Caremark PHC, LLC

I would like to start off saying I have MSI have been getting *** for the last yearsI started working for the State of Florida and the *** *** *** used accredo pharmacyIt was changed to CVS\caremark 1/6/I received my day refill from December untill March 2015, The next refill was to be due in June When I did not receive a call for refill from CVS I called them June 20,around 12:00pm, on 6/21/around 6:35pm, at this time I spoke with different CSR who was not sure why the medication was not in their system to be deliveredand they were working on it On 6/28/around 12:03pm I called to inquiry about the medication and was tol I had to call my neurologist to get a new prescription which I did around 12:13pmI spoke with *** my doctor nurseBy this time I was out of medication because the last days ran out in June*** let me know she sent a new prescription electronic to CVSOn 6/29/I spoke with the Droffic

I had a prescription that should have been partially paid by a pharmaceutical company's co-pay assistance program It took many months before I could get any answer as to whether I owed any money I was told that the co-pay assistance program refused payment, even though they paid the preceding month and the following month CVS refused to assist me to find the cause of the problem They sent my case to a collection agency, even though they refused to address the issue This process took many phone calls over several months

I am the primary care physician who was caring for *** *** She is under my care for obesity, borderline diabetes and hyperlipidemiaI tried to prescribe weight loss medication called *** for the patient This medication was declined by CVS Caremark but I was instructed by them to write a letter of medical necessity in order to get it coveredI wrote a letter of medical necessity and it was declined again with the instructions to try another medication from their formulary alternativesI prescribed one of the medications from their recommended formulary alternatives and it was deniedI was recommended to write another letter of medical necessity for the formulary alternativeThe letter was reviewed and the medication was deniedI spoke to a representative to ask why they recommended formulary alternatives and then denied itThe representative told me that the formulary alternatives were no longer covered but now methamphetamine was covered with a Copay of less tha

August 19, 2015 Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont*** *** *** *** *** ***
*** ** *** Complaint ID: *** / *** *** To whom it may concern: This letter is in response to the correspondence we received from
your office on August 7, Thank you for the opportunity to address Mrs*** ***’s concerns as expressed in Complaint ID: 1***. Upon review of Mrs***’s concern regarding Mr*** ***’s billing charges, action has been taken to correct the matterOn December 1, Mr*** was charged a $copaymentPrior to the next shipment in December, Mrand Mrs***’s benefits changed to ***The result of this change was that the prescription in question would need to be processed through Mr***’s medical benefitMr***’s medical benefit was verified on December 10, and CVS/caremark was advised there was a $deductible that had not been met, along with a $maximum out of pocket that also had not been metAfter further investigation our benefits verification department contacted *** who confirmed that the April 1, was processed incorrectly as an out of network claim which was applied towards the deductible*** has resubmitted the claim for processing; it can take up to days for an update.We sincerely apologize for any frustration or inconvenience that Mrs*** and Mr*** experiencedWe value our members 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 Mrs*** have any additional questions or concerns; please do not hesitate in contacting me at 1-866-***. 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 want to extend my thanks to CVS for breaking with protocol to see that this situation reached the right result. I regret having to involve the Revdex.com to reach this point, but I am glad we were able to resolve the matter.May I ask for your guidance in how to print off/save the requisite documentation should I ever have to challenge this issue again? In other words, I thought this issue had been resolved previously, but sometimes it seems that CVS's left hand is unaware of what it's right hand is doing. I want to have clear documentation that this charge has been erased so that it does not get sent to collections or something of that nature.Aside from the above, I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*** ***

This is in response to your inquiry dated October 20, which was received on October 29, for a mail order prescription.I verified with a pharmacist, the member’s prescription was written for bottles; however, per the directions provided by the physician, bottles would last daysThe
plan allows prescriptions to be filled for up to a day supply; therefore, we are unable to fill a quantity that would take the member over a day supply.We are unable to credit the member the monies for this prescription as it was filled in good faith per the directions provided by the physician.I spoke with the member and advised of this informationThe member was not satisfied; however, he did not require any further assistance at this time

Complaint ID: *** / *** *** To whom it may concern: CVS Caremark administers the prescription benefits portion of the health plan for *** *** Idaho, of which Mr*** *** is a memberThis letter is in response to the correspondence we received from your office on August 18,
Thank you for the opportunity to address Mr***’s concern as expressed in Complaint ID: ***. We have investigated Mr***'s concern and upon reviewing interactions with our CVS SpecialtyCustomer Care team we recognize that there are several opportunities for additional training and coaching for our staff. We apologize for the frustration Mr*** experiencedWe value our members, and while it certainly is not the kind we enjoy receiving, feedback of this nature is critical, and we thank you for itWe are confident that future service will better reflect our commitment to our purpose of, “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 Thank you in advance,*** ***

In order to properly investigate your concerns, we are in need of additional information. Please provide us with the following information: Your childs first and last name along with the Date of Birth, and the medication in question. ?

December 23,
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
*** *** *** *** *** *** *** **
***
Complaint ID: *** / *** ***
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the *** Health Plan, of which Mr*** *** is a memberThis letter is in response to the correspondence we received from your office on December 8, Thank you for the opportunity to address Mr***’s concerns as expressed in Complaint ID: ***
Upon review of Mr***’s concern, we confirmed our mail order pharmacy has attempted to contact him when there are issues with their mail order requestsRegarding the recent order for Mr***’s son, our records reflect two attempts were made to contact Mr*** at ***The reason for the call was to notify Mr*** of a payment issue but we were unsuccessful in reaching him, however we were able to leave voicemail messages. Due to privacy concerns and to remain compliant with HIPAA we are limited to how much information we can provide when leaving a voicemail massage. Mr*** may contact me directly if he would like to update our records with a new contact phone number
We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value our members 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 Mr*** have any additional questions or concerns, please do not hesitate in contacting me at ***
Sincerely,
*** ***
Member Advocate

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.
Regards,
* ***

I'm a kidney transplant patient and have strict medication regimentToday's date is 4/8/Now this is well within the Flexible Spending yearCVS Caremark mail order would NOT refill any of my medications over a $balance!! They said it was days oldWell days back still puts leaves me eligible to use my Flexible Spending account
But the point is a $balance and they are going to refuse to refill ANY of my life sustaining medications!! Kidneys are hard enough to come byI hate to wait 3+ years for this oneWhat gives CVS Caremark the right to play god over a $ balance!!
Then to make matter worseI spoke to a CVS Caremark phone representative yesterday (4/7/and they told me after a Supervisor approval it would be covered by my flexible spending accountThank god I called today because there was one more med that needed to be refilled and told they wouldn't fill it because of my outstanding balance of $4.72!
This is not the first time I had this same i

I had a prescription that should have been partially paid by a pharmaceutical company's co-pay assistance program It took many months before I could get any answer as to whether I owed any money I was told that the co-pay assistance program refused payment, even though they paid the preceding month and the following month CVS refused to assist me to find the cause of the problem They sent my case to a collection agency, even though they refused to address the issue This process took many phone calls over several months

ON SEPTEMBER 9, I WAS CHARGED BY CVS CAREMARK FOR A PRESCRIPTION THAT I ORDERED USING THIER MAIL IN ORDER FORM ON THE FORM I COMPLETED WHEN I SUBMITTED THE PRESCRIPTION I INDICATED USING THE CHECK MARKS THAT I WANTED TO CHARGE A NEW CARD FOR THE PRESCRIPTION COST AND I PROVIDED THE CARD NUMBER AND EXPIRATION DATE IN THE NECESSARY FIELDS THE SAME DAY I GOT A NOTICE FROM MY BANK THAT I HAD BEEN CHARGED A $OVERDRAFT FEE AS A RESULT OF THE $PRESCRIPTION FEE THAT POSTED TO MY ACCOUNT BY CVS CAREMARK I CONTACTED CUSTOMER SERVICE ON SEPTEMBER 10, AND EXPLAINED WHAT HAD HAPPENED THE REPRESENTATIVE THAT I SPOKE WITH DID THE NECESSARY RESEARCH AND HAD THE PHARMACY PULL THE ORIGINAL ORDER FORM AND NOTED THAT I DID IN FACT PROVIDE INFORMATION ON THE NEW ACCOUNT I WANTED TO BE CHARGED INSTEAD OF THE ACCOUNT THEY HAD ON FILE THE REPRESENTATIVE STATED THAT SHE WAS FILING A DISPUTE ON THE CHARGE AND THAT I WOULD BE CREDITED BACK THE $OVERDRAFT FEE WITHIN BUSINESS DAYS

I am a type diabeticCVS Caremark has a program called Diabetic bundling or pricing planThis allows the customer to pay for the first insulin prescription and all other corresponding prescriptions (needles, test strips, other insulin types) to be included in the order for $This runs the customer $per order
On 08-23-2015, they charged me $
On 11-04-they charged me $
On 02-12-they charged me $
They will not fix the first two orders at allThe 3rd order, they did refund $222.62, however, that still leaves me paying $and it should only be $On this order, they did ship in two orders, but they were both sent and processed on the same day (2/12) so it still should be only $
I have contacted them repeatedlyThey will not assist nor call me back

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

I'm a kidney transplant patient and have strict medication regimentToday's date is 4/8/Now this is well within the Flexible Spending yearCVS Caremark mail order would NOT refill any of my medications over a $balance!! They said it was days oldWell days back still puts leaves me eligible to use my Flexible Spending account
But the point is a $balance and they are going to refuse to refill ANY of my life sustaining medications!! Kidneys are hard enough to come byI hate to wait 3+ years for this oneWhat gives CVS Caremark the right to play god over a $ balance!!
Then to make matter worseI spoke to a CVS Caremark phone representative yesterday (4/7/and they told me after a Supervisor approval it would be covered by my flexible spending accountThank god I called today because there was one more med that needed to be refilled and told they wouldn't fill it because of my outstanding balance of $4.72!
This is not the first time I had this same i

I placed order # *** on 4/20/I received an email from you all informing me that my order had been shipped and was giving the tracking #I then went to the post office after the tracking # indicated that my package was available for pick upWhen the clerk brought the package, the tape was coming off and I could see inside of itI could see that the items inside were not the items I ordered, therefore, I refused to sign for the packageInstead, I refused the packageThey told me that the package will be returned to senderI called CVS.com toll free # on several occasions and have been told excuse after the next as to why my refund has yet to be processedIt is now 5/18/and my refund has yet to be processed 1st of all, the items inside this package were not the items I ordered2nd of all, I refused the package after the clerk brought it out

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,
*** ***

October 17, 2017Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and VermontDonald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705 Complaint #*** / *** *** ***To Whom It May Concern:CVS Caremark administers the prescription benefits portion of the CB *** ***
health plan, of which Mr*** *** is a memberThank you for the opportunity to address Mr***'s concerns as expressed Complaint # ***Upon review of Mr***'s concerns we were able to process his request for paper claim reimbursement as of October 9, Mr*** submitted $for reimbursement but only $was allowed per plan benefit guidelinesDue to this guideline, check # *** was sent to Mr*** for the amount of $Currently there is an open request with Mr***'s plan benefit to allow the entire $be considered for reimbursementOnce there is a response to this request, follow up will be made with Mr***.Additionally, upon completion of our internal investigation; it has been determined that our customer care team failed to meet our level of expectations. Upon review of Mr***'s interaction with the customer care 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 customer care team with whom Mr*** interacted.We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value Mr*** 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 Mr*** have any additional questions or concerns, please do not hesitate in contacting me at 1-***.Sincerely,*** * ***Member Advocate

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.
Regards,
*** ***