The company I work for uses Optum RX for coverage. I've been an insulin dependent Diabetic for 35 years.
They demanded pre-authorization for my Novolog script. Fine. Had my Endo contact them and "pre-authorize it". I was down to a half bottle of insulin.
Went to fill the script at my pharmacy. Rejected by Optum RX. Spent 8 hrs on the phone with them and my Dr's office. Now out of insulin and seriously pissed off.
Called the NY State Attorney General's office and filed an official complaint. Called them again. Get your manager on the phone now. "Why?" Because I'm going to have to do to the emergency room tomorrow because you're not covering my Insulin script which keeps me alive.
On hold 30 minutes, hung up on. Called back again. On hold 45 minutes, hung up on. Called back again (SERIOUSLY PISSED OFF NOW) - put your manager on the phone NOW.
After 3 calls from me, not including my DR, finally got a manager on the phone who called my pharmacy and covered my Novolog and then signed me up for a 3 month supply mail order,
I'm so glad I pay for their coverage. Yesterday my 14 year old daughter's Endo contacted their pre-authorization group to have them fill her 3 month Novolog script. They denied it and told the Dr's office we don't cover Novolog only Humalog. Amazing, they just covered mine less than 3 weeks ago but now they don't cover my daughter's who is on my insurance.
I pity the person I talk to on Monday morning because I will have no mercy on you. Additionally, I will be contacting my VP of Healthcare and the NY State Attorney General again to advise them of your ***
Reason of review: Order processing issue.
Preferred solution: Honor your coverage and legal rights of your patients.
I didn't like: Incompetent untrained.