Fighting The Man

That’s what it feels like, at least. Over the last week I’ve spent hours (literally) nearly every day calling around to the great trifecta of pharmacy, insurance company, and doctor’s office. Well, now that there are three pharmacies involved, I guess it’s a pentagon? Or maybe a pentacle?

The update is that there is no update. Optum Rx, the pharmacy my insurance requires that I use, shipped out the easy stuff (prednisone, doxycycline, valium) and then pretty much gave up on the rest. After my repeated phone calls and copious amounts of time spent on hold, I finally found out they transferred my prescriptions for injectables to Freedom Fertility, but would still be sending me the syringes. Then they apparently just deleted the prescription for syringes from their system, because why the hell not? No one there could figure out what happened to it as of this morning, so I was back on the phone with Freedom Fertility (which, apparently, is always “experiencing higher than normal call volume” that requires a 25-minute hold before you can speak to anyone). I begged them to add the syringes onto my order, which they are going to do. Whew!

Overall, Freedom Fertility been much easier to deal with except on the issue of insurance. For some reason they refuse to run my order through insurance until it’s ready to ship (in other words, at the very last minute), which means that they won’t even tell me whether a prior authorization is required until sometime next week. This is stupid, because I can almost guarantee my insurance is going to piss and moan about paying for all this, and may cause days (or weeks) worth of delays. This isn’t my first rodeo with ordering specialty meds. But I just have to hold my breath and hope that next week when they try to process everything the insurance will approve it without a hitch so they can ship it that day to arrive on time. If anything – ANYTHING – doesn’t go as planned my shipment won’t reach me in time and my cycle will be all screwed up – and possibly canceled. But I can’t convince them to do things any faster. Trust me, I’ve tried.

The only thing I could think of to move things along was to call my doctor and ask them (again) to send in prior authorizations for all these drugs to my insurance. But I can’t even get through to the insurance coordinator.

This is where I'm at right now. Chaos.
This is where I’m at right now. Chaos.

I actually broke down in tears this morning because I was so frustrated by all of this. Seriously, I don’t know how much more of this I can handle. It doesn’t help that I’m in the middle of midterms and I am so stressed already. My husband didn’t quite get it until this morning when I had him on speakerphone with me while I talked to the pharmacy so he could hear how messed up everything is. But he can’t really do anything to help because, you know, he has an actual job to go to. So he’s really sympathetic, but it’s on me to figure this out.

I hate everything.


3 thoughts on “Fighting The Man

  1. If you need help navigating UHC and Freedom Fertility I have direct line phone. Numbers for very helpful people in medical billing and claims submissions at Freedom. be sure you are clear with them at Freedom that tour injectables are billed MEDICALLY not as pharmaceutical!!! A lot of the general “order takers” don’t know what this means, it gets distributed past their department. And Freedom ALWAYS send syringes, alcohol swabs, sharps boxes, gauze, etc. You should only be charged your co-insurance or co-pay and Freedom will bill. I had a claim outstanding for SEVEN MONTHS and freedom made sure it got handled and never asked me to pay it.


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