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Old 01-11-2012, 02:08 PM
 
Location: Tigard, Oregon
854 posts, read 2,481,871 times
Reputation: 656

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Quote:
Originally Posted by myrc60 View Post
HIPPA maybe violated if you make that call.
Very good point that hasn't been addressed yet; HIPAA will likely prevent your discussing the specific situation. They will tell you. HOWEVER, you can still call and ask a generic questions such as "What happens when..." or what's your policy on "x".

I do get that she feels "ashamed", but if you remove the emotion from the situation, she doesn't need to; it's not like she did anything wrong or dishonest.

Additionally she needs to determine what she wants to do. It isn't clear from your posts:
1. Does she still want it = negotiate the price and plan for a delayed pick up. Or
2. Does she NOT want it = and tell them the mistake that occurred and that she cannot afford it.

If she really doesn't want it she may still feel obligated to pay (her call), but they just might have a policy that allows her to walk away. Again, no one will know until they call.

You are good friend and she's lucky to have you on her side!
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Old 01-11-2012, 02:12 PM
 
Location: Mostly in my head
19,644 posts, read 53,609,203 times
Reputation: 18599
Quote:
Originally Posted by myrc60 View Post
HIPPA maybe violated if you make that call.
no, b/c she will have given her permission.
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Old 01-11-2012, 02:28 PM
 
Location: Tigard, Oregon
854 posts, read 2,481,871 times
Reputation: 656
Quote:
Originally Posted by SouthernBelleInUtah View Post
no, b/c she will have given her permission.
To whom? She would have to give the provider/pharmacy permission to release info and talk to her friend and she doesn't want to call them.
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Old 01-11-2012, 03:05 PM
 
Location: home state of Myrtle Beach!
6,237 posts, read 18,166,086 times
Reputation: 3420
Quote:
Originally Posted by SouthernBelleInUtah View Post
no, b/c she will have given her permission.
Quote:
Originally Posted by zoso1979 View Post
To whom? She would have to give the provider/pharmacy permission to release info and talk to her friend and she doesn't want to call them.
Ya, I haven't seen any indication that this friend has been given permission to deal with her medical providers and that is why I mentioned HIPPA violations. The provider doesn't have to take the call from the friend on her behalf without a signed agreement between all parties.
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Old 01-11-2012, 03:33 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,964,752 times
Reputation: 3424
Default Update...

Quote:
Originally Posted by myrc60 View Post
HIPPA maybe violated if you make that call.
Firstly, let me say you folks are great! What great feedback & comments! Thank you all. <Where's the blowing a kiss emoticon?!>

Okay, it's all straightened out. Big weight off her shoulders!

I convinced her to let me call the pharmacy for her. I told her at least I'd have the info... if she didn't want to hear what they said today, I could wait 'til she asked... my crafty way to get her to relax a bit & move forward. Re: Hippa, I hadn't thought about it, but coincidentally, we didn't discuss medical condition, names of prescriptions, patient's name, etc... I didn't even give her name, just said a few prescriptions were waiting to be p/u (one requiring special mixing) & only asked general questions... I addressed the $$ issue & if a patient would be liable.

This pharmacy said the prescriptions would be either placed back into circulation (if pills) or in the case of the cream, stored for 1-mo then discarded if they don't hear from the patient. They called her once, they would have tried again once or twice over the course of 30-days, then purged the prescription from the computer & discarded the cream.

As an aside, this would also mean that if someone simply forgot about a prescription, then showed up after 30-days, they won't fill it & another prescription would be needed from the doctor... at least with this pharmacy in CO. She did indicate that every pharmacy & state has their own rules, so as we all agreed, calling to enquire was the only way to resolve it.

Turns out after much soul searching & number crunching, she will keep her insurance, at least for a few more months. I suggested she call family & even though embarrassing, ask for someone to help pay her monthly premium... with the stress she's currently going through, this is not the time to cancel her insurance & she's had a plethora of recent health issues... none severe, but stress can exaccerbate them. She was going to pay out of pocket for necessities, but although it might be a bit costlier, she'd probably be paying the same amount long-term & she'll have the reassurance of insurance should she need surgery or have an accident. That's already happened to her, which is why she purchased the policy on her own anyway.

I also suggested she p/u her prescriptions. She has 2 pills & the cream... she'll need to pay for all, but they're for different issues & again, they may only worsen with the bit of stress she's under. Her mother immediately said she'd gladly pay for her prescriptions & any others in the future, so she's fortunate. She'll also pay 1/2 her premium & a sister with pay the other 1/2. Whew!

I have a fitness center & year-round, heated pool in my bldg & can bring her as an occasional guest, so talked her into coming with me. In fact, so she won't put it off, I told her I'll pick her up twice/wk & drop her off... this way she won't get down in the doledrums & nix working off a bit of stress. We all need that, yeah?

Thank you all again. Glad this story has a happy ending. A bit of a bumpy road for her, but, we all experience that & I do understand not being able to think clearly when in the midst of a hail storm. We've all been there, too.

Cheers again for the great responses! You've all been very helpful!
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Old 01-11-2012, 03:46 PM
 
Location: Tigard, Oregon
854 posts, read 2,481,871 times
Reputation: 656
Quote:
Originally Posted by PatanjaliTwist View Post
Firstly, let me say you folks are great! What great feedback & comments! Thank you all. <Where's the blowing a kiss emoticon?!>

Okay, it's all straightened out. Big weight off her shoulders!

I convinced her to let me call the pharmacy for her. I told her at least I'd have the info... if she didn't want to hear what they said today, I could wait 'til she asked... my crafty way to get her to relax a bit & move forward. Re: Hippa, I hadn't thought about it, but coincidentally, we didn't discuss medical condition, names of prescriptions, patient's name, etc... I didn't even give her name, just said a few prescriptions were waiting to be p/u (one requiring special mixing) & only asked general questions... I addressed the $$ issue & if a patient would be liable.

This pharmacy said the prescriptions would be either placed back into circulation (if pills) or in the case of the cream, stored for 1-mo then discarded if they don't hear from the patient. They called her once, they would have tried again once or twice over the course of 30-days, then purged the prescription from the computer & discarded the cream.

As an aside, this would also mean that if someone simply forgot about a prescription, then showed up after 30-days, they won't fill it & another prescription would be needed from the doctor... at least with this pharmacy in CO. She did indicate that every pharmacy & state has their own rules, so as we all agreed, calling to enquire was the only way to resolve it.

Turns out after much soul searching & number crunching, she will keep her insurance, at least for a few more months. I suggested she call family & even though embarrassing, ask for someone to help pay her monthly premium... with the stress she's currently going through, this is not the time to cancel her insurance & she's had a plethora of recent health issues... none severe, but stress can exaccerbate them. She was going to pay out of pocket for necessities, but although it might be a bit costlier, she'd probably be paying the same amount long-term & she'll have the reassurance of insurance should she need surgery or have an accident. That's already happened to her, which is why she purchased the policy on her own anyway.

I also suggested she p/u her prescriptions. She has 2 pills & the cream... she'll need to pay for all, but they're for different issues & again, they may only worsen with the bit of stress she's under. Her mother immediately said she'd gladly pay for her prescriptions & any others in the future, so she's fortunate. She'll also pay 1/2 her premium & a sister with pay the other 1/2. Whew!

I have a fitness center & year-round, heated pool in my bldg & can bring her as an occasional guest, so talked her into coming with me. In fact, so she won't put it off, I told her I'll pick her up twice/wk & drop her off... this way she won't get down in the doledrums & nix working off a bit of stress. We all need that, yeah?

Thank you all again. Glad this story has a happy ending. A bit of a bumpy road for her, but, we all experience that & I do understand not being able to think clearly when in the midst of a hail storm. We've all been there, too.

Cheers again for the great responses! You've all been very helpful!
Very Happy to hear!
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Old 01-11-2012, 03:53 PM
 
Location: Islip,NY
16,959 posts, read 19,737,674 times
Reputation: 17230
I am so glad it worked out for her. Medical insurance and RX's can be very costly. If My husbands boss did not pay for our medical coverage in full I do not know what we'd do. I only work part time. All we pay is co-pays and Rx's. we have a very good plan with oxford. That's a huge savings for us. When I was working full time I carried the benefits and it was costing us like $500 a month.
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Old 01-11-2012, 04:06 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,964,752 times
Reputation: 3424
Quote:
Originally Posted by zoso1979 View Post
Very good point that hasn't been addressed yet; HIPAA will likely prevent your discussing the specific situation. They will tell you. HOWEVER, you can still call and ask a generic questions such as "What happens when..." or what's your policy on "x".
You're spot on with that Zoso & Myrc. Did just as you suggested (see other post).

Quote:
I do get that she feels "ashamed", but if you remove the emotion from the situation, she doesn't need to; it's not like she did anything wrong or dishonest.
Very true, I agree. But I've been in her shoes once or twice in my lifetime & in the heat of distress sometimes one doesn't think clearly. Before suggesting anything at all to her, I listened for a couple of days whilst her wheels were spinning & she was just thinking outloud. Then I began writing a list of medical expenses she'll need with insurance & without. Nothing is dire, but, she's in need of a bit of care for minor issues (dermotologist, gyn, nagging neck/foot/back injuries... seems a lot, yeah?), but, enough to keep her a bit flustered & in need of some physical therapy. Adding to it, in her distress she tripped in her flat 2-days ago & really hurt her shoulder (she couldn't drive today), only adding to her stress... now she needs to find a GP. Sometimes when it rains it pours, yeah?

Quote:
Additionally she needs to determine what she wants to do. It isn't clear from your posts:
1. Does she still want it = negotiate the price and plan for a delayed pick up. Or
2. Does she NOT want it = and tell them the mistake that occurred and that she cannot afford it.

If she really doesn't want it she may still feel obligated to pay (her call), but they just might have a policy that allows her to walk away. Again, no one will know until they call.
Right. I wasn't specific as she hadn't decided on what she should do. Best thing when someone is near breaking down is to listen, I find. Then I said I'd call the pharmacy myself, find out the info & she could ask me when she's ready. Also, I told her I had suggestions, would write them down & she could ask me, if she wanted, when ready. I don't like to push, but also won't listen to more than 2-days of the same wheel churning. I let her calm down (homemade muffins work wonders!), then suggested she sleep on it & we'd discuss options. Getting her to call her family was hard, but was the best solution afterall (homemade muffins work wonders!). At very least, although having a bruised ego, at the same time, she feels the support of her family. The bruised ego will heal in time. Again, we've all been there.

Quote:
You are good friend and she's lucky to have you on her side!
You're very kind. It's so much easier to make someone else's decisions, isn't it? We're not emotional or attached to the outcome. I just let her de-stress a bit, but with the new shoulder injury this am, told her she really should just stay on insurance & p/u her scripts... then said let's figure out how to do that (family).

I'd like to compliment you & all with the same. I'm a stranger... a yank who grew up in Europe so insurance is brand spanking new to me... so I can't tell you how much I appreciate your help & everyone who replied. You've been on my side, as well, mate. Cheers for that!

If you're nearby, I make great homemade muffins!
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Old 01-11-2012, 04:08 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,964,752 times
Reputation: 3424
Quote:
Originally Posted by SouthernBelleInUtah View Post
no, b/c she will have given her permission.
Don't want to forget a personal thank you to anyone who replied. It's all worked out for the best now, so that's great. I thank you for your input. It's been most helpful to me, since I knew I'd be the one making the pharmacy call for my mate. Cheers.
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Old 01-11-2012, 04:31 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,964,752 times
Reputation: 3424
Quote:
Originally Posted by lubby View Post
I am so glad it worked out for her. Medical insurance and RX's can be very costly. If My husbands boss did not pay for our medical coverage in full I do not know what we'd do. I only work part time. All we pay is co-pays and Rx's. we have a very good plan with oxford. That's a huge savings for us. When I was working full time I carried the benefits and it was costing us like $500 a month.
I do understand, Lubby. And, cheers for the good wishes for my mate. I'm a big believer in good thoughts & wishes pushing positive energy forward, so I return them to you. It was quite nice... I saw her face lighten immediately from relief after speaking with family. As adults, we all dislike having to ask for help. I told her it was simply 'floating'... they're floating her 'til she's on her feet & then she can pay them back in due time.

We're prepared to offer her the sofa if she needs, so I didn't want to offer to help pay meds/premiums. I've seen $ ruin far too many situations between friends, so I'd prefer that's a last resort. I'd rather offer moral support, a place to sleep & a warm meal if/when she needs. She may not take us up on it often, but it's a genuine offer (I've got a great, generous boyfriend... I'm very lucky)... & as they say, the shoe could be on the other foot, yeah?

Glad your husband's coverage is so good. It's a huge relief, isn't it? Best luck to you, as well.
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