Lessons in Customer Satisfaction - how to run a Mail-order pharmacy

[jgibson2[$]]

Some of you may remember my frustration with my health insurance provider a few months ago. Well, they've been at it again.

It is almost time to refill one of my husband's prescriptions, so I visited the mail-order pharmacy web site. I had a prescription bottle in my hand that said "may refill 1 time after April 13" The pharmacy web site said "no refills" I just love computer errors.

Thinking that this might be simple to fix, I fired off an email to customer service. I got the following reply.

Thank you for your online inquiry. Our records indicate Rx #XXXXXX9280-09 has expired. Your physician wrote this prescription on 06/28/01 and the prescription expired on 06/28/02

I sent a rather sarcastic email asking them just what calendar they were looking at, then compounded my frustration by picking up the phone and dialing the customer service number.

The cheerful woman who answered the phone started to tell me that the prescription had expired, then realized that couldn't be the problem. Then she insisted that we'd used all our refills, despite what was written on the label of the bottle I was holding. When that didn't fly, she proceeded to inform me that the required prior authorization had expired and that there was nothing she could do about that, because that is Blue Cross's problem.

When I stopped screaming, she informed me that there was no need to raise my voice. We chatted for several more minutes, with me trying to avoid saying anything my 6 year old might repeat in front of the pastor.

She must have found the note in my record that says "be nice to this lady, we've screwed up a lot" because she abruptly began to apologize for my inconvenience and to figure out how she could fix the problem.

The customer service representatives I've talked to since January all seem to have this very rapid reversal from beaurocratic doublespeak to apology after a couple of minutes on the phone with me, so there MUST be a note. Too bad it's not at the vey top of the record where it would help keep my blood pressure from soaring out of control.

Now I have her first name, her extension number, and the mail-order pharmacy office where she works. I also have her promise to follow this up personally to make sure the prescription actually gets filled. I'm giving her until Thursday, then I may have to chat with her again. I hope not. At least I have a name and number so I won't have to go through the "Your prescription expired 2.5 months from now" boogie again.

[pluckyduck]

I can't think of anywhere except in the healthcare field that a company could get away with such poor service.

There was a time, back before managed care, that if you didn't like the service you got from one place, you moved to another. There's just not much incentive for places to get their acts together.

Andrea
who doesn't like managed care...the anti-capitalism

[jgibson2[$]]

Andrea,
At least they're doing better. It only took one phone call to get the last foul-up straightened out and I'm hoping for a similar record this time. OK, one email and one phone call. The thought of actually sending someone an email that says "your prescription expired 2.5 months from now" is pretty mind-boggling. I thought that the ability to read and write was pretty basic to customer service work. Apparently the ability to reason isn't -- at least not in healthcare.

Much as they've fouled things up, at least they send the right medications. A local pharmacy managed to screw that up several years ago. I don't think that pharmacist is practicing in Maryland any more, though. She made the mistake of telling me that my doctor had authorized the change. He's not one to take that sort of thing lightly.

[pluckyduck]

A good friend of ours runs an independent pharmacy. He became our friend by being our pharmacist first...truly amazing man who helped Don through the maze of caring for his father who had all of the wheels falling off the bus. Not just a couple times he got prescriptions from the doctors, told Don why he thought the prescriptions weren't the right meds, called the doctors, talked with them and had the prescriptions changed. He was never critical of the doctors..it's just that his business is the drugs and the drugs only and he's often in the position to know better. You can't program that kind of knowledge into a computer, it comes from one-on-one care.

Managed care and the agreements made between large conglomerates have shrunk his margins so that he'll make $4 on a $400 prescription. Add in the part where he has to lay out the 400 bucks for the drugs himself and wait to be reimbursed and you can see the money tie up alone costs him more than he's going to make.

Fortunately, he's a good businessman too, so he's found a way to keep the pharmacy growing and thriving. (He's also an "expert" on holistic medicine, with a full line of that kind of stuff -- at least there's some margin there.)

My point is choice. If those yahoos at the mail order pharmacy can't even read a prescription expiration date properly, how much guidance are they going to be able to give?

Not everyone needs the level of service that we've been able to get from our local pharmacy... but plenty of people do, and plenty more people do than even realize that they do! (Did that sentence make sense?)

Imagine Mom and Dad, in their early 70's, sending their prescriptions off to this mail order place and getting lost in the maze. It really burns my toast.

I pride myself on running a simply excellent customer service/inside sales department. What motivates me? That there are 19,000 other places customers can go. We don't wow them, they are moving on. That's captialism. Managed care drives out capitalism and that's bad. For all of us. How many people who would otherwise be good independent pharmacists are going into another line of work looking at the impossible margins on drug prescriptions? Managed care is intent on squeezing them out.


Andrea

[quasar]

I won't use mail order pharmacies. They screw up too often and are awful about fixing their mistakes. I've tried three different mail order companies over the years (through different insurance policies) and they've all been equally bad.

God forbid you need to take a large dose of a medication, because they don't fill prescriptions as written. Well, I'm fairly resistant to a lot of medication and I take large doses of most of my maintenance meds. Pretty much every time I've sent in prescriptions I've gotten their idea of a reasonable dose and not what the written prescription called for. And it happened silently - no calls to me or to my doctor, just less would show up. Sometimes a lot less. Even when my doctor has called them directly they've filled what they feel like and not what he ordered. And even after I'd get it straightened out they'd do the same thing each time I refilled.

I've had them refuse to fill scripts because they claim the drug doesn't exist, I've had them add handling fees on top of my supposed copayments, I've had them fail to ship drugs they claimed were shipped until I spoke to supervisors who admitted they weren't shipped (after three or four folks claimed I never requested them). I've had them refuse to refill in time to get new supplies before the old ones run out. I've never ever had a remotely pleasant conversation with one of their customer service reps.

So I refuse to deal with them. I'll pay a little more for the ability to yell in person when someone screws up my scripts and get it fixed that day when I need it fixed.

Janice

[MrsNormanMaine[$]]

Don't get me started on mail order pharmacies or the idiots they employ to answer the telephone. I recently had the opportunity to tour one. It's amazing! It's impressive! It's inhuman! It employs McDonalds rejects in customer service...

Your best bet for pharmacy service is a small independent pharmacy with a pharmacist behind the counter who will really get to know you and your family and who can head problems off before they happen; this is especially true if there is any sort of chronic illness in the family.

Dr. MNM

[theeye]

Originally posted by MrsNormanMaine
Your best bet for pharmacy service is a small independent pharmacy with a pharmacist behind the counter who will really get to know you and your family and who can head problems off before they happen; this is especially true if there is any sort of chronic illness in the family.

Small independent pharmacies can be wonderful.

Years ago, when my grandmother was near the end of her life, a local pharamacist was extraordinarily helpful to us.

My grandmother was an old woman who was determined to live forever. She firmly believed that if a little medicine was good, then more must be better. She would do the rounds of all the free medical clinics in her area and get them all to give her as much medicine (usually the same medications -- though often with different brand names) as she could get.

My father discovered that she was hoarding medication in her apartment. No matter how he yelled at her that she was going to kill herself, she wouldn't stop. And she was forgetful -- she'd just grab a handful of pills now and then and swallow them, often getting double or triple dosages of medications that she had in duplicate or triplicate.

So he essentially ransacked her apartment, finding bottles and bottles (often open and spilling loose pills) everywhere -- in her sock drawer, in the cutlery drawer, under the bed.

He dumped everything into a big box and took it all over to the local pharmacist, who sat down with him and helped him sort it all out. My grandmother was taking heart medication and other medicine that she really needed -- the pharmacist was able to help him determine which medications were duplicates, told him what everything was and double-checked the various dosages for appropriateness. Even helped identify loose pills from their markings. And he explained to my father which pills should be taken with food, which on an empty stomach and generally helped organize a regime, which my father enforced by grouping the pills in individual dosages.

That pharmacist, out of the goodness of his heart, spent an extraordinary amount of time helping my father straighten things out and quite possibly saved my grandmother's life. You won't get that kind of help from a mail order pharmacy.

[sylvanb]

It's hardly a small pharmacy, but CVS is the best we've ever dealt with (store, not web). We've used them for about 10 years, usually using the automated phone system for refills, and there's never been a problem. When a prescription has run out, they call the doctor for the renewal, and call us to let us know. Our local one is open 24/7, the people fall all over themselves to be helpful, and I've even made a friend.

I'm not biased because they're a Rhode Island company I am biased because I had a couple of job interviews there and was really impressed with how they looked from the inside. But mostly I'm biased because their CS has been so consistently good.

[jgibson2[$]]

I really prefer the small, independent pharmacy where I get nearly all our prescriptions filled. There are a couple of ongoing prescriptions that are just too expensive to fill locally -- those are the ones they perennially screw up. Those and my glucose test strips are just about the only business they get from us, and if it was just my husband, he'd have to find a way to pay for them locally, because he wouldn't deal with this crap.

I do pay more for some prescriptions just to have them filled locally, but there are a few things that I can't afford to do that with. They're also medications that it won't kill anyone to go without for a few days while I bite someone's head off.

Performance has definitely improved, though. The web site says that the prescription shipped today. So far, the web site has been accurate on THAT point, anyway.