Sandra Leal, PharmD, MPH, CDE, FAPhA
Have you ever found yourself waiting forever to get your prescription filled at the pharmacy? I mean, how much time does it honestly take to count 30 pills into a bottle and label it? It should just take a few minutes, right? It’s a common question.
As a pharmacist with prior work experience in a community pharmacy setting, I want to shed some light on why it may take an exceptional amount of time to fill your medication. Each state has specific requirements that pharmacies must abide by as well as federal requirements that all pharmacies must follow.
Missing Prescription Information
No system is perfect and same goes for the process of filling a prescription. When you provide a prescription to a pharmacy (whether that be physically with a piece of paper or electronically) the prescription must be complete with the information that is required and enforced by the state or federal government.
Sometimes when prescription orders are received, they are missing important information that is necessary before a pharmacy can dispense them. Sometimes this missing information can be obtained from you, the patient, but sometimes the pharmacy staff must track down the missing information from the doctor’s office you obtained the prescription from. It takes time to contact your physician’s office and get the needed information.
Are the Medications Safe for You?
If everything checks out okay, the next step is to ensure that the medication is safe for you to take. This is the main job of the pharmacist. With our clinical knowledge and years of learning about drugs and how those drugs affect a disease or condition, we analyze your prescription. By analyzing your prescription, the pharmacist will look for drug-drug interactions and drug-disease interactions. This is very important because sometimes a patient has multiple doctors. Occasionally, these doctors do not communicate or share medical records with each other, and are unaware of all the medications his/her patient is taking.
It is at the pharmacy that the pharmacist can find and prevent errors before a medicine is dispensed to you at the pharmacy pickup window. We also make sure the dose, frequency, and directions make sense and are appropriate. Sometimes we need to reference more information about you in order to make a clinical assessment.
This may mean that we need to ask you a few things, like how much you weigh, if you are taking any dietary supplements or herbal products, or if you may be pregnant.
Dealing with the Insurance Company
Once that step passes, we can process the prescription through insurance. This often tends to be the most time consuming step of ordering a prescription. It’s worth noting that if the patient does not have their most recent insurance card with them, it will add to any delay (sometimes significantly) – so, PLEASE, always carry your current insurance card. Please understand that the pharmacy is not your insurance company.
When a pharmacy fills a prescription, what we really mean is that we process a prescription by transmitting information, also known as a claim, to an insurance company. Most of the time the insurance approves the claim but sometimes the insurance denies the claim. If this happens, we may have to contact the insurance directly and this takes time.
Other times the insurance company gives us information as to why the prescription is not covered under your insurance plan. This information may then need to be communicated back to your doctor. Occasionally, the medicine you were prescribed is not on your insurance company’s formulary.
And still other times a prior authorization (PA) is required for prescriptions to be insurance eligible. Once all the steps above are checked, the pharmacy can fill your medication. The last step is to match the medicine bottle to your prescription to make sure we did not miss anything. Once that is taken care of, we can safely and legally, provide the medication to you.
As a patient, please be patient and try to understand that we are doing the best we can to get your medication to you in a timely fashion. We do not intentionally want you to wait longer than necessary, but we need to ensure that the medication we are filling for you is also safe for you.
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