A Very Frustrating Couple of Days!


A Very Frustrating Couple of Days!

man-pulling-his-hair-outThursday: I receive a message today from the clinic that the online charting site that we have been using is going down as of February 15th. This charting service was operated by the clinic and was made part of their clinic medical record. Their reason for discontinuing is due to increasing costs for software licensing and increased security concerns.

Does anyone have any online charting sites that the use that are free or very low cost?

I would even consider a computer program that is free or low cost. I will keep my hand written chart but do like the online record as a back up and to produce printed reports to take to appointments and emergency binder use. I have tried spreadsheets and documents before but have never been able to get a descent format and have had compatibility issues trying to access them else ware if they have a different version or after upgrading.

Any ideas would be appreciated.

We had to start rewrapping mom’s leg today as it has started to break out again!

Friday: Chiropractor, dialysis, pharmacy and laundry today. Get to dialysis to pick Mom up and am told they have scheduled her for a Fistulagram on Thursday. I will have to be with her at the appointment and need to stay with her for 24 to 72 hours after the procedure because of the sedatives that will be used and the unusually long time that it takes to get out of her system.

They have order this because she is having recirculation in her fistula so her dialysis is not as adequate as it should be. We will get our instructions for this on Monday as the doctor is at dialysis on Monday. I get to the pharmacy at 3:15 p.m. Yesterday morning ordered four prescriptions refills for pick up at 3:00 p.m. today and the prescriptions are not yet ready!

Three of the prescriptions are on review status and 1 is awaiting prior authorization from the insurance and needs the doctor’s signature and diagnosis codes to submit to insurance. The pharmacy claims that they faxed the doctor yesterday afternoon but have yet to receive it back which is not normal for the doctor.

I called the doctors office and they claim that the form was just faxed over 10 minutes ago and that the doctor was at one of the satellite clinics this afternoon and was on her drive back so was unavailable. I was told if it would have been faxed yesterday as the pharmacy claims or even this morning that she was in and would have filled it out and signed it.

I was also informed that the doctor will not be back in for paperwork until Monday. Mom has one of this pill left for Saturday morning and it is to help with her Charlie horses and the pharmacy will not even fill an emergency supply of them until they have the form back and submitted and processed by the insurance company. That will take 3 to 5 business days to complete. I called her case manager at her MCO as her nurse was not in the office today. By this time it is 4:20 p.m.!

At this point they still do not have the three that were on review status complete yet and I was also awaiting a call back from the case manager as she was going to see what she could do about paying for an emergency supply through them instead of the insurance company. When they finely get the other three prescriptions ready I am informed that they only filled two of them complete and the other they filled a three-day supply because they do not have enough of it in stock and will not get more until Monday afternoon this is at 4:45 p.m.

At  5:25 p.m., I received the return call from he case manager and they have sent over an authorization for the emergency supply of the other prescription and confirmed that the pharmacy received it. But they informed her they would not fill it until Saturday because it came in after their cut off for filling new prescriptions for the day! So I will have to make the 19.8 mile round trip to the pharmacy tomorrow to pick up the emergency supply, which takes about an hour in traffic to get there and probably play their games again of not having the prescription ready!

I will only be paid 15 minutes for today and the mileage for today. I will not be paid my time or mileage for tomorrow as they will only pay for one trip to the pharmacy per week unless you have a new prescription and all pharmacy trips must be in conjunction with an approved appointment with the maximum payable time for a qualifying pharmacy pick up being 15 minutes.

I am also going to have to take time off from caring for my friend to go do this and lose pay there unless I can work something out with him to do things at a different time which he has told me he will work with me on this. I have called the corporate customer service number of the pharmacy to file a complaint which they have logged and are having the regional manager give me a call.

This is not the first time I haven't had prescriptions filled by the time ordered. I have talked to the district manager before and was told that they would talk to the pharmacy and get this corrected. The manager also told me that if there was a problem on filling them that they would call me to let me know so that I could make arrangements with the doctor or the insurance company or her MCO. They failed to call and did not have them ready on time again!

I would change the pharmacy we use but the part D insurance that Medicaid bought for her only has one preferred pharmacy in the immediate area. If we go to a non-preferred pharmacy we have to pay 20% of the prescription price plus a higher co-pay! Next closest preferred pharmacy is about 45 miles one-way and transpiration would not be covered because they will only pay for a trip to the closest preferred pharmacy.

If we decide we want a different part D plan Medicaid will not pay for it.  Medicaid will not pay for any prescription as they have bought her the part D and they would not pick up if we dropped this part D and would require us to purchase a part D plan on our own! The dialysis center is also getting upset about how the prescriptions are being filled as they are required to do a monthly review on her prescriptions (I have been out of some of them several times because of filling issues) and are looking at what options are available. Her case manager at the MCO is upset about all of this and is also going to see what options are available from them.

I have also decided that I am going to tell the regional manage when he calls me that I am going to tell him if it keeps happening they will be getting a bill for my extra time and mileage!

All of this has Mom upset and threatening to stop dialysis and stop taking her medication if it keeps up. The dialysis center is also going to making a referral for a psychological evaluation to see if she would be competent both psychologically and also emotionally to make the decision or not!

I had a verbal fight with her tonight to get her to take her medication and get on her CPAP. I will see how long she keeps her CPAP on and hope she make the Medicare required minimum of over four hours! (Four hours and six minutes as it has to be 4.1 hours based on the way machine reads.) MCO has stated that if she is not incompliance with her CPAP and meds that I will not get paid.

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For charting I need to keep her bp readings, O2 saturations, sugar counts, when she took her meds, CPAP on and off times with machine reeding, and general condition notes and activity notes as well as dietary notes.


Oh, Larry, this is just awful. And, the worst part if that it's all preventable! None of this should be happening. What a nightmare! I'm sorry for all that you and your mom have to go through. \r\n\r\nI'll post your request for charting software and see what we can find for you.\r\n\r\nWe're all behind you on this so whatever else we do to help, please let us know.\r\n\r\nI so hope today will better.