Monday, October 28, 2013


Last week, when I called Aetna Specialty Pharmacy for my Enbrel refill, I was instead informed that I would be unable to get my refill until I obtained a new prior authorization form. Though I was frustrated not to be given warning that I would need this paperwork, I got the appropriate form from my doctor as soon as possible. This morning I called back to order my refill. After confirming my Aetna ID number, name, and birthday, I had the following conversation:
Me: Hi. I would like to order a refill of my Enbrel.
ASP Person #1: Let me put you on hold.
(lengthy pause)
ASP Person #1: You will need prior authorization.
Me: Yes I know. I had my rheumatologist send the paperwork last week by fax. 
ASP Person #1: Yes but it hasn't been approved yet. 
Me: Oh. How long does that take?
ASP Person #1: 7 to 14 days.
Me: Really? I'll miss two doses if it takes that long. Isn't there anything we can do to speed up the process?
ASP Person #1: That's not my department. Here's a number you can call.
At that point I'm pretty sure I muttered something about this being a stupid system, then promptly apologized since I know it was not Person #1's personal fault. So I call the second number and get an automated machine, which makes me enter my Aetna ID number and my birthday and then confirms my name before turning me over to a human. But I'm not sure what the point of that was anyhow, because the first thing Person #2 did was ask me for the exact same information. Then this happened:
Me: Hi. I'm trying to find out how long it will take before I can get a refill of my Enbrel.
ASP Person #2: Ok. Let me transfer you over to the pharmacy.
Me: No! I just talked to them. They told me that I need to call you. 
ASP Person #2: If you want a refill you need to talk to the pharmacy.
Me: They told me I need a prior authorization, which my doctor sent. I am trying to find out how long it will take to have that approved.
ASP Person #2: Can you hold please?
(lengthy pause)
ASP Person #2: It has been approved.
Me: Really? The pharmacy said it would take 7 to 14 days.
(thinking: good thing I bothered to call this second number instead of just waiting to hear back from the pharmacy)
ASP Person #2: No, it's approved now. Let me give you the approval number.
Me: Great. So I just call the pharmacy back with this number and I will be able to order my refill?
ASP Person #2: Yes. I can transfer you there right now.
Me: Thanks!
But (of course) it was too good to be true. She transfers me back to the pharmacy, and, after a lengthy hold (of course) I get a human. She (of course) wants my Aetna ID number, birthday, and name for the fifth time. Then this happens: 
Me: I'd like to order a refill of my Enbrel. 
ASP Person #3: Let me put you on hold
(lengthy pause)
ASP Person #3: Oh. This was just approved today. Unfortunately you can't order a refill at this time.
Me: Why not? They just transfered me over here and said I could.
ASP Person #3: Well the system isn't letting me. It takes some time for the different systems to connect. 
(thinking: does it? Pretty sure the interwebs are instantaneous...)
Me: So...what does that mean?
ASP Person #3: You can try calling back in a few hours. Or maybe tomorrow.
Sigh. Forty-five minutes later, it turns out I might maybe be able to order my Enbrel in a few hours. Or tomorrow. Or in 7 to 14 days. It's unclear.

The only thing that is certain is that I will be missing today's dose of Enbrel. Sigh.

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