TIPS for dealing with the OptumRX runaround

You found this website because you are extremely frustrated with OptumRx. Me too.

You have exhausted the usual steps - contacted Customer Service (multiple times), asked for a supervisor (still no help), received prior-authorization (they lied), have written a formal appeal (they laughed in your face). You and your physician have spent hours upon hours on the telephone and filling out request forms but still no resolution to your prescription drug order. So now you feel like there is nowhere else to go but to voice your complaint here.

The truth is, you have laid the groundwork for the next level of action, and that is to file a formal complaint against OptumRx with the Insurance Commissioner for the state in which you live. Furthermore, you can also file a formal complaint with the BBB against OptumRx and don't forget to involve your employer's internal benefit administrator as they may be able to get this resolved.

Filing these formal complaints will get you past the Customer Service run-around for which OptumRx is so famous for. But first you have to exhaust the normal channels of communication within OptumRx so that you can file a proper "case" with the Insurance Commissioner (and don’t forget that the BBB complaint and your employer's benefits administrator can bring attention within a higher level at OptumRx).

I hope these tips help so you can be moved to action instead of feeling frustrated that you have hit a brick wall in dealing with OptumRx. Worst case scenario is to file a lawsuit, but if you follow the proper procedure and are forced to escalate to the Insurance Commissioner etc., you will likely get your matter resolved. Pity that we have to resort to these actions when the problem could and should have been resolved at the OptumRx Customer Service level.

Edward Maurice Feaver

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Reason of review:
Order processing issue
Preferred solution:
Deliver product or service ordered
Monetary loss:
Product or service
Prescription Drug
Review category
Drug Stores and Drugs
review #594102

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Nov 23, 2015 #1068714 Colorado Springs, Colorado

Wow! Thank you ever so much! I will be on the phone first thing tomorrow! I have been beating my head against the wall for over 2 years!

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Apr 11, 2015 #970734 Pahrump, Nevada

Thank for the information. I actually put this in my bookmarks so I can use it.

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