Credit Where Credit’s Due

It’s not often I get to talk about how well things in the healthcare system work. Especially systemically as opposed to individually. I’ve had some good experiences with individuals, but generally the best I can say about the system is that it’s a hassle that costs me money.

The one exception I can think of is when I went from Aetna specialty pharmacy to another pharmacy benefits manager, and it was a disaster. When I met an Aetna pharmacy employee at a conference several years later, I told him I never knew I had it so good until I had to switch. He responded that no one had ever said anything like that to him.

That instance was comparative. The hassle of Aetna had been put in perspective by the disaster of the new company. Now, I am happy to say that I have found a little slice of the system that actually works works. Not comparatively but, for lack of a better word, proactively. I don’t like that I have to spend time on this task, but the time spent is now minimal and the process is easy.

I have your attention now, don’t I? What about healthcare could possibly be easy?

It’s my pharmacy set-up again. The mail order part, anyway.

I didn’t understand at first. When I first switched to the Maryland Health Benefit Exchange, I wasn’t sure what to expect. It was the easiest of the insurers I had experienced of the three I had used in the past, but that had been employer-sponsored. Would being on the exchange plans make it different?

When I first submitted my prescriptions for medication and durable medical equipment, I got a message saying that my prescriptions were ready for pickup at a pharmacy over 30 miles away. It took a few calls to cool my anger at my assumption that this was just another hassle the system had added to my life.

Eventually it settled into a routine of half-a-dozen notifications when prescriptions are ready, which, if there is no co-pay, just get filled and sent. No checking, no time spent on my part, and no hiccups when the prescriptions run out. For those that do require a co-pay, there are still notifications, and persistent calls – by a person! – until they get approval to charge my card. Here is how a typical conversation goes when I find a convenient time to pick up:

Me: Hi. Are you calling for approval to charge the card?

Them: Yes.

Me: You have it. Go ahead.

Them: Is your mailing address still XXXX?

Me: Yes.

Them: I will send it out today and it will be there tomorrow. Is that ok?

Me: Perfect, thanks.

Done. In less than two minutes. Even when I have had to update prescriptions prematurely, they have called before I had a chance. It’s such an unexpected deviation from the norm. It is kind of amazing what injecting a little humanity into a large bureaucratic system can do.

As I read what I am writing, it feels like I might be a little too impressed. Perhaps this should serve as an example of how so little can go such a long way.  And since we are in the midst of the holiday season, I thought I would take the opportunity to give credit where credit is due.

Thanks, CareFirst BCBS and Walgreens!