This post is neither a rant nor a roast. I have no intention to cast every Pharmacy Help Desk under the bus or paint every Help Desk Representative with the same brush. If however, as they say, the shoe fits…well, wear it you must.
The general state of affairs among many pharmacy Help Desks these days is frankly abysmal. If you are not a retail pharmacy employee you may be entirely unfamiliar with this segment of the managed care business. The job of the help desk person is, presumably, to help. A pharmacy calls the help desk when encountering problems transmitting a prescription online. But given the types of interactions that I and many of my fellow-pharmacists have encountered by these help-desks, one wonders if such a job title is appropriate.
I like to think I’m a reasonable person. As a community pharmacist for 20+ years I have encountered my fair share of rejected claims and transmission problems. I don’t think, in all those years, I have ever thought it was the fault of the person working at the help desk. I can’t recall ever calling a help desk and initiating an angry tone with an otherwise innocent party.
But I have become guilty of descending into frustration when trying to get what seem like otherwise straightforward questions answered. What passes for “help” at these help desks is amazing. My hope is that a good-natured CEO of one of these health plans will read this article and take a little of this to heart.
What, specifically, are the issues we encounter when we are just trying to help one of your paying members fill a legitimate prescription?
- Long and frequent hold times. I personally don’t know of another industry that allows for such enormous wait times and hold times. Most of our pharmacies would go out of business if we made a patient, doctor or anyone else for that matter wait so long for help. “May I place you on a brief hold?” Why? Are you ringing people out at a register, running a drive-through and telling customers which aisle the Tylenol is in…all at once? I doubt it. You, it seems to me, have one job. Am I wrong? And if you are that busy, how expensive can it be to hire a few more people?
- Untrained individuals. I don’t personally know the academic qualifications required to be a representative for a pharmacy help desk, and I’m not calling into question their personal intelligence. And while I have encountered many polite and otherwise gracious individuals, some of them don’t seem to be conversant with the basic functioning of a retail pharmacy. Some don’t even seem able to manage basic math. I spent an unbelievable amount of time on the phone the other day trying to explain to a representative why a 28 day supply of medication would, in fact, not last 30 days. This is troubling. I’m pleading for better training for these individuals who often stand in between a patient and their critical, life-saving medication.
- Frequent transfers. This seems to be almost a strategy designed to frustrate and hopefully exasperate the pharmacist or pharmacy technician into simply hanging up. “Let me transfer you to member’s services…or the prior authorization team…or the provider line…or the health plan…blah, blah, blah.” We are treated like worthless ping-pong balls in some sort of cruel game of technician table tennis.
- Simple hang-ups and disconnects. No industry seems so fraught with technical difficulties with their phone lines as the pharmacy help desk. How many times am I sitting there talking only to look down and notice the line has disconnected? I wonder. Is there any repercussion for a help-desk employee dropping a call? Could it be that such practices are an “easy way out” since I have about 0.0001% chance of actually getting the same person on the line again when I call back…if I have time to call back?
- Repeated information. What is the point of me entering in my NPI number, then confirming my NPI number, if the help desk representative is just going to ask me again when they finally answer the phone? Does that make any sense?
- Too many questions. My name. The pharmacy name. Pharmacy NPI or NABP. Call back number. Patient name. Patient DOB. Patient address. Patient ID number. Really? We get less information from someone we are about to do heart surgery on. What’s your name and DOB? Okay. We’re good to go. But not the pharmacy help desk. Seems like they want everything but my blood type.
- Too many options. Really? Press 1 for such and such plan of Massachusetts, press 2 for such and such Medicare D plan, etc. Can the questions coming into a help desk be more complicated or diverse than the questions coming into the average pharmacy? But do you ever call your pharmacy and hear: “If you have a question about antibiotics, press 1. If you have a question about contraceptives, press 2.” Seriously? Just answer the phone and answer the question.
- Inadequate or inaccurate information. The pharmacy is often trying to help explain plan benefits to a sick patient. We are going out of our way to call them and find out why this drug costs what it costs, or why it isn’t covered. And all the representative can tell us is to have the patient contact their health plan. What? You can’t tell us their deductible or tier structure or why their copay has gone up? This isn’t rocket science. I remember calling a help desk asking where a patient needed to send their specialty prescription for processing. I called 3 times and got 3 different answers.
Help desks need help. This wasn’t meant to be a snarky article. But somebody needs to speak up and point out a problem. If you are an executive in one of these PBMs I would love for you to spend some time thinking about this problem. Unless, of course, this “lack of help” is part of the plan. I would like to think otherwise.
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