Friday, August 15, 2014

Unhealthy insurance - Part 2

The saga continues
Mishandled Rx is SOP*

AvMed, Humana: Are you listening?


This entry unfortunately is a continuation of the Humana and its docs rant posted Wednesday, August 6, 2014. This time Humana Customer Service gets a gold star.


On Wednesday, July 30 I gave the people at Leung Healthcare in Hollywood FL - I can't write "my PCP's office" since I now am relegated to seeing a physician's assistant (PA) and no, PAs are not RNs - a request, written in large letters, for four (4) prescriptions. Each was to be for a 90-day supply. To my Edward Bear mind, that was a pretty simple request.

Apparently the request was too complicated.

I need four (4) prescriptions.

* Send ZXY prescription via fax to RightSource.

* Hand me the remaining three (3) prescriptions and I will get them filled locally.

Only one (1) prescription was to be faxed to RightSource, Humana's contract mail order pharmacy. I spent many years as journalist and technical writer so I believe I know how to write clear and unambiguous English.

Three prescriptions were to be handed to me so I could take them to my local pharmacy (Publix) which dispenses two (2) of my meds gratis; no charge to me or to Humana.


RightSource has received the Rx for one of my meds three times.

The first time the order (from another practice) was filled promptly and correctly.

The second time my then PCP, proving he either can't count or won't listen, ordered 240 capsules. I take four capsules a day. By my math, that comes to 360 (30 capsules * 4-a-day = 120) * 90 days =360 capsules).


On Wednesday, August 6, 2014, I called the practice and asked if my three (3) prescriptions were ready.

To paraphrase, I was told: "Well, gee, I can't find anything. Maybe they were sent to RightSource. Why don't you (the patient) call RightSource and check?"

I refused to call RightSource, telling the office person she should contact RightSource and get back to me before the end of the day. Today is Friday, August 15, 2014 and I still am waiting to hear from anyone at Leung Healthcare.


Today, Thursday August 7, 2014, I received a package from RightSource.

And the snafu - that's accurate because this obviously IS the normal situation - continues.

Inside the package from RightSource were three (3) bottles of pills.

Two bottles contained a total of 180 pills which are taken one pill twice-a-day - a 90 day supply. (Yet, the bottle shows I have THREE (3) refills remaining.

The third bottle contained 90 pills of a one-a-day medication; a 90-day supply. This medication's prescription also was supposed to be handed to me. As with the earlier prescription, there are three (3) refills, so I'll be good for 120 days. According to there are less than 140 days until December 31; unfortunately that means one more trip to Leung Healthcare. Unless, of course, if there is another foul up not yet discovered- or I decide to skip 20 days between now and the end of the year.

The third "hand the patient the prescription" has yet to arrive.

The fourth prescription, the one that was supposed to be faxed to RightSource also was missing.

Did RightSource get the scripts? Will I get the remaining meds before running out in another few days.?

The first time RightSource sent a mail order it sent a 90 day supply - 3 containers, each with 30 days' worth of pills. (How did it happen that RightSource got it right? Different prescribing doctor; different practice.)


Humana was charged $13 each for two prescriptions that I normally get for free - no cost to me or Humana - at Publix. While the $13 is not going to break Humana, the real issue , is that these charges get me very close to Humana's maximum annual allowance for prescription medications. (Humana's maximum is in line with other Medicare Advantage providers; the limit is not the issue - REACHING THE LIMIT is the issue.)

At the end of the day - the day being Thursday August 7, 2014, I am left wondering if tomorrow's mail will bring the rest of my meds and will the delivery contain a 90-day supply of two meds and, maybe, an 80 day supply of the medication for which I so far received only a 30 day supply.


Letter to Dr. Gilbert Leung, the physician who owns Leung Healthcare, setting forth my problems with his Hollywood practice. I noted that I now am out of one critical medication (due to the pervious script's mishandling). I also related my communication with the office staff in trying to resolve the issue. This is my third (3rd) letter to Leung or his wife/administrator; none of which to date have received the courtesy of a reply.


The third of he four medications arrive. As with the previous two (see Thursday, August 7, 2014, above), this 90-day supply shows "3 Refills before (date).

I still have heard nothing from Leung Healthcare - neither it's Hollywood office nor its owner or his wife; this cavalier attitude is most "off-putting."

How did "cavalier" morph from "horse soldier" to "don't care attitude?" (See bottom for Merriam-Webster's definitions.)


HUMANA, in a response to a web-mail message I earlier sent, informs me that "RightSource does not have an active prescription for (medication) on file." RightSource got scripts for everything BUT the most critical medication, the one medication I told the people in the Leung Healthcare office to fax to RightSource.

Humana gets a gold star for tracking down what Leung Healthcare SHOULD have done two weeks previously.

Are all medical offices so badly run?

Last year I was with AvMed and I had an excellent PCP by the name of Edwardo (Eddy) Perez-Stable, a/k/a Dr. P-S. Unfortunately, the office staff almost never anything it right. (My wife still sees Dr. P-S - different insurance - and reports that the office still manages to mess up simple tasks.)

AvMed, in its questionable wisdom, dropped Dr. P-S' practice and, in a fit of pique, I dropped AvMed and signed on with Humana.

On first blush, I thought the practice where I reluctantly now go had a first rate office staff. A façade; this group is no better - and possibly worse - than the staff that is supposed to support Dr. P-S. (AvMed also lists Leung Healthcare.)


Rx = Prescription, script (Yes, the graphic is deliberately upside down.)

SOP = Standard Operating Procedure

CAVALIER According to Merriam-Webster's online dictionary, "cavalier" as a noun means " a gentleman trained in arms and horsemanship" and dates back to at least 1589. "Cavalier" as an adjective id defined as "marked by or given to offhand and often disdainful dismissal of important matters"; this dates to at least 1641.

Wikipedia gives an interesting background on how the word was associated to Merriam-Webster's adjective definition.

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