Medicare Part D – Mexican Food and NPI

First off, Merry Xmas to everyone.

The 1st is looming closer and closer.  For those in you not in pharmacy, the best way I can describe the feeling is as such.

You just ate at this Mexican food restaurant.  The food was good, but you have this feeling in the back of your mind that you will be spending the evening peeing out of your butt.  However you aren’t 100% sure that you’re gonna expode out of your backside, you’re just 98% sure.

Thats how we feel right now.  I’m about 98% sure this is going to be total clusterfuck, but there is a small hint in the back of my head that it might be okay.

Now something that complicates this whole clusterfuck even more: The dreaded NPI number.

How many doctors have you gotten an NPI number from?  How many insurance companies are going to ‘suddenly’ require an NPI number on 1/1/08 without any prior warning or notice?  How many doctors have you asked “Hey, whats your NPI number?” only to get a “Whats an NPI number?” answer?

For Xmas, all I want is a 5th of good scotch, a few cigars, a box of fentanyl patches and a well-heated hot tub.

Comments #

Comment by PharmStudent on 2007-12-24 09:50:41 -0800 #

I work at Walmart in St. Louis. We haven’t gotten any NPI number for anyone. We enjoy the luxury of our corporate headquarters putting them in for us on Dec31.
We were told not to put any numbers in…
Good deal eh?

Comment by hiptocode on 2007-12-24 10:57:25 -0800 #

we got all of our NPI’s in early 2006, there has been more than enough warning. BCBS and most major carriers have already started using them.

Comment by one_angry_tech on 2007-12-24 15:01:31 -0800 #

With no sarcasm what-so-ever, all I can say is Happy New Year!

Comment by rph3664 on 2007-12-24 19:18:09 -0800 #

Reason #36,413 why I am glad I no longer work in retail.

Comment by http://openid.aol.com/blastoff2them00n on 2007-12-25 06:03:58 -0800 #

I work for neither Walgreens nor Rite Aid… can’t you do a Medicare Part D eligibility lookup and then just submit the claim to whatever comes up in the reject message? It got me through the last new year and will probably get me through this one too.
Most of the seniors at my pharmacy have their lives more together than a lot of the younger people who come in. I had a girl come in yesterday who didn’t have her insurance card with her, tried getting me to put it thru to Wellpoint/Anthem/NextRx. Of course, it rejected. I’m on hold with Heather from Anthem and have the “nothing good will come of this call” gut feeling. I ask the girl to call her dad who’s the card holder. After several instances of ::sigh!:: and “are you serious?!?”, she calls her dad, who starts giving me the medical insurance info for BC/BS of Maryland. When I ask him if there is anything like an RxBIN on the card or any 6 digit numbers, he tells me not at all. I ask for anything that says “for pharmacists.” and he goes, “Why would you need that, that’s a different card!”
Long story short… she had Catalyst Rx and once I got the info, she got her 5 dollar copays and her ZPak. A happy ending… but like I said, most of my Part D seniors have life more together than that. Even my Namenda ones.

Comment by RxTechKim on 2007-12-25 10:11:09 -0800 #

TAP, you are scaring me. This will be my first January 1st in the pharmacy. I hope it’s not as bad as you are letting on. Damn….looks like I may need to break into the CII cabinet….

Comment by http://openid.aol.com/mikells43 on 2007-12-25 13:05:45 -0800 #

lol u dont need fent to enjoy ur holidays. im glad i dont need fent anymore its nasty shit. and good luck with the new part d leg bullshit. my pharmacist is allready bitching. merry xmas

Comment by Chris B on 2007-12-25 17:47:17 -0800 #

Oh I just can’t fucking wait

Comment by PharmDunk on 2007-12-25 20:10:22 -0800 #

http://www.indystar.com/apps/pbcs.dll/article?AID=/20071225/BUSINESS/712250321/1003/BUSINESS
Your finally getting some attention!!!
Keep up the great work.

Comment by Mike on 2007-12-26 03:39:43 -0800 #

To complete the analogy…. Not only do you have to blow from your ass, but you’re nowhere near home…. You have to use a port-o-potty… And there’s no toilet paper ( or only a roll of the brown paper towel type)…. And the whole time that your spray painting the bowl, bitchy old people are knocking on the door whining about the wait!

Comment by Chris on 2007-12-26 12:33:19 -0800 #

I already feel like crying! I’m going to ask for a couple of favors from the general public…

1. Upon receiving your new insurance card, remove your old card(s) from your purse/wallett and cut them up! Yes, you will get them confused, and yes, they will confuse me.
2. Please don’t bring me the letter that says your coverage is effective as of 1/1/08 and expect me to know your ID number. Or even worse, a print-out from the internet that says you have “Anthem” with no other information.
3. Don’t get up to the front of the line and bitch that you waited for 20 minutes, and then proceed to whine about your new insurance card. Ultimately, this causes the same problem that made you wait in the first place.
4. Your ID # is not nescesarily the ID # for every single screamer (a.k.a. child) that you have. So don’t yell at me when I say, “This is not the right card.”
5. No, I can’t take your new information over the phone and tell you what each of your 15 scripts will cost you. You supposidly read that contract before you signed it, right? You should already know what your scripts cost.
6. If it’s possible, avoid your friendly pharmacy until the second week of January. And if you do visit, don’t mind the pharmacist in the back drinking the whiskey.
7. Please drop off your new card with your rx. This will help avoid #3 above. If your calling ahead, tell me that you have new coverage so I don’t get 15 rejected claims.
   Sigh…

Comment by Prophetess of Doom on 2007-12-27 08:54:42 -0800 #

Hello! Merry Christmas, Happy Solstice and all that. For your NPI needs, please follow this link. I hope it helps. I LOVE it! NPI numbers for everyone!!
https://nppes.cms.hhs.gov/NPPES/NPIRegistrySearch.do?subAction=reset&searchType=ind

Comment by Jason on 2007-12-28 07:38:51 -0800 #

This is the reason that I took the first 4 days of the year off. I’m going to let the techs wrestle with this problem first and then once they’ve figured out a workable solution I’ll come back to work.
3rd-year intern

Comment by madrph on 2007-12-30 05:39:18 -0800 #

Prophetess of doom, you’re the greatest!!!

Comment by grumpytech on 2008-05-08 22:38:06 -0700 #

I know, late info…
Starting in March of 2007, I made up a form for my techs to send to ALL the dr’s that they were faxing stuff to. I requested md name, address, updated phone number, dea, california license number and NPI. It actually worked pretty well. But try getting a 6 page fax in a tiny font of every dr at Loma Linda (a local HUGE hospital). I got dr’s I never saw before…
Sorcha