Caremark PHC, LLC

Dear Sir or Madam,
Thank you for giving us the opportunity to address the beneficiary’s concerns regarding her mail order account with SilverScript Insurance Company’s Medicare Part D Prescription Drug Plan (PDP)This letter is in response to your correspondence dated May 2,
Thank you

December 4, 2015Revdex.com*** *** *** *** *** ***
*** ** ***Complaint ID: ***/*** ***To whom it may concern:CVS/caremark administers the prescription benefit portion of the *** *** Plan, of which Mr*** *** is a member. This
letter is in response to the correspondence we received from your office on November 19, 2015. Thank you for the opportunity to address Mr***'s concerns as expressed in Complaint ID ***. Upon reviewing Mr***'s concerns it was determined that the medication in question could not be filled outside of a Caremark Specialty Pharmacy due to plan benefit guidelines Mr***'s request for paper claims reimbursement was denied correctlyIn an effort to resolve this situation in Mr***’s favor a one-time exception to allow payment for April’s date of service has been granted. There are a few pieces of information that we would require to process the paper claim reimbursement. We have attempted to reach Mr*** by phone but have not been successful. We would need Mr*** to contact us at *** in order to better assist with the processing of this claim.We sincerely apologize for any frustration or inconvenience that Mr*** experienced. We value Mr*** as a member and we remain fully committed to our purpose, "helping people on their path to better health". Should you or Mr*** have any additional questions or concerns, please do not hesitate to contact me at ***.Sincerely,*** ***Member Advocate

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #***I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*** ***

My company changed providers at the 1st of the year to CVS so I attempted to create an account on the websiteI was able to create the account, but no information was transferredWhen I went to log back in later to check the data transfer I was unable toI changed my password and connected, but when logging out and back in it fails again, so I called to talk to someone and was hung up on when I told her to stop interrupting me and actually answer my question about my accessI called back and spoke to another equally helpful individual, and when I told her I needed to file a complaint about the first person she hung up on meI called a 3rd time and asked for a supervisor and told the girl about my previous callsI told her I would be filling this complaint, and she told me to go ahead and do so

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #***I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*** ***

My physicians office placed an order for my prescription and I was told CVS Caremark would have to fill the prescription and they would call to schedule delivery This was the first week of April 2016/ My appointment was for the 15thI never rec'd a call so I ended up calling the 12th to ensure my prescription would be delivered on time for my dr apptWhen speaking with the rep they told me the delivery date would be the 14th so I would make my Friday (15th) appointmentCome Friday the prescription never arrived I called and was placed on hold at least times for over ten minutes each time and the reps did not come back on the lineFinally a rep did not put me on hold and told me that there were not any notes as to why they did not ship the medication it just simply didn't shipAlso, that it was noted to ship that morning and I would have SaturdaySo I completely missed my appointment and there was no reason as to whyI took off the morning for this specifically and had bee

I am just trying to refill a prescription The prescription is from June And good for refills Second refill was October Tried to submit 3rd refill, January 26th
One of the medicines showed "on hold" with request in to doctor I've called times about it this week, Jan 30th, Feb and twice today, asking about the issue Every time I get a different answer I point out that the prescription hasn't changed, they first insisted they needed more information I asked what was different than in October? They told me later I could put a patient override for the medicine and it would go out on *** immediately I checked back later that day, it showed back "on hold" so I called the 4th time I am not getting any resolution and talk to someone different each time
Again - prescription is JUST a "refill", 3rd of refills called in back in June Nothing has changed from doctor since originally received Whatever has changed is from Caremark's end and they

CVS Caremark and CVS Specialty Care have both shown very poor customer serviceIn one instance promising to call me back and never doing soIn another instance telling me it takes hrs to receive a faxThe poor customer service put my medications back nearly a week

My Ophthalmologist Sent a Prescription for *** * One Drop in Right Eye at Bed Time Dispense Bottles for a a month Supply - I was sent only boxes with my most recent order (which is a month supply) and CVS Caremark has charged me my Day copay!
When I called CVS Caremark to try and resolve this issue the Pharmacist told me my eye doctor only Ordered bottles and not the I requested a copy of the Original Prescription and when I reviewed it my Ophthalmologist had actually ordered that bottles be dispensed! The Pharmacist LIED to me!
I Expect an apology and Resolution of this issue because the CVS Caremark Contract with my Health Insurance is for a month/day supply of medication for the copay I am charged

I was given a prescription from my doctor for a drug that needed to be compounded because I take it at a very low dose Since CVS is my designated pharmacy through my insurance plan, I called their specialty pharmacy on 3/24/to find out if they could compound my particular drugThe representative said they could I asked her to make sure because it wasn't a common drug or dose, she put me on hold to find out She then assured me they could I checked with her one more time and she said yes, they could do it, I only needed to fax my prescription to them, and she gave me the fax number I asked if it could be emailed, she said no, it must be faxed So I faxed it to them the following day On April 3rd I received a phone call from CVS and was told they could not fill the prescription but they could send it to a compounding pharmacy for me, and I gave them the fax number of The Medicine Shoppe, a compounding pharmacy that assured me that they compound my drug within hours B

I made the mistake of registering my credit card information with CVS *** for mail order prescriptions; I've had issues with them auto-charging me for 30-day prescriptions from my doctor I did not order in the past When this has occurred (two or three times), I laid down and paid it without complaint
Recently, I placed an order for a $generic brand prescription When I received the order, though, I noticed they had auto-charged and mailed me a $name-brand prescription I've been making efforts to return this for refund via their online "care" and call center without any progress This is borderline theft

CVS has been charging my *** support program thousands of dollars in which they are not owed, as I have *** *** *** *** insMy out of pocket was exhausted by June/ however CVS charged my support program dollars in July which CVS shouldn't have and again in November they charged both of these were paid by my ins company at percentThis is only of the many fraudulent charges they have made against my support programWe have found they have done the same thing with my husbands *** support program

I have cvs caremart plan through my husbandI know my plans benefitsMy doctor have prescribed this medication for several years nowIts the brand, not generic as I had bad reaction to it at startThis has been recorded since starting with Cvs insuranceEvery time I am renewing the medication I am running into obsticles with the insurance because it is written as a brand by the doctorOngoing patternLast night I drew the line after having a very unpleasant phone call with one of the phone associates named *** (10/16/2017)I had called my doctor to fill the medication several days before and when picking it up at the pharmacy the cvs tells me to pay double the price I usually doAfter talking to the rep at the insurance they told me I have to have the doctor call them to appeal to get it for the price I usually pay which is $125/prescription days supplyThis I have paid this year and never heard of this claim beforeUsually its about doctor did not fill out something co

CVS Caremark is the absolute about getting your your prescriptionsLast year I had to go months with medication I needed because they said I "had my fill for the year" even though I obviously hadntIts a shot you take every three months and they would not provide it to me claiming I already claimed too many for the year wich would have literally been impossible as I would only inject myself ever three months as prescribedso now what happened is *** somehow lost my insurance without ever informing me even though all claims go through caremark, they had me pay for the prescriptionsand now are refusing to refund me because they said I picked the medication upWHY WOULD I NEED A REFUND IF I NEVER PICKED THE MEDICINE UP!?!?!?!?!?!?! So they have effectively stolen hundreds of dollars from me for falsely charging me for prescriptions that were zero cost under my insurance policyCVS CARE MARK WILL STEAL YOUR MONEY !!!!!!!

CVS Caremark ships me automatic refills for prescriptions that I do not have enrolled in automatic refills I turned off auto-refill for prescriptions on 11/6/ I received an email on 11/22/telling me that these prescriptions, including that my doctor took me off because it was affecting my potassium levels, were being shipped and charged to my credit card I immediately called CVS Caremark upon receipt of the email to cancel the shipment The representative said it was too late to cancel the shipment She said that auto-refills are started days prior to shipping, so I told her I cancelled my auto-refills days ago She then changed her story, saying that I had cancelled my auto-refills three hours after the refills had been started I asked for a refund for the prescriptions, and she said I would have to ship them back I spent half an hour speaking to this representative, and now I'm expected to go to the post office to return items I never ordered Th

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ***Please add your rejection comments below.
Dear Sir or Madam,I am requesting that complaint #*** be reopened.On 9/29/15, CVS/Caremark responded to my complaint with:I spoke with the member on September 23, and advised per his *** *** benefits, he does not have out of network benefitsI also advised him there is not an option for reconsideration as he is not being denied a benefit The member did advise this is the only pharmacy in the US that is able to fill the medicationI advised the member I would do some additional research for him and contact him back. I contacted *** *** ***, a preferred pharmacy, who advised they are able to order the ingredients and could compound the medication into a lozenge. I spoke with the member today and advised of this informationThe member stated he would contact *** *** *** and his physicianThe member did not require any further assistance at this time.It took more than days to confirm whether or not *** *** *** would be able to fill my prescription but I have since learned that are able to do so, leaving me back at square one; having coverage for a medically necessary medication but being denied any reimbursement because the only pharmacy in the US where it is available is out of network with no sort of appeal process.Thanks,*** ***

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #***I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*** ***

May 27, 2015 Complaint ID: *** / *** *** To whom it may concern: CVS/caremark administers the prescription benefits portion of the *** Insurance Plan, of which Ms*** is a memberThis letter is in response to the correspondence we received from your office on
April 28, Thank you for the opportunity to address Ms***’ concerns as expressed in Complaint ID ***. Upon review of MrMs***’ concern we verified that the medication in question was received via electronic prescription from the prescribing physician's office. This prescription request was not initiated by CVS/caremark mail order and was fulfilled in good faith. Additionally there were no notes on Ms***’ profile at the time of this order asking that our pharmacy not fill prescriptions unless directly approved by her. Our filling pharmacy does not accept and does not return to stock unused portions of prescriptions that are returned by our members because we would no longer have any assurance of the strength, quality, purity or identity of the medication. For this particular situation, CVS/caremark return policy does not allow for the return of medication for credit. If the recipient refuses the shipment or returns the medication outside of acceptable reasons for a return under our policy, the recipient is still responsible for the full copayment Although there is no evidence indicating an error on the part of CVS/caremark, on March 20, Ms***’ was sent a mailer in which she returned the full quantity of the medication in question to receive a full credit as a one-time courtesyOur records reflect that we received the order back on April 30, and also credited her credit card the full amount of $the same day. We value Ms*** as a member and we are confident that future service will consistently reflect our commitment to our purpose, "helping people on their path to better health." Should you or Ms*** have any additional questions or concerns, please do not hesitate in contacting me at ***. Sincerely, *** ***Member Advocate

June 22, 2015 Revdex.comDonald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705Complaint ID: ***/ *** *** To whom it may concern: CVS/ caremark administers the prescription benefits portion of the health plan for Hanover Insurance of which Ms
*** *** is a memberThis letter is in response to the correspondence we received from your office on June 11, Thank you for the opportunity to address MsClark’s concerns as expressed in Complaint ID ***.Upon review of this concern, we confirmed that our specialty pharmacy has been working with MrGary *** to resolve his concerns with filling and billing his wife’s medication.Mr*** was contacted directly by *** Kfrom the specialty billing department who reviewed his billing history with himHis HCSA CC was billed correctly and Mr*** was satisfied with this follow up and resolutionMr*** was also provided ***'s direct contact telephone number should he need assistance in the futureMr*** was also provided *** Moen as his new single point of contact for assistance with the filling and refilling of his wife's medication Additionally, upon review of Mr***’s interaction with our specialty team; we recognize that there were several opportunities for additional training and coaching for our staff. Feedback has been provided to each member of the specialty customer care team with whom Mr*** interacted. Please note that our goal is to ensure that our valued customers receive only the highest level of customer care We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value Ms*** as a member and we remain fully committed to our purpose, “helping people on their path to better health”Should you or Mr*** have any additional questions or concerns, please do not hesitate in contacting me at ###-###-####. Sincerely, *** ***Member Advocate

The company has refused to cover an infant formula for my daughterIn the state of NJ insurance companies are required to cover infant formulas are prescribed by a physician for for infants under that have been diagnosed with a milk protein allergyOur physician has sent an appeal which contains documentation of the perscription and diagnosis of the milk protein allergy