Back when the PBM’s started – 1969 .. entities like PCS .. charged every pharmacy a annual fee.. $25 ( I think – but that was 44 yrs ago ) for the privilege to bill them..
http://pbmauditlawyers.blogspot.com/2014/01/express-scripts-implements-new.html#!
Express Scripts Implements New Credentialing Processes for Compounding Pharmacies Requiring Detailed Information and Documentation
From the article:
Express Scripts, Inc. has recently adopted new credentialing processes for compounding pharmacies that differ markedly from pharmacies’ previous recredentialing format.
compounding pharmacies will receive an email invitation to a website to complete the online recredentialing form, and will be required to pay a $1,000 non-refundable application fee. Express Scripts intends to roll this out in phases among different groups of pharmacies, until it ultimately has a single compounding network.
I wonder if they are going to reimburse those pharmacies that compound and chose to not be part of their network .. and patient pays cash… or is this just another “restricted network” and “cash cow” for Express Scripts …
Filed under: General Problems
No way!! Next time have patient call Dr. and have their nurse phone in new rx.
Damn Express Scripts! I was on the phone for over 45 minutes today trying to transfer THEM a prescription! Had a doctor send us a script for Evista, too expensive at the local pharmacy, patient asked us to transfer to Express scripts mail order. I told her to call them have them call us for the transfer as is the NORMAL protocol (filling pharmacy calls the other). They told her they didn’t do that. So I had to call, number patient gave me, they didn’t do, all the phone drone said is “we can’t do that here”, after she didn’t help at all only repeating “we can’t do that” I asked for the number for the doctor line, waiting on hold, finally reached a pharmacist….. We can’t do transfers! OMG! Got the correct number, called back, was on hold, finally reached a tech, took all my info, put on hold, transferred to a pharmacist, took my info AGAIN, finally was able to transfer the Rx….. Total time, between 45 min to an hour…….
And is my chain being reimbursed for any of this? No! How much did the patient save by going via mail order? One brand copay ($45), how much did my chain pay me for spending time on the phone transferring out a prescription? Average of $1 a minute, between $45 and $60…..
Only reason I did it was the patient is a nice woman, and she does fill with us regularly…. (and I did make her wait 2 days before I had time since I knew it would take SO long!)….
My chain payed me about $60 to handle the case, (including time of her asking in the first place, phone time on status updates, and time to actually transfer), amount saved by patient $45 (per a 3 month, so possibly $180 over the course of the year of the RX), amount my chain received in payment? $0…
Extra profit by Express Scripts? Who the hell knows, they don’t publish their true financials,… Though they probably charged the plan sponsor more then the true cost to just have me fill it in the first place!
I fucking hate mail order!!!!