<p>We had a similar problem with Rightsource. They are incompetent and it is always to their advantage. It took more than 2 months for me to receive asthma medication because they charged me so much for it that they kept stopping the order because of the excessive price. Really, it was almost comical, me calling them while getting more and more short of breath trying to untangle their knots and promising to pay their hideous price.</p>
<p>Worse, my D had to go to the ER because her meds were so late. They had a question about the dosage, and rather than calling the patient, or the doctor, they called my house. They called 4x in one day (so they say) and never left a message. Since they “couldn’t get through to anyone” they dropped the order. I finally got it restarted, and would call every single day to make sure it was actually going through. I found out that they also had a problem with this order because someone had taken down our (default) credit card number but hadn’t attached it to the order. How could you be that stupid? You have to call every day to be sure! </p>
<p>Then, they signed up both of us for automatic refills, without our knowledge or consent. One of the drugs the prescription had run out for, and it is a controlled substance, and they just sent it! </p>
<p>I want to complain to H’s HR department but frankly, they are just as stupid. They told us that when someone lives “out of area”, like kids at college, that there is no out of network cost. Wrong. Is that fact anywhere in the glossy 14 page employee medical benefits brochure? NO. They say, “oh, of course your child can see any doctor they choose”. What they don’t tell you – that choice could be very expensive!</p>
<p>And how do you know? You have to visit the website for Humana - you CAN’T log in - and there are several arcane search parameters you must know in order to find out who is in or out of network for this out of area place. There is no way you can do with without getting the specific information you need from HR, which they don’t provide you upfront (or any place in that 14 page brochure)! </p>
<p>I know where I would start cutting to save some healthcare dollars!</p>
<p>If you are in California, and your coverage is through a “health plan” (which it likely is), then the regulatory body that you need to contact is the California Department of Managed Health Care, not the California Department of Insurance. </p>
<p>Do you have to use mail order? Our insurance is through West Virginia Public Employees Insurance Agency and ES is our prescription administrator. We can take our prescriptions to any pharmacy that takes PEIA, which is virtually all of them in our area, and Express Scripts covers them. That might be an arrangement that PEIA has with them, though. </p>
<p>I do have to use mail order for any long term prescriptions or I pay full price out of pocket. I am working on this and will pursue complaints with all of the relevant bodies. My D called her Dr yesterday and asked for a prescription to be called in to Walgreens. Still hasn’t been done! Does anyone do what they are supposed to do?</p>
<p>Sometimes the doctor’s office wants the pharmacy to call or fax them with the prescription request, especially if it is a refill. I would call every damn day. </p>
<p>Yep. Sometimes you have to be a squeaky wheel. I’ve resorted to making the receptionist so sick of me that she begs the doctor to do what he’s supposed to do. I once told a receptionist that I was going to call her every hour on the hour until they took care of the matter. It worked.</p>
<p>And no, EPTR, you can’t count on anyone to do what they’re supposed to do. Sometimes they surprise you but you certainly can’t rely on it. It does seem like the entire healthcare/insurance industry is the worst, though. </p>
<p>In addition to creating a lot of work for docs, express scrips also seems to be using some of their data in research. …Not that there is anything wrong with that…
<a href=“http://lab.express-scripts.com”>http://lab.express-scripts.com</a></p>
<p>Update!
Got a wonderful email from the doc last night. My D gave me permission to communicate with her. Turns out that she sent the prescription several times to ES and called them on Friday to straighten things out. She said that the meds should be on the way and are being expedited. She also phoned in a one week supply to the local pharmacy to hold my D over until the other comes. Especially impressive, she gave me a number to call her on and instructed me to have her paged to the phone if there was any other issue concerning this.</p>
<p>I would complain to my surer who contracted with Medco. We fortunately were OK when we used mail order pharmacies contracted by CVS. One of them was Medco, as well as a few others. Am happy the insurer finally contracted with CVS, where you can get Rx at local pharmacies instead. </p>
<p>When I had issues, I’d always raise them with insurer and pharmacy. Hope it gets resolved and that insurer contracts with new pharmacy for next year. </p>
<p>I would also complain to the insurer. Apparently their lack of customer service is effecting the bottom line: their last quarter profits were down, they didn’t meet the earnings expectations and they’ve recently announced that they are laying off nearly 2,000 people and closing two facilities in Texas. Also, the CEO, Mr. Paz, is selling large amounts of the stock while the price in declining. </p>
<p>I am very happy with our local CVS. Never any problems. Recently there was an issue where my doctor’s office had to be called to approve a refill. Somehow this didn’t get done (the doctor’s office is usually very efficient) and I didn’t realize until Friday night that the refill wasn’t ready. I was out of meds, the CVS pharmacist gave me an emergency supply of 6 pills to last until the office was open on Monday. I didn’t even ask, this was offered as soon as I said, OMG, I’m out of pills. I wasn’t even charged for them, not sure whether my insurance was or not. I expected the refill to have 6 pills less than ordered, but it didn’t.</p>
<p>When I’ve been advanced a few pills from CVS, they always deduct it from the rest of the pills that I get as the 2nd batch, but always pay when I pick up the rest of the Rx. </p>
<p>Have had some glitches with CVS–their system calls and tells you there is an Rx to pick up but when you get there, they have nothing. Seems like they’re working things out though and that hasn’t happened for a while recently.</p>
<p>Glad you have had success working with them. They’ve had to switch from the local system to the CVS system and probably the bugs were related to the crossover.</p>
<p>There are minor problems, like things going on auto-refill, but they’re easy to resolve. The main thing is that the people working in their pharmacy actually want to solve whatever problems come up as quickly as possible. </p>
<p>It took. E five days an umpteen phone calls to both the pharmacy and doctor to get a prescription filled that I have been taking since I was nine years old…needs to be refilled every six months. You would think they would have it down by now. But NOOOO. I go through this song and dance every six months. Annoying.</p>