I’m a professional. I’ve been doing call center work for years. I don’t get flustered easily. I lost it for a second this call.
A while ago I was working “Pharmacy Help Desk”, meaning pharmacists and pharmacy techs called us when they had trouble processing prescription claims. Sometimes the calls were about medical devices, like blood pressure machines, that were billed to the patient’s prescription coverage as well.
Me: Thank you for calling, how may I assist?
Pharmacy tech: Yes, I’m getting a weird rejection for this device and I don’t know what it means, can you please help?
Me: Absolutely! So it says “NDC (national drug code) not on file,” so basically our system doesn’t know what the device is in order to properly adjudicate it. It may be something that was recently added to the market so we don’t have it on file yet. What kind of device is it?
PT: It’s an erectile-disfunction device.
Me: … I’m sorry?
PT: It’s a penis pump. The patient was told his insurance would cover this.
Me: Ah, I see. Is it ok if I place you on a brief hold while I look into this further for you?
PT: That’s fine.
I put her on hold, laughed a bit, told everyone passing by my desk the call was about a penis pump, just getting it all out of my system.
Then once I had regained composure I very calmly told her we would have to do an NDC inquiry to get it added to our system (takes 2 weeks) but in the meantime she could try to process other models to see if they went through instead. In the end I think this was something where she needed to be billing the medical coverage and not the Rx coverage, but I don’t know for sure.
Anyway, I hope the patient eventually got what he needed…
submitted by /u/gwynforred