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I SO agree with the complaint from JazznJavaSF. I, too, used Prescription Solutions for many years until the were taken over by OptumRx and I never - or seldom - had a problem. Now, every month I get closer to having a heart attack, panic attack, hiatal hernia attack and any other attack available to me after dealing with these people. I kid you not, EVERY month involves at least 4-5 phone calls. I even wrote to the CEO and let him know what was going on........like he really cares! .

These people, in addition to not being well trained or even smart, are the most outrageous liars. If you call them 4 times for an issue (I usually call more than that), they will give you 5 answers. Yes, you read right. I called once and in one conversation they gave me 2 different and opposite answers - both of which turned out to be wrong.

There is also a billing problem. It is impossible to reach their billing department. They simply won't put you through. I order two meds at a time to be overnighted together. They are due the same time so I see no reason why they should be handled separately. The first pain med finally got here and I was charged the overnight charges. I also had a non-narcotic med (which is strangely unaffected by their professed "processing" time. I boldly noted that this SHOULD NOT be overnighted. Additionally I attached a separate note saying the same thing. They sent the no-rush med and charged me the overnight charges and it was days before I received the second pain med and they charged me the overnight charges AGAIN. Do I have to tell you I'm not paying the $15 for EACH shipment? Three overnight charges for what could have gone out in one package? C'mon guys. I'm not the billionaire. You are confusing me with the CEO of your company.

I am 70 years old and have several conditions which cause me horrendous pain. My caring doctor has prescribed 2 narcotics but since I live in the drug capital (??) of Florida, I cannot buy either of these in local pharmacies. I have a poverty plan with United Healthcare for meds only and THEY OWN OPTUMRX. I call to complain every month but I'll give you 3 guesses who they defend. Yesterday I spent hours on the phone calling government agencies but I got caught in the bureaucratic loop, with everyone telling me to call someone else - sometimes the very people who told me to call them. I should move to a country where they actually honor and respect their older citizens. Oh, wait, I can't afford it. I don't eat THAT many pop tarts.

I order 2 narcotic meds at a time which my doctor can't prescribe until the day before they are due for renewal (may be specific to Florida) and then have to pay $15.00 overnight charges (which is taken from my already unhealthy food budget). OptumRx then sits on the prescriptions with a myriad of excuses - "Your drug company (US Healthcare) denied them [not true], we never got it [not true], we have to verify this with your doctor [doubt that since they have a valid prescription], the dog ate the prescription. Then I have to wait 7 days or more for them to process the scripts, which I'm sure is done by machine. The order form I send them tells them in red marker, underlines and highlighted in addition to a repetitive hand-written note, to overnight the meds back (another $15 out of my food money - now down to buying nutritious pop tarts from the dollar store for meals). Now, overnight to me means it's mailed Monday and I get it Tuesday. Right? Today is 1/5/13 and I have been given several different delivery dates by OptumRX as to when I will be receiving the meds. Would you be surprised to hear I still don't have the meds?

All this time since I received the prescription from my doctor (12/18) - [remember, the med runs out on 12/19] I have been in severe pain but nobody gives a ***. I MIGHT be able to get them on the east coast of FL but I can’t afford the gas and my SIL’s car has preceded me in death. NOT ONE government agency did a single thing to help me. Where do we get off calling ourselves a "caring" country. At 70 years old I have finally become a total cynic.

I am totally heart-sick (as well as body-sick) that we treat our seniors so poorly. I know I sound flippant about all this, but if it weren’t for my humor I would crawl into a hole and put it in after me, or become another Sybil. As it is, I just sit in my room all day because it hurts too much to walk around. My doctor asks me if I am getting any exercise and I just laugh. She understands what I mean. Am I eating well? Pop Tarts (dollar store equivalent, of course) taste just fine when you’re hungry.

For those people who tell me to just change insurance companies I tell them I can’t. I have TWO choices here in Florida: US Healthcare or one another (who it isn’t necessary to name). The second company’s co-pays are just way too high for me and I can’t afford them.

I know nothing will come of this but at least, if JazznJavaSF reads this s/he will know they aren’t being paranoid……that this problem isn’t their fault. If there are two of us, you can bet there are loads more.

I may be old but I'm feisty and these people just don't know who they are messing with. I'll be the squeaky wheel and I'd scream from the rooftops if I could get up there. Y'think 60 Minutes will read this? ***! SOMEBODY has to care.

Review about: Optumrx Prescription Refill.

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Anonymous
#1477733

You must be one of the problems why is it when I talked to customer service I get a different answer every Tim and promises that end up being lies you homers are going to get someone killed the whole company should be run out of business you don't know what your doing. For your company it's all about money not your customer what a joke optium Rx is

Anonymous
Chicago, Illinois, United States #1319433

I know it doesn't count but I care,I also understand your situation. I wish someone could change this mess,I'm basically working to pay for my health insurance so I can get my meds so I can work,all my hard earned money is being taken by UMR & Optumrx.

I to am getting the run around.With no ansewers.

I've spent countless hours on the phone with them even the lady in charge of our insurance plan,she didn't get ansewers either. They talk about keeping us healthy but all they've done is stressed me out now I'm on anxiety med.THANKS A LOT Optumrx & UMR

Anonymous
#1310372

We want to help you, because without your business, we would not have a job to go to.

As a customer service rep with the company, I can assure you that we go above and beyond to assist our members.

However, there is so much that we can do as agents. If the plan that you have does not allow you to receive that medication due to a PA requirement, then our hands are tied. My suggestion would be, is to find call in before you ask your doctor to submit that PA and find out what type of information is required. Have you tried other medications and they have not worked for you, and this is the one that does.

Are you allergic to certain active ingredients in other meds, and that is why your doctor wants you to use this particular one. What is your history of using this med. Why does your doctor feel you should take it. All of these things factor in when the PA dept reviews your request.

The more your doctor submits about you, your condition, tests that you've already taken, other meds you've taken and have not worked...MORE INFO is best! We are on your side!

Anonymous
to anonymous Chicago, Illinois, United States #1319438

If u are on my side then,I tried vyvanse, u claim it works the same as Adderall just a different delivery system. .I tried it,it was a horrible experience I wasn't able to sleep,seen silver dots before my eyes also my apatite was gone.,many more bad reactions.I had to go back to Adderall, Optumrx & UMR still will only cover 30mg.I'm on 60mg..I complied to trying something else it didn't work,I've spent countless hrs.on the phone trying to find out why 3 months of Adderall wasn't being applied to my deductible, after trying 3 months to get an answer & $700.00+ dollars later I was told I need to see a phy.is the only way you'll cover it.If it isn't required for vyvanse then why is it for Adderall? How am I to get refunded for money spent because Optumrx didn't give me any ansewers & I feel I shouldn't have to see a different doctor to get my meds.especially because you had better covering it for several months prior?

Anonymous
to Anonymous Chicago, Illinois, United States #1319439

I know u have a very difficult job.I have the utmost respect for your Profesion. So I don't want u to miss direct my fustration.Its the trouble with the company & the FDA rules & regulations.

Anonymous
Gardnerville, Nevada, United States #1285570

I read your statement....my husband

(61 yrs old) and myself (age 58) are so familiar with this BS as well, we cannot comprehend how optimum RX medicare Part D insurance that we have worked very hard all our lives and this is what we're stuck with how are they allowed to take away our ability to function on a daily basis, it's taken years to get us at a functional level to begin with. Might as well just fluff the pillows because that's where We will land once again.

It's sad but true.

May God bless all of you out there that are suffering such as we

Anonymous
Sun City, Arizona, United States #1249598

OptumRx is run with a telemarketer mentality. OptumRx calls every 2-3 days wanting you to use their prescription medication service.

The prices are much higher than a drugstore.

OptumHealth itself now stands accused of committing Medicaid fraud in three lawsuits filed against it this year. Do not use this service if you can help it.

Anonymous
Marysville, Washington, United States #1249260

I agree! OptumRX information is often wrong. They have NO credibility.

Anonymous
Kenton, Ohio, United States #1237405

GO GET THEM!!!!!!!!!

Anonymous
Staten Island, New York, United States #1191909

Amazing to find out that we were paying $78 instead of $7 for a prescription for my 9 year old mother these people are a rip-off morning

Anonymous
#1078687

Anonymous

Anonymous
#1061745

I feel for you. But, cheer up!

they aren't doing it because you are old!

They treat all of their customers like the low life *** that we are. They know that most of them are tied into their system through their company health care benefits, and they know you can't do a THING about it.

Anonymous
#1015120

After being on a medication for several years this company decides not to refill this due to cost. This company needs to get reprimanded they are heart less fools who only think of the bottom line. Well I hope the one who get there nice quarterly bonus checks enjoy them at our pain and suffering.

Anonymous
#974281

This place is by far the worst place i have every had to deal with. Their CSR don't know what they are talking about and do not give out the correct information.

I have been dealing with this company for 2 weeks now. I was told that i would get my sons ADDERALL which he is out of within in 2 business days if i paid for expidited processing and 2 day shipping. I told her i would she said she noted the account. I was told last THURSDAY that my order was recieved and then received ANOTHER email today telling me that it will be delayed.

The longer they wait the longer it will be before my son can get his head in the game at school. If he was homeschooled this wouldn't be an issue because he wouldn't need the medication, but since i don't have that luxury then he NEEDS IT FOR HIS TEACHERS SAKE! I don't care who you are or how you want to pretend that this company is the greatest people in the world ANONYMOUS but you are not the one that has to deal with these people. I have paid out of pocket for my prescriptions for the last 1 1/2 years because i didn't want to have to deal with this mail order ***, and now i decide to try it one time since i have to pay for the insurance and you are already screwing me over.

I will be filing a class action lawsuit against this company, once i figure out how. if someone else knows how please get the ball rolling and i'll be there with you.

This company does not deserve any more of our money, and I've already given them money from me for free just to get treated like ***.

Anonymous
Everett, Washington, United States #954955

THE CALL-TAKERS FORGOT WHOM IS THE CUSTOMER, SEEM TO WANT WIN THE CONVERSATION AS THEY ARE "SMARTY-PANTS" PEEPLES.....GET ROBO-CALLS AFTER EVERY RE-FILL, RE-ASKING QUESTIONS..DONT LIKE THEMS AT ALL...

Anonymous
#860942

I am also an OptumRx employee, and let me tell you.. I'm definitely a patient advocate.

But I do want to shed some light on what happens within the company.

I haven't been with the company long, but I do plan to stay to help improve some of the issues the system faces, that in turn delays your (the patients') orders.

That being said, I do want to begin by mentioning that processing time can take between 7-10 BUSINESS days. While customer service is available 24 hrs/day - 7 days/week.. this does not mean the same for our carriers; that being said, weekend shipping/delivery is very rare regardless of how soon we process an order. Also, our processing time is actually much quicker than the time allotted above.

Now, I understand that when a patient is almost out of medications, or has been waiting for a prescription, it is very stressful. But I always try to explain to patients' that the processing time is a precautionary period, it also does not take into account the shipping time. 7-10 BUSINESS days takes into account the time to resolve any unforeseeable issues with your order, shipping time (standard) is then between 2-6 BUSINESS days once processing is complete.

Examples of some issues with your order could be as follows:

1) Deductibles: Whether a medication has a $5.00 co-payment for a 90ds, yet your insurance is attempting to collect on a $5.00 deductible still outstanding, so now the total due per the order be $10.00, we are obligated to call and inform the patient what is happening with the order.

2) Billing issues: Many times, normally for new generics or more expensive medications, your co-payment amount will be higher, or your INSURANCE will not cover the medication all together (claiming Non-Formulary). At this point, we are also obligated to call the patient and inform them. I speak with many patients that get upset that, quote: "OptumRx is trying to kill them because they think they know better than their doctor, and don't want to cover a medication they've been on for 20 years." In reality, OptumRx is your pharmacy folks, we receive the prescription, process per your doctors instructions, bill the medication through your INSURANCE, fill your order, check for accuracy, and finally ship the medication to you. All billing is done THROUGH YOUR INSURANCE.

Just like a local/retail pharmacy we handle the care of your medications ONLY. 3) Medicare plans: This issue ONLY pertains to you - When you reach the Coverage Gap, or Doughnut Hole as many refer to it, we have to approve the prices, which may I add are OuTrAgEoUs, with you each and every time we are about to ship your medications. Why is this? During your initial coverage phase you're paying a more standard co-payment amount, depending on the tier of the medication.

The Coverage Gap may be a different price every 3 months that you order the prescription. We are limited to the information received by your insurance, so we are never given a reason as to why the amounts fluctuate, but the fact that the prices differ prompts a phone call, which in turn can cause a delay in your order. 4) "Ship and Bill" Procedure: Where patients send a check or money order once receiving their medications. The company does allow this, to counter the previous statement made.

The only reason we are not allowed to offer it (the patient has to request it themselves) is due to the delay it creates in your order. The company prefers a credit card on file due to the following reasons. The company realizes that not all patients have a credit card to apply on file and so in turn allows the patient to send back a check or money order. Why does it delay your order?

Firstly, we have to approve the amount with you. By law, we cannot send a medication, say at a $100.00 cost to you, that you open, utilize, and THEN realize the amount due. At this point you are unable to return the prescription and get a refund, so the patient ends up upset (understandable, right?). To avoid that, we have to get your approval that you are aware of the amount, and also your confirmation to pay that amount EACH AND EVERY TIME.

You also have up to 60 days to pay off your balance, 60 days folks! I doubt any local/retail pharmacy gives you the meds for free, essentially, for 60 days before collecting payment. But many of our patients are on SS, and make payments once a month. If a payment is missed, regardless of its amount, we do have to collect the "Past Due Balance" or the current orders balance before sending anymore prescriptions, which not only delays your order, but this also generates another phone call.

This is why the preferred method is to apply a credit card on file. But even then, keep in mind that if an expiration date needs to be updated, a card is no longer valid, or an HSA on file has no more funds on it, we need to give you a call and correct the situation. Many patients get upset that we call them, and in excess I do apologize. But unlike a local pharmacy, you do need to update these issues with us or the system will generate a phone call which can delay orders as well.

In turn, clerks are also only allowed to approve "Ship and Bill" orders $100.00 and under, all orders over this amount must get approval, which sometimes causes the order to ship out later than when the actual phone call took place. 4) Doctor errors: Many patients refuse to blame their doctors for why their orders have been delayed, but more often than not.. they are the reason. Many doctors send us a script for a 30ds, which is understandable since this is normally what patients receive at a local pharmacy.

In order to get a 90ds, we fax the doctor a request.. from that point it's a waiting game on our end. Also, many doctors make mistakes in regards to quantity and dosage, which means we need to contact them to correct the issue. Keep in mind, this also happens when a doctor does not allow a generic substitute, we then need to fax the doctor for permission to dispense a generic to you.

Quite the opposite, when your doctor does allow for a generic, but the patient has a history of receiving brand name only, we do not need to contact the doctor, but we need to contact YOU. At OptumRx, many of our patients request the generic form of a medication, so if a generic is permissible, we process the medication as generic, regardless of your history. This prompts a phone call to the patient to verify if the brand medication is still what the patient is requesting. Many times when our pharmacists review your orders they also find drug interactions with the other medications you are taking, and at that point we need both the doctors, and your approval as to understanding the potential risks.

Say it with me, another DELAYED order. 5) Price Discrepancies: ANY time a "Price Check" which is a quote, or estimate, differs from that of actually billing a prescription through your insurance, again we are obligated to call and inform you of your ACTUAL order total. Many of this unforeseeable issues actual rely heavily on how quickly we are able to contact you, or your doctor, to get the issue resolved. We have a three attempts system.

Whether that be faxing your doctors office three times, before requesting that the patient intervene and contact their doctor directly. Or contacting the patient three times, each time leaving voice mails with both a number to call, and a "Reference Number." Now, I understand that was a lot to take in; but, I do truly hope this will shed some light as to why orders get delayed. For the instances that an order does not fall under any of these issues, I do sincerely apologize on behalf of the company. No company has employees that are all 100% committed to protocol and procedure, but when an order gets into the right hands we are fully obligated to overnight orders, at no cost to the patient of course, and put the patients at ease by resolving the issue as quickly as possible.

So please, if ever there is not a reason as to why your order has been delayed, demand that OptumRx fix the issue.

Most representatives are more than capable of doing so. Thank you, -An OptumRx Employee

Anonymous
to Anonymous #1065430

Doesn't matter. I have been with them since Medicare less than 6 months ago.

Optum RX has screwed things up over & over, made unauthorized charges to my credit card and refused to let me return the medication until I got my bank involved on a 3 way call. After I finally got a credit on my account AFTER I had to pay because of the billing cycle date I was notified they were going to send the medication to me again. What? I had to call again to get this mess straightened out once agaain and told them they are under no circumstances to charge my card again without my authorization.

I am going with another company next year. I will NEVER give this company a nickel of my business ever again!

Anonymous
Hammondsport, New York, United States #815923

WoW! They sound as good as Accredo another AARP 'special' lies all the times incompetent, will tell you it was shipped when it was not, will lie that they need a doctor's prescription even when it was faxed while I watched from the doctor's office and reported as successfully sent yet they deny and demanded another copy claim that it was lost.

ever receiving a prescription. The local pharmacy will try to match OptumRx honest deal as the big print is not accurate.

Get lots of Tums before, preferably elsewhere. Besides what about all this privacy bull where every clerk in many pharmacies with whom I have no dealings nor intend to and many insurance clerks know mu medical facts?

Anonymous
#811195

I work at optum and agree...the company has us hide information from members. Doesn't want us to even offer ship and bill even though we can do it.

Acct department is always messed up the bills are never right. They have something called client pricing where we have an agreement with the members plan to charge members more money for the medication then the pharmacy gets billed to make more money. Force members to use mail service to get a bigger book of business and make more money. Our systems never are working and information is never loaded correct.

We have to fill out forms for that and they never get answered on time. The company never calls members back when they should. We have work around for work around because things never work and if anyone ever says my system is updating that's code for the system is down again..they overwork employees and give us horrible benifits and bad shifts to work..and that's just some of the bs involved with this company...out of stock of meds all the time ..i can go on and on. This company treats employees and members like ***.

They are worried about 1 thing...making money..they even have tranings to help Iinform members of mail svc..they want us to be like undercover sales people. This whole company is a joke and working here has seriously made me an angry person..i don't like who I am when I work here!

Anonymous
to optumisbad #842989

I have actually had an on-going problem getting prescriptions from OptumRx that I paid for 3 weeks ago over the phone, and after speaking to 3 different customer service reps, and thankfully, taking notes from each call, I am in the middle of collecting all notes, and turning it over to the local police. First, my prescriptions were sent first-class mail, then after it is "lost", they tell me they are sending me the prescriptions 2-day air, and now after a week has passed on that, now they are sending it to me "overnight".

I keep getting told to go to my local pharmacy ( where OptumRx has "prevented" me from filling my prescription--and you know, getting it right away with no hassle whatsoever, in the past ) to get an override there, only for my local retail pharmacy have run-arounds with them as well trying to get them to pay for my prescriptions that I should have received, weeks ago!!

I'm frankly tired of their B.S. and have filed a claim with the police dept and with my attorney. I used to have Express Scripts through my employer until they switched to OptumRx and it isn't only me out of our company, who is having numerous problems with them.

With Express Scripts, nobody where I work at, had any issues with them whatsoever, and we're in process now of convincing our employer to go back to Express Scripts as a result of all the troubles all of us are having with OptumRx.

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