I did sense and say this week looked to be challenging, but I had no idea how challenging.
With first the fiasco in getting my license renewed, then the bozo at the gas station and now what happened at this morning’s pharmacy appointment, it’s taking all I have not to turn into the stereotypical Angry Black Woman.
Arriving five minutes early, checking in for the latest Covid vaccination was easy breezy.
Told the pharmacist would be with me in 15 minutes, I sat where I was told to sit and waited.
Then I waited and waited and waited well beyond 15 minutes until finally a pharmacy clerk walked over, paperwork in hand, said my medical provider was refusing to authorize the charge.
Why the refusal is unknown, especially since I couldn’t get the vaccination at the medical center because they only offer Pfizer and I do Moderna. But my provider failing me, and other patients, is now legendary, so I rolled with it, said "I’ll pay".
Then I waited and waited and waited and waited some more.
Beginning to get hot and bothered, I went back to the window asked, "Did you people forget I’m waiting for a shot?"
Guy at the window said, "Sit over there. The pharmacist will call you up shortly".
"That’s what I was told 30 minutes ago", said I.
I wasn’t loud, but my voice was at a tone and pitch that got his attention, the attention of all others working behind the counter, AND the attention of customers waiting for pharmacy orders.
A little aggression goes a long way because he got up, went over to whisper something to someone and, before I knew it, someone walked over, asked for my payment of $139.99 and the pharmacist called me in for the shot, and I was outta there in less than 7 minutes.
Is the Universe testing me?
Is it just that it’s my turn … my astrological moon is in manure?
Whichever it is, it appeared the test wasn’t quite yet over because, feeling the need for chocolate to calm down, clean eating went out the window and I used the cellphone to put in an online order at See’s Candy Store, knowing it would be ready for pickup by the time I arrived.
The order was ready and to make certain the correct person was picking up, the young lady asked for my name and the last four digits of my telephone number.
Of course, I knew my name, but my brain was still so raddled by the problems at the pharmacy that I scrambled the last four digits of the phone number.
She questioned it.
"Look! It’s me. No one is going to come in here and commit fraud for a box of chocolates" said I.
I left with my candy, no further questions, and a treat for my Little Stalker, as she’s sure to come knocking before the holidays are over.
Now back at the complex, chocolates and hot coffee having pulled me from the edge, and thinking clearly, you already know I'll be putting in a claim for the $139.99 with the provider on principal, which they probably will decline.
Another thing that occurs to me is that perhaps the pharmacy is in the wrong, because I also have medicare.
I don't know how those things work but, when the provider said no, could not the pharmacy have billed medicare?
They have a record of my number. Who did they bill when I had my other shots there?
As for why the provider refused to authorize the transaction, it's probably because so many of its members, tired of not being serviced in a timely manner, have been going off plan; but inasmuch as they could not give me Moderna, will be interesting to see the reason for declining when I request reimbursement.
Oy Vey! What a week, and it's not over yet.
We have UHC Medicare Advantage and the shots were free.
ReplyDeleteI really need to switch medical providers. Someone told me to check with AARP.
DeleteAccording to the Medicare website... Medicare covers the updated (2023–2024 formula) Moderna or Pfizer-BioNTech COVID-19 vaccine for people 5 and older.
ReplyDeletehttps://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-vaccine
So the pharmacy screwed up. They should have gone Medicare when the medical provider refused the charge. Is there anyone left in the world that knows what they're doing????
DeleteWow! Your day sounded like many of my WEEKS! My astrological has taken root in the manure...I swear. I'm sorry you had a bad day, but chocolate and coffee do help heal many wounds. Thankfully my insurance covered all my shots and boosters. Did you get an RSV shot? I highly recommended it for those of us in that 'certain age' group. Fingers crossed things will be on an upswing for you. Me...I'm always waiting for the other shoe to drop and inevitably it does! Yikes! Happy Thanksgiving and may it be a good one!
ReplyDeleteParanormal John
I should stop complaining about people and be grateful for a single bad day, even a bad week, as WEEKS sounds so disheartening. So, enough about me as I now worry about you.
Delete"my astrological moon is in manure?"
ReplyDeleteI've had weeks, heck, months like that so I hope it gets better for you.
And I can just see you, having someone question if the chocolates are yours! I'd feel a smack coming on ....
I'd given her my name. That should have been enough. Things will get better if I stay home, avoid people.
DeleteWell, poo. Since you're over 65, the shots should be covered. That's bizarre. I'd call your insurance. Good that you got vaxxed hanging around all of those people though. Yep, a little candy helps. Have a restful Turkey Day (watch the Macy's parade?,) and stay away from turkeys. Linda in Kansas
ReplyDeleteI've already submitted a claim for reimbursement. $139 is not a ton of money, especially in comparison to how much they themselves are charging me for health care and not generally providing health care, but it's just the principal of their refusing that necessitates asking for reimbursement. As for the turkeys, I'll do my best to avoid 'em.
Delete“My astrological moon is in manure” ... That says it!
ReplyDeleteCould be worse I suppose. Instead of cycling through manure, my moon could be stuck in quicksand. This will pass.
DeleteI was thinking that perhaps your provider was Kaiser until you said you might switch to AARP...so that theory is out the window. Our health coverage changed in July. Because I have lifetime coverage through the school district where I taught for 21 years, we have really good coverage, or did until the school district sold us off to Aetna Advantage which now takes the place of, or in addition to, Medicare. The pharmacy stuff has changed a bit, but we had no problems getting our Moderna Covid vaccine.
ReplyDeleteI do have K and, in the past, they were pretty great, had a good reputation. Those days are gone. I only have a week or so to switch, not enough time to do a thorough investigation. I'll live with them for one more year while I check around.
DeleteJust FYI, I would gladly commit fraud for a box of chocolates.
ReplyDeleteROFLMAO!!!!!!
DeleteFight it! Fight, fight, fight . . until they tire and give up. They will.
ReplyDeleteRound one is on.
Deleteour flu shot and our covid were free with medicare. Just regular medicare. Are you old enough to be on medicare? They probably knew that but made you pay because you brought to their attention their lack of kindness and professionalism. Geez that was wrong. If on medicare it should be free, no matter what. I suppose if you have medicare advantage it could be different but I don't think so. I'd try to get your money back.
ReplyDeleteI do have medicare, so not only did my provider screw up, the pharmacy also screwed up. Waiting to hear back on the claim for reimbursement I immediately submitted.
DeleteMedicare paid for my covid and flu shots. My pharmacy and doctor's office have Medicare listed as my primary and what they don't pay is generally covered by my insurance. You should call your pharmacy and see if they even submitted the claim to Medicare. Are you new to it by chance?
ReplyDeleteNo, not new to it and this pharmacy has a record of medicare being used on previous covid shots/boosters. Something went haywire this time and I was so off center at the time that I didn't think to question why they were contacting my primary to approve the charge rather than running it through medicare as they'd done in the past.
Delete$140.00 for the vaccination?????? Oh. My. God. Roberta
ReplyDeleteAnd still word on the street is "It's free". I don't know why because, when the shots first became available and I was getting mine, I'd blogged about a gentleman there who'd been required to pay for his. So I guess paying and free are hit/miss.
DeleteWell the government was paying for it when it began. And now they are not. So people won't get the shots since $140 is a lot of money for many people and we will have yet another grueling pandemic. It is still ongoing. We both have Covid as I write. We missed Thanksgiving. And we have had all the shots....where will this all end....Roberta
DeleteSo sorry to hear you're both ill over there. Scary that you took the proper precautions. Be well.
DeleteWell, if Angry Black Woman works I say work it GF. *Winks* I go on the Warpath myself and go straight up Old School Apache when Tested beyond my limits of maintaining my Calm... always works for me. *Smiles* I managed to squeeze most of the GAP Insurance Premium back that they stiffed The Son for and didn't pay out on his Claim, they refunded him $800 when I went Postal over the Phone and told them I was an Influencer on Social Media *Winks* and would put them on blast. *Ha ha ha* They can't know what Influence I have, Right? Well, you KNOW I did anyway, put them on blast, coz it is a scam this GAP Insurance fraud they pull, but it must have been worth the Payout to them to not have me call back... and The Son appreciated it so much that he paid for Thanksgiving Dinner. *LOL*
ReplyDeleteI love your Influencer threat. ROFLMAO! but like you said, whatever works.
DeleteWow, I had no idea the vaccines were that much. I have Medicare too and my doctor just brings my shot with her when she comes to see me. My insurance has always paid it so I didn't know it was that much out of pocket. That's nuts.
ReplyDeleteIf you thought that was a lot, I see RSV is $319!!!! I'm beginning to become suspicious of what shots are really needed, what are scare tactics to enrich the drug companies.
DeleteMoon is in manure. Only you could come up with that. So funny. I'll have to use it.
ReplyDelete