The Pharmacy Process
Posted Aug 31, 2019 12:16 PM
So if you guys don't know who I am, I run this eWhore group on hackforums. But before I did that, I was a full-time pharmacy technician at Walgreens. I was there for just around 4 years and learned all the ins and outs of how the pharmacy process at least in America works. So I thought I would share that knowledge with you guys! It's honestly a pretty easy process, just a ton of very very small steps that need to be done for the prescription to get filled. So to get this started, there are two types of prescriptions. There are your normal everyday prescriptions like heartburn medicine, allergy medicine, etc. Then there are your controlled substances. That's basically your Adderall, fentanyl, most patches, etc. The controlled substances are put inside of a huge safe and only the pharmacist can unlock it. Everything else is just out on shelves in alphabetical order. We have audit's every month from some drug board and they basically come in and count all of our controlled substances to make sure there is not staff abuse or stealing. The pharmacist can also do the audits but most of the time someone else came in and did them. Ok, now that you know the difference I'll start the process.
So basically it all starts with a patient going to a doctor and the doctor writes a prescription for the patient. The doctor can either send us the prescription electronically or he can give a physical copy to the patient, and the patient will go to the pharmacy of their choice. 90% of the prescriptions when I was there were electronic. Once we get the script either electronic or physical, we scan it and type up the prescription on a computer. We type the instructions that the doctor gave, the number of pills, any special messages the doctor has about the script he writes on the there. Once we type up all of the scripts we submit it to the pharmacist. The pharmacist does a quick check to make sure it was typed write and then approves it.
Probably one of the most annoying parts of the pharmacy is insurance. Ok so let's say the patient brings the script in for the first time. We take the script, scan it, then ask them if they have insurance. If they don't have insurance then they can either pay the cash price or look up a coupon code on GoodRX. If you don't have health insurance please please look up GoodRX. It saves a ton of lower-income families a ton of money each year. Literally is just free insurance codes that people can use to save hundreds. But 80% of people do have insurance. So we take in the card, scan that as well, and type up all the information from the card onto our computers. Remember how I was talking about typing up the prescription and submitting it to the pharmacist. Well, part of the process of typing it is running the insurance with it to see if it is covered on there plan. 95% of the time we just type the card number for number, run it with the medication and boom the insurance fully covers it. But the other 5% of the time, it won't run, won't be covered, and that's where it becomes true hell in the pharmacy. We first have to tell the patient it's not covered which will piss them off, we then have to discuss alternatives. Most of the time they just end up looking GoodRX coupons. But some of them want us to call the insurance companies. We always find a solution. But this is by far the worst part. Insurance.
Ok, so now the scripts have been typed and the insurance has worked! Nice! So what happens now when the pharmacist approves the script, it prints out a physical piece of paper that has the drug name, quantity, location of where the drug is in the pharmacy, etc. It's the piece of paper you get when you pick up your scripts that are stapled to the bag. Basically, a huge pile of scripts will print out, and the techs will find the drug, pour it out onto a counting tray, and pour it into a pill bottle and put a sticker on there. If it's a controlled substance they are required to count it twice, circling the number when they've counted it the second time. Then they grab the pill bottle with the sticker on it and they grab the paper script and put it into a small blue container.
The blue containers get stacked up next to the pharmacist. What he does is grab the container, scans a barcode on the paper, and it pulls up what the pill is supposed to look like on his computer. He then pulls out some of the pills and puts them under a microscope to see if it matches what's on the screen. If it does he clicks verify on the screen, puts the pill bottle in a bag, and staples the bag to the paper. Then he puts it in this box to be put on the shelf for them to come to pick up.
Once the customer comes, they give us their last name, we type it into the system and it shows us all scripts that are ready for pick up. We had like 40 different crates all marked alphabetically by the last name. We'd just go to the tote based on their last name. We grab it, scan it, if it's a controlled substance we are required to see ID and document it. We actually have to write down a ton of personal info for controlled substances just since the state requires it. Then we ask if they have any questions for the pharmacist. If it requires payment they pay, but most of the time insurance will cover all of it. And then boom, the customer has their script and everyone is happy.
Hope you enjoyed my ted talk <3
