know specifically which medicines I've tried before and for how long. I give them the reasonably long list, they say it will be a few days and they'll call me when they have an answer from insurance. La de da, all is well. Except five business days go by with no word. I've been rationing my remaining meds, and am down to my last pill. I call the doctor's office and ask about the status of my pre-auth. The answering lady says she doesn't have that information, but she'll leave the message and that doctor's nurse will give me a call back.
I wait an hour and no call. This was within normal business hours at a small office, so an hour seemed like a good time to wait. Instead of calling the doctor again, though, I call the pharmacy to see if maybe the authorization had come through and I just hadn't gotten a call. No go, but the pharmacist is absolutely wonderful. Without me asking for anything he says he'll call and find out what's up, and to call back in half an hour. Half an hour later, I give them a ring, and the beautiful pharmacist has called both the insurance and the doctor for me. And guess what? The insurance never got the information, so my claim was in limbo. The doctor's office answer? "Oops! We'll get that in right away."
That was on Friday afternoon. I really didn't expect anything to be fixed before the weekend, and there was nothing Monday either. So in the meantime, I've been paying $4.50 a pill just to get me through until insurance can make a definite decision. Assuming the doctor's office actually put it through this time.
Small? To the doctor's office, perhaps. A small little pre-auth slips through the cracks. To me it's a huge problem, though. It may not be a "life saving" medicine, but without it I very quickly spiral into a suicidal depression. Plus, withdrawl from Cymbalta is hell. I think I'll be finding a new-new doctor.
I really can't express how wonderful the pharmacy has been, though. When I called to check the status with the pharmacy yesterday, they said they'd call the insurance for me again today if it hadn't gone through. I'm going to bake them cookies as a thank you when all this is over.
EDIT: The pharmacy just called me. One of the techs called the insurance company and everything is all worked out. So much love on the pharmacy people. =)