This is the message I sent to my drug Dr on Friday, March 6th…
(Just for you, my inner monologue in blue.)
Hi Dr. Z, (which is actually what I call him because I can’t pronounce his last name and calling him drug Dr might not be conducive to a good, long term relationship…)
Re: Refills of Vyvanse. I’m hoping that, after we talk today, this prescription will continue. It’s working very well. (He asked me to call him today to report in which is why I’m not going into the wonked side effects and miracles of starting this med in this missive.)
Since it took almost 3 weeks to obtain the first prescription…
…because of all the controlled substance authorization forms going back and forth interminably, I’m hoping we can both minimize and provide enough time so that I don’t have a gap.
(What follows are the dry, boring instructions to my very helpful drug Dr that I’m 77% sure he will ignore.)
My insurance carrier, Commonground, farms out prescription coverage to OptumRX. I spoke with a rep yesterday. She explained that, instead of sending your prescription to Walgreens, you can go directly to them and submit the form they eventually need to get. 2 options:
Go to OptumRX website, click the Healthcare Professionals link in the upper right hand corner and follow the prompts to Prior Authorization Department and fill out the form online.
Or
Call them at 800-711-4555 to go directly to their Prior Authorization Department and give them the info over the phone.
According to them, this will radically decrease the amount of time it takes to authorize use of this drug prescribed by my Dr but the insurance industry knows better whether or not I should have. (I didn’t actually include this snarky paragraph in my message to my drug Dr. No reason to antagonize my monkey. Or call him a monkey. He’s actually a great guy.)
Otherwise, this is what happens: (this is totally skimmable. you’ll get the point really quickly)
1. You submit prescription to Walgreens.
2. I see it on the Walgreens website as in process.
3. Walgreens sends it to Commonground
4. Commonground sends it to OptumRX
5. OptumRX tells Commonground that it’s a controlled substance and needs a Prior Authorization form
6. Commonground tells Walgreens
7. Walgreens faxes the form to Aurora
8. I notice the prescription is no longer on the Walgreens website as in process so start trying to track it down.
9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 21 and 21. (Note: this first go-around, Walgreens was faxing it to the wrong number. Tried a couple times. No response. Stopped trying. I called Walgreens and Commonground. Called Aurora. They provided the fax number. I called Walgreens and gave them the correct fax number. They tried again. Aurora called Walgreens and gave them the right fax number too while I simultaneously received a voice mail message from someone at Aurora explaining to me that my prescription was delayed because they hadn’t received the prior authorization form from Walgreens.)
22. Walgreens successfully faxes form to Aurora
23. You’re in the Aurora office on Fridays so the form waits
24. You fill out the form
25. Aurora faxes to Walgreens
26. Walgreens to Commonground
27. Commonground to OptumRX
28. OptumRX to Commonground
29. Commonground to Walgreens
30. Walgreens filled the prescription and I ran to get it
31. Letter from Commonground arrives about a week later confirming the Vyvanse prescription has been approved but only until May 7th – as you know.
If we wait until my May 8th appointment with you to start this over again, I will be without my prescription. (Logic. Doctors can’t argue with logic. Right?)
Please help. (Read: please don’t read all the snark into this message because I cannot afford to alienate you.)
Thank you. (Read: it’s not you. It’s them. It’s us against them. Except when it’s you.)
Susan (No last name needed because of course you remember me. I make it hard to forget me.)
I’m Susan Scot Fry, the author of “A Year of Significance”. In 2020, I take on the greatest nemesis of my life: Binge Eating Disorder. With a side of aplomb sauce. Honest, occasionally humorous and sometimes I swear.
A Year of Significance 