30 Days of US Healthcare: Insurance Kickbacks

Day 13

30 Days of US Healthcare

[ie_kp]

As a pharmacy technician, I gotta say that everything here was spot on! Except for how quickly they were able to talk to a real person at UHC

[sam]

As a retail pharmacist, I can CONFIRM this is what we doing everyday. Calling doctors and change to insurance perferred. God damn US Healthcare

[alexandermold]

Love me that "not" blatantly illegal stuff US insurance can do!

[radnukespeoplesminds]

This opthamologist is waging war against for profit healthcare one short at a time and I am here for it.

[jtkane]

I have hit this never ending stream of new prior authorization needs for basic meds in the last couple months through my clinic. It is eating up about 5 hours per week which is all the "admin" time I'm allotted for extra charting. Our volume went from about 25/day to 45/day as of last week and we dropped down to one PA or NP covering that portion of our clinic.

Haven't been able to play with my son at night for 2 weeks due to getting home right at bedtime.

I hate how our healthcare is run. I just want to raise my family and help people.

[DarthSithari]

That "it's almost always bad news" line hits home. Pharmacy gets stuck as the middleman between everyone.

[carmenlewis]

I'm a pharmacist in the USA and I can vouch that this is LITERALLY what I deal with every day.

[neospriss]

As a US pharmacist, the pain of this video is all too real. The only thing is he missed the "oh, now you have to pay a brand name copay for the drug that we won't cover as the generic". So now they have a $100 copay on brand name med that the generic costs $45 cash.

[Janesomeone]

I used to work in a pharmacy and this was an almost daily occurrence. It’s insane how long I’d spend on the phone with people who either said “we don’t cover it anymore” or “you need a prior authorization”.

[eldrago]

Politicians: but we can't nationalise health care. The government is so inefficient.
US: Spends far more on administrative costs related to healthcare than any other nation because of how hard it is to order medication.

[Eleutherarch]

As someone starting medical school in the UK, I'm studying this series carefully so I can get a handle on the way prescribing will be over here in 10-15 years. Thanks for the course. How much do I owe you?

[jakem]

I "love" that we're 13 days into 30 days of us healthcare and they've all just been about trying to pay for it.

[whoshotashleybabbitt]

“PHARMACY! It’s so good to hear from you, even though it’s almost always bad news.”

Oh Paediatrics, always being the most upbeat about any situation.

[TKDB]

The most absurd part is when the insurance will only cover brand, but the brand *copay* is higher than the *self-pay* price for generic. Which in my experience as a pharmacist seems to be about half the time these kickback shenanigans are in play.

[scottmsg]

My favorite is after doing a prior authorization for a prescription, the insurance company turns around and says, “Just kidding, we really didn’t need that! We just hoped you’d give up and not make us spend any of the patient’s money.”

[BlackCanary]

[Screams of anguish] I take Qvar. My pulmonologist writes my prescription for two puffs twice a day instead of one so I hit the 90-day medication maximum for three inhalers instead of having to buy them one at a time for maximum price. (They can't give me two for the 90-day price because that would be 120 days of meds and you can't have more than 90. Never mind that I've been taking these meds for decades.)

[TheVillainOfTheYear]

I'm a utilization review nurse for a hospital typing this while on hold with UHC trying to set up a peer to peer. Please do one on their phone tree and/or how they generate a million auth numbers for the same encounter. Placed in obs? One number. Updated to inpatient? Two more auth numbers. Denial? New auth number. Then when you call for a peer to peer, they're confused about which auth you mean.
Edit: when I got them on the line, they did it again. Multiple auth numbers. I figured out their game and they forwarded me to a phone tree.

[christinesmith]

Meanwhile in Australia I walk in the pharmacy with my script. Pharmacist tells me “your doctor has prescribed a brand name med that costs $40 do you want to switch to the generic and save $10?” No need to call anyone as they are same medication and pharmacist allowed to switch brands.

[microblot]

Sometimes I get awfully frustrated watching Dr. Glauc videos and then I remember I live nowhere near U.S. Have to actively remind myself "not my circus not my clowns" to calm down

Hope this goes viral and things change for better

[lizmalsam]

Pharmacist here. I’ve just been triggered!!! 😱😱😱 The accuracy of this vid is astounding & horrifyingly true ~ except at how fast this can be done!! I’m so glad I’m retired now!! 😂😂😂