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Reviews Caremark PHC, LLC

Caremark PHC, LLC Reviews (712)

In order to properly investigate your concerns, we are in need of additional information.  Please provide us with the following information: Member ID number, Date of Birth, and the name of the medication in question.

January 13, 2016
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
290 Donald Lynch Boulevard, Suite 102
Marlborough, MA 01752-4705
Complaint # [redacted]
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for the [redacted], of which [redacted] is a member. Thank you for the opportunity to address [redacted] concerns as expressed Complaint # [redacted].
Upon review of [redacted]’s concern we further verified the [redacted] plan requires members to fill a 30-day supply of a new medication/prescription before processing of a 90-day supply. Because of this plan benefit rule, members should not send new prescriptions to Mail Order for processing. The prescriptions in questions were reduced and processed correctly as a 30-day supply in accordance with the plan benefit. [redacted] is responsible for communicating all plan details to their employees. Additionally, feedback has been provided to the member of the customer care team with whom [redacted] interacted with that provided misinformation. 
CVS/caremark administers the prescription drug benefits for the [redacted] health plan. As the administrator of the [redacted] health plan, we are required to administer the prescription portion of the benefit plan in accordance with the benefit features adopted by [redacted].
We value [redacted] 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 [redacted] have any additional questions or concerns, please do not hesitate in contacting me at 1-[redacted].
Sincerely,
[redacted]
Member Advocate

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
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 #[redacted]. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
Regards,
[redacted]

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 #[redacted]. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
Regards,
[redacted]member id isw [redacted]    Date of birth is 02/02/1957

July 21, 2016
Revdex.com
290 Donald Lynch Boulevard, Suite 102
Marlborough, MA 01752-4705
Complaint Id:  [redacted] / Complainant:  [redacted]
To whom it may concern,
CVS/caremark administers the prescription benefit portion of Ms. Aloha [redacted]'s health plan with...

State of Florida.  This letter is in response to the correspondence we received from your office on July 12, 2016.  Thank you for the opportunity to address Ms. [redacted]'s concerns as expressed in complaint ID [redacted].
Upon review of the concern, our specialty pharmacy has confirmed that Ms. [redacted] contacted our pharmacy on June 20, 2016 to order her prescription for Copaxone®. At this time she was informed that the prescription was expired and we would contact her physician to obtain a new one. Our dispensing pharmacy sent request to the prescribing physician’s office on June 20, 2016 and June 22, 2016 however; our attempts to obtain the medication were unsuccessful. Our records reflect that the physician office did not contact our pharmacy to provide the new prescription until July 6, 2016. Ms. [redacted] was contacted this same day and delivery was scheduled. We have confirmed that Ms. [redacted] was able to pick up the medication at the retail CVS pharmacy on July 11, 2016.
Furthermore, we have verified that Ms. [redacted]'s plan requires members to utilize CVS/Specialty pharmacy for specialty medication.  If the medication is obtained outside of the plan parameters, the plan member will be responsible for the full cost.  Please keep in mind that CVS/caremark only administers the prescription benefits for State of Florida and must adhere to the provisions set forth by the plan sponsor.
Lastly, upon review of Ms. [redacted]'s interaction with the customer care team, we recognize that there were opportunities for additional training and coaching for our staff.  Where necessary, feedback has been provided to each member of the customer care team Ms. [redacted] interacted with.  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 Ms. [redacted] experienced. We value Ms. [redacted] as a member and we remain fully committed to our purpose of "helping people on their path to better health". Should you or Ms. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at ###-###-#### my business hours are from 9:00 a.m. to 5:30 p.m. Central Time, Monday thru Friday.
Sincerely,
[redacted]
Member Advocate

July 8, 2016
 
Revdex.com
[redacted]
[redacted]
 
Complaint ID: [redacted]/ [redacted]
 
To whom it may concern:
 
CVS/caremark administers the prescription benefits portion of the health plan for...

the Rural Letter Carriers Association, of which Mr. & Mrs. [redacted] are members. This letter is in response to the correspondence we received from your office on June 28, 2016. Thank you for the opportunity to address Mr. & Mrs. [redacted]’s concerns as expressed in Complaint ID: [redacted].
Upon review of this concern, we confirmed that Dr. [redacted] information regarding his medical practice was incorrect in our database. This information has been updated and corrected to reflect Dr. [redacted] current location in Minnesota, as well as updated phone and fax information. To ensure that Mrs. [redacted] will not have any further prescription refill concerns, she has been enrolled into the Adopt a Member program. Mrs. [redacted] has been contacted by [redacted] from the Adopt a Member program, who is her assigned point of contact from July 6, 2016 thru January 6, 2017.
 
We sincerely apologize for any frustration or inconvenience that Mr. & Mrs. [redacted] have experienced. We value Mr. & Mrs. [redacted] as members and we remain fully committed to our purpose, “helping people on their path to better health”. Should you or Mr. & Mrs. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted]
 
Sincerely,
 
 
[redacted]
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 # [redacted]. Please add your rejection comments below. 
I am rejecting this response because it does state correct information. They did not mention that they illegally charged my credit card without authorization, no apologies for the hardship they caused me with my bank, and there was no remedies to satisfy my outstanding balance since they messed up.
Regards,     
[redacted]

Complaint ID: [redacted] To whom it may concern: CVS/caremark administers the prescription benefits portion of the health plan for the PBA of The City of [redacted], of which Mr. [redacted] is a member. This letter is in response to the correspondence we received from your office on June...

24, 2015. Thank you for the opportunity to address Mr. [redacted]’s concerns as expressed in Complaint ID [redacted]. Upon review of this concern, it was determined that Mr. [redacted] utilized the caremark.com website to obtain copayment information for his medication. We have confirmed that the copayments provided to Mr. [redacted] via caremark.com with the option to obtain his prescription from either CVS/caremark mail order or his retail CVS Pharmacy for the same co-payment was not accurate. Mr. [redacted] is able to utilize either pharmacy; however, there is a difference in cost between a 30 day fill through mail order compared to utilizing a retail pharmacy including a CVS Pharmacy. An update to the website is currently in process which will be more specific to estimates provided for 30 or 90 day fills. This change will take effect in August 2015. As a courtesy, we are providing a courtesy credit to Mr. [redacted] in the amount of $5.17 for the difference in the estimate provided; a check has been issued as of July 2, 2015. We sincerely apologize for any frustration or inconvenience that Mr. [redacted] experienced. We value Mr. [redacted] 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. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted]. Sincerely,  [redacted]Member Advocate

December 28, 2015
Revdex.com
290 Donald Lynch Boulevard, Suite 102
Marlborough, MA 01752-4705
Complaint ID: [redacted]/[redacted]
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for Teacher’s Retirement System of...

Texas, of which Mr. [redacted] is a member.  This letter is in response to the correspondence we received from your office on December 18, 2015.  Thank you for the opportunity to address Mr. [redacted]'s concerns as expressed in Complaint ID [redacted]. 
Upon review of Mr. [redacted]’s concern, we found that the plan requires prior authorization for the medication in question.  The prior authorization was initiated on December 16, 2015.  The completed criteria form was received on December 23, 2015.  Prior Authorization was approved for 24 months from December 23, 2015 thru December 23, 2017.
We sincerely apologize for any frustration or inconvenience that Mr. [redacted] experienced.   We value Mr. [redacted] as a member and we remain fully committed to our purpose, "helping people on their path to better health".  Should you or Mr. [redacted] have any additional questions or concerns, please do not hesitate to contact me at [redacted].
Respectfully,
[redacted]-[redacted]
Member Advocate

June 1, 2016
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont[redacted]
Complaint #[redacted]/Mr. [redacted]
To whom it may concern,
CVS/[redacted] administers the prescription benefits portion of the [redacted] health plan, of...

which Mr. [redacted] is a member. This letter is in response to the correspondence we received from your office on May 16, 2016. Thank you for the opportunity to address Mr. [redacted]’s concerns regarding his issue.
 
Upon review of this concern, we have confirmed Mr. [redacted] was prescribed a generic medication and requested it be filled through our mail order pharmacy. There was an issue in filling this medication therefore Mr. [redacted] received the brand name medication instead of the generic and was charged the brand price. CVS/[redacted] does acknowledge this was an error and a pre-paid envelope will be sent to Mr. [redacted]’s home to retrieve the brand name medication. Once we receive the brand medication, a reimbursement for the charge of the brand medication will be sent to Mr. [redacted].
 
We value Mr. [redacted] 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. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted]
 
Sincerely,
 
 
[redacted]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 # [redacted]. Please add your rejection comments below. 
The response is unacceptable.  CVS told me to go buy it somewhere else because they did not have the medication.  Had CVS had the medication, my insurance would have paid the total cost and I would not have had to pay anything.  CVS needs to reimburse me 100% of my cost. 
Regards,
[redacted]

March 10, 2016
 
 
 
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
[redacted]
[redacted]
 
Complaint ID: [redacted] / [redacted]
 
To whom it may concern:
 
CVS/caremark administers the...

prescription drug benefit for the [redacted] health plan, of which Mr. [redacted] is a member.  Thank you for the opportunity to address this concern.
 
In reviewing this concern, it was confirmed the medication in question is on a maintenance exclusion list specific to [redacted]. The medication in question can only be filled for a maximum of a 34 day supply per fill. This information is available on the [redacted] website. There is a maintenance exclusion form available on the [redacted] website which members can complete and submit for an exception to this plan directive.
 
We value Mr. [redacted] as a member, should you or Mr. [redacted] have any additional questions or concerns please do not hesitate in contacting me at [redacted]
 
Sincerely,
 
 
[redacted]
Member Advocate

In order to properly investigate your concerns, we are in need of additional information.  Please provide us with the following information: Member ID number and Date of Birth,

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 # [redacted]. 
 
Regards,
[redacted]

January 27, 2016
Revdex.com of Eastern MA, ME, RI, & VT[redacted]
[redacted]
Complaint ID: [redacted] / [redacted]
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the [redacted] health plan, of which Mrs....

[redacted] and Mr. [redacted] are members. This letter is in response to the correspondence we received from your office on January 20, 2016. Thank you for the opportunity to address Mrs. [redacted]'s concern as expressed in Complaint ID: [redacted].
Upon review of Mrs. [redacted]’s concerns regarding her husband’s medication we verified there was no record of receiving a Prior Authorization request from Dr. [redacted]. The first time a prior authorization was requested for the medication in question was on December 7, 2015; the criteria form was faxed to a Dr. [redacted]’s office. On December 18, 2015 the prior authorization request was closed due to no response from the prescriber. On January 19, 2016 a new prior authorization was requested and submitted to the new prescriber, Dr. [redacted]. A call was placed to the prescriber’s office on January 20, 2016 to initiate a verbal prior authorization over the phone but it was not completed; a member of the office staff stated they would be responding to the request. On January 21, 2016 the criteria form was received in our prior authorization department and approved from January 21, 2016 thru January 21, 2019. Furthermore, a paid claim was processed for the mediation in question at retail [redacted] Pharmacy on January 21, 2016.
We value Mrs. and Mr. [redacted] as 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. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted].
Sincerely,
[redacted]
Member Advocate

Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
[redacted]
[redacted]
 
Complaint ID: [redacted] / [redacted]
 
To whom it may concern:
 
CVS/caremark administers the prescription benefits portion of the [redacted]...

Health Plan, of which Mr. [redacted] is a member. Thank you for the opportunity to address Mr. [redacted]'s concerns as expressed in Complaint ID: [redacted].
 
Upon review of this concern, we verified that Mr. [redacted] had a prior authorization which had expired in July of 2015.  The fills of the medication in question prior to the prior authorization being expired all consisted of a $40 copayment. On December 28, 2015 our filling pharmacy received a request to refill the medication in question, due to no active prior authorization in place the order processed for 24 units at the $82.27 copayment. The plan benefit covers the medication in question at 50%, Mr. [redacted] was charged $82.27 and his plan benefit paid $82.27. The reason the medication in question was filled as 24 units for a 90 day supply was because the plan allows the medication in question to be covered without a Prior Authorization with a limit of 8 units every 25 days or 24 units every 75 days.
 
A new request for prior authorization was received on January 5, 2016 and approved through January 5, 2019. Additionally the $82.27 which reflected as owed on Mr. [redacted]’s account has been absolved. As of June 2, 2016 Mr. [redacted]’s account is at a $0 balance.
 
We value Mr. [redacted] 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. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted]
 
Sincerely,
 
 
[redacted]
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 # [redacted].
I cancelled auto-refills on 11/6/17, as your representative confirmed on the phone.  This is 16 days prior to the ship date, and was told by the representative that auto-refills had to be cancelled 11 days prior.   CVS shipped me items I didn't order and didn't follow their own policy regard auto-refills.  I will leave the box on the porch and they can arrange for shipping/pickup of the items that I didn't order.  I'm not going to the post office in order to not be charged for items I didn't order.  This is the second time CVS has shipped me prescriptions that I didn't order and I shouldn't have to keep dealing with this.  It's an abusive practice.
Regards,
[redacted]

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 #[redacted]. I want to add that over the phone they also promised to send me a check for all my out of pocket from the 8/1 date until the date of resolution.  I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
Regards,
[redacted]

March 29, 2016
Revdex.com
[redacted]
[redacted]
Complaint ID: [redacted]/ [redacted]
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for [redacted], of which Mr. [redacted]...

is a member. This letter is in response to the correspondence we received from your office on March 16, 2016. Thank you for the opportunity to address Mr. [redacted]’s concerns as expressed in Complaint ID [redacted].
Upon review of Mr. [redacted]’s concern, we have confirmed that the prescription in question is classified as an over-the-counter product and is not covered by the [redacted] prescription drug plan. CVS/caremark administers prescription drug benefits for the [redacted] Plan. As a benefit plan administrator, we administer and adhere to benefits in accordance with [redacted] prescription plan documents and prescription benefit plan design. If Mr. [redacted] or the prescriber desire to appeal the plan coverage, the request must be sent to the CVS/caremark Appeals Department. The request may be submitted by fax at [redacted] or by mailing the request to:
CVS/caremark
Appeals Department
[redacted]
We sincerely apologize for any frustration or inconvenience that Mr. [redacted]’s experienced. We value Mr. [redacted] as a member and we remain fully committed to our purpose of "helping people on their path to better health". Should you or Mr. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted].
Sincerely,
[redacted]
Member Advocate

my doctors have access to all my medications through my [redacted] profile they don't need cvs caremark to let them no anything .the medication they said my doctor said for me not to take was out I couldn't take them anyway my doctor's nurse said they didn't get the letter plus she thought it was funny that they sent the letter about my meds she couldn't stop laughing so it made her happy at least I think its defamation of my character . they are a legal pill pushing organization.they could care less about service or integrity.the bottom line is profit.I don't buy there retail pharmacy they were always called and wanted to know if wanted to meds that had refills on them refilled I asked them to stop to no avail.I now use other retail pharmacy's and they don't harass me.
R egards,
[redacted]

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Address: 1 Cvs Dr, Woonsocket, Rhode Island, United States, 02895-6146

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