Tuesday, August 20, 2013

OptumRx Sucks just like Express Scripts and Medco

I really thought I had finally gotten away from the skulduggery of Express Scripts when I signed up for my part D medicare coverage through AARP's United Healthcare.  Little did I know what I was in for.  If you are unfamiliar with my escapades with these two firms please be my guest and look at my past posts on them. You will not believe the heroics that one must go through to deal with them.

Well, I have almost met my match with OptumRx.
We went through the usual with the first Rx.  They said the drug was not in the formulary and that it would require precertification.  We went through that with flying colors and in anticipation of the next roadblock I had the physician send in advance the required Rx that would be needed to be filled and a spare to the house just in case they screwed it up.  We were away on vacation when the automated messages started arriving on my cell phone indicating that they had approved the drug based upon the physicians report.  They called to say that they had received the Rx. They called to say that they had shipped the Rx.  We waited and waited, but no delivery was in sight.
I called. They promised that it would arrive the very next day. Nothing.  I called back. And that is when holly hell broke loose.
First, I notice that it was very strange that I had called at 5:15pm and got the message that the office was closed and that I must call between 8am and 8pm.  Ah ha!, this must be eastern time.
I called the next morning at 7am pacific time (10am eastern).  Got the same message, that's strange.  There was an option 6 for emergencies. I dialed and bot a human.  That was better than the day before when no one answered the emergency number. I explained that the message explained that the office was closed and that I would have to call back later, but that it didn't made sense.  She did not know what to make of it, she said I had not dialed the emergency number and that she could help me. I explained the situation and she said that the delivery was going to occur that very day and that I should be patient.
I was patient, but no package arrived.  In anticipation of the problem I took the spare Rx that I had gotten for the drug down to the pharmacy to get it filled (we are out of medication at this time).  The pharmacy could not fill the Rx, nor did they have any of the meds on hand. I would have to wait till the morning to contact OptumRx.
I called OptumRx and got the same silly messages about the office being closed. I tried many times. I tried the emergency number, but that did not work either.  The only option left was to use the Spanish option.  I dialed 1 for Spanish and got a representative who spoke to me in Spanish.
I speak Spanish so this is fine for me.
As an aside, did you know that for most organizations that hire Spanish speaking customer service representatives, they must also speak English. Further, if you find the wait too long for the English customer service you can oftentimes have a shorter wait for the Spanish representative and then proceed to speak in English.  I have tried this many times and have never had a problem doing it.  In truth, I think this is a form of discrimination against English speakers, or a form of harassment when the  company wants to slow down the rate at which they are handling customer service calls.
Anyway, I explained everything to the representative and he referred me to a specialist. The specialist took down the information and said that she would contact the pharmacy and get back to me in about a half hour.  After three hours I called the pharmacy to see if the situation was straightened out. It wasn't.  I called the number for the specialist over the next few hours and got no response. I finally called the main number again (Spanish option) and got through to a representative that finally got me to the original specialist.  The specialist explained that she had been out to lunch (yea, "out to lunch", for 4 hours, right). Everything would be straightened out.
Three hours later, nothing.
I paid full price for the meds. I can't wait any longer.
Now, why doesn't their phone system work. I called the number and got the option for complaints.
They could not deal with me since their system was down.  Yes, there was a problem with the phone system over the last few days, it is not fixed and who knows how long it has really been not working.  This has got to be the greatest scam in history.  They are paid to deal with filling Rx's an so slow down the rate at which they fill Rx's that's all they have to do is made their phone system deep 6 all, or most of, the phone call they are getting.

Good going OptumRx.
February 28, 2014. Update:
Things have muddled along with OptumRx.  They have been very slow to deliver. Deny receiving Rx's, etc.  All the usual stuff to deal with.  I have now run into a new class of problem with them.
We had ordered an Rx just after the beginning of the year and they claimed that we needed a new Rx from the Dr. since the old Rx was stale.  They required a written Rx mailed to them.  This is like when I was in grammar school and the teacher wanted a signed note from my mother. Oh well (yawn).  This was sent in by the Dr. and we a received call from OptumRx that they could not accept a Fax of the Rx. Dr. claims to have sent in a hard copy via snail mail, but sent a Fax in advance advising them that the snail mail was coming (Oh well). It was taking so long to get the Rx that the Dr. gave me a 30 day supply to fill locally, which I did.  Rx still not arriving from OptumRx.  Called and found out that since the local Rx was filled they had to wait until 2 weeks before that supply was exhausted before they shipped.  They indicated that they would ship at that point (new Medicare rules require them to get permission before shipping a new Rx. Permission granted. Further waiting. No delivery. Called OptumRx.  The claim is we never gave permission to send the Rx.  Gave permission again.  Waiting and waiting, called, shipped. waiting, waiting, called, to be shipped, waiting, waiting, called, shipped that day to be delivered in 3 to 5 business days, signature required. Delivered the very same day as that last call, no signature required. Oh well.

Now for the interesting part.  I now get my credit card (CC) statement.  There are three charges for the same amount.  Once in January (what was that for) and two on February 20 (why two).  Inquiring minds want to know. I called to find out what they were doing.  The first charge was for the medication that was never sent out.  The two on February 20 were for the same Rx.  I have a credit, so they say, for 2 times the amount of the copay.  Why did they charge me so that they could have the credit on my account?  Please refund.  Okay, BUT -- The information they have on my credit card does not match the credit card I have.  The expiration date is different.  The date they have is further into the future by over 2 years.  Possible explanation is that my CC is about to expire next month. Perhaps the CC company gave them the new expiration date so that transactions would not be rejected??????.  I called the CC company. First, they have not issued me a new card yet. Next, when they do issue it, they would never give that information to the vendor.  And, finally, the date I was given by OptumRx does not match the soon to be issued expiration date given to me by OptumRx as the expiration date on the card that they have on file.
How the hell have they been charging things to my account all this time?????
To be continued.
March 4, 2014.
I have been watching my on line credit card transactions to see if the OptumRx credit has been issued. No chance.  However, I do note that there is yet another $7.00 charge on my account from OptumRx. This one is strange.  It was charged on 2/19, one day before the other two charges for $7.00 but posted on March 26. Strange.
I am finished with trying to resolve this with OptumRx. I called the CC company and disputed the two charges for $7.00. Tune in next week.
Note to self: I have to check every charge from OptumRx on my CC statement from now on against Rx's filled to make sure they are not over billing me.



  1. You are allowed to refill 3 weeks before you run out of medication, just incase you're too slack to keep up with your own refills. Yes the system is down quite often at OptumRX. Also, it is staffed by people who take calls from people like you even though we are supposed to be skilled to take calls from pharmacies and not annoying customers. Our lives revolve around the lies we're told by the staff at OptumRx or West Corp (the 3rd party company that answers most of your calls). We spend at least 8.5 hours listening to the problems that UHC/OptumRX causes with people complaining about how long it takes us to do it. When people threaten to leave OptumRX and go to the local pharmacy instead I actually encourage them.

  2. It makes me a bit relieved to read about someone else having the same problems that I have with them. They are horrid. It seems to get worse with each order. Had the same EXACT issue with them saying that I didn't give authorization for order to be sent. Um.... why exactly did I call then? And I also was triple charged for the order. It has been a CRAZY road. I've decided that I will change my Medicare prescription coverage next year, just to get away from them.

  3. Thanks for the comment. I knew I wouldn't be alone on this one. When you find a better fulfillment company I would be interested to know. I have gone through quite a few at this point and they are all the same. I almost wish that I was back with Express Scripts because I had figured out through the use of a special assistant to the President of the company how to get results every time they screwed up -- just call the assistant. It was amazing how fast she could fix things. The part that was pathetic was the number of times I had to call her.

  4. To add insult to injury, I was at the doctor's office the other day and they prescribed a generic drug. It emailed to OptumRx. They called the other day to get authorization to fill the Rx. I authorized it. Today they called to verify the shipping address. What luck. You will not believe this.
    I asked for the charge. They told me $115. I said it can't be. It is a common generic drug. I asked them what the retail price was. They told me a number over $500. (90 day supply). I told them to hold the Rx.
    I called the local pharmacy and asked them how much for the same drug. They asked if I wanted a tablet or caplet. I asked what the difference was. They said the Cap was $89.96 and the Tab was $500+. I called the Dr. and asked what they prescribed. They did not specify Tab or Cap.
    Now, I see, they get to fulfill with generic to save you money, but then pick the more expensive variant to send you. Nice job OptumRx. What idiots.

    1. One more point. I called the Dr. to get them to specify Cap. Then OptumRx counters with the fact that they don't carry the Cap and that I have to take the Tab at $500+. I told them to forget it. Local pharmacy for $89 retail, no insurance is the solution. What a scam.