Caremark PHC, LLC

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 s's
I reject this response,  it is a carbon copy of the previous response sent by the company almost 2 weeks ago  please send me my required medication  Regards,
[redacted]

[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]

Dear Sir or Madam, Please review the attached response. Sincerely, SilverScript Insurance Company

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. 
As requested, my membership ID is [redacted] 01 and my date of birth is [redacted].
Regards,
[redacted]

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. 
My mother's name is [redacted] her Member ID is [redacted], her meds in question are [redacted] and possibly 1 other for stomach acid in the May 28, 2015 shipment we DID NOT ever received for a 90 day supply. The Transderm Patches was just overridden this evening after hours of frustration on the phone with [redacted] today to allow our local pharmacy to fill.
Regards,
[redacted]

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 of the patient in question as well as the medication in question.

[redacted]
 
[redacted]
 To whom it may concern: CVS/ caremark administers the prescription benefits portion of the health plan for the World Bank of which Mr....

[redacted] is a member. This letter is in response to the correspondence we received from your office on May 14, 2015. Thank you for the opportunity to address Mr. [redacted]’ concerns as expressed in Complaint ID [redacted].  Upon review of this concern, we confirmed that our mail order pharmacy processed and filled the order for [redacted] correctly. Although Mr. [redacted]’ prescription was written for a quantity of 135 patches, our pharmacy was only able to dispense four packets which are equal to 120 patches. This medication is dispensed in packets of 30 patches which cannot be broken down; therefore, we were unable to fill the order for the quanitity requested. Unfortunatley, we are unable to comply with Mr. [redacted] request for an additional 15 patches. Mr. [redacted] may contact his physician’s office to obtain a new prescription for a quantity of 150 patches (5 x 30). Additionally, upon review of Mr. [redacted]’ interaction with our 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. [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 Mr. [redacted] 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

August 19, 2015 Revdex.com[redacted]Complaint ID: [redacted]  To whom it may concern: CVS/caremark administers the prescription benefits portion of the health plan for [redacted], of which Ms. [redacted]...

[redacted] is a member. This letter is in response to the correspondence we received from your office on August 6, 2015. Thank you for the opportunity to address Ms. [redacted]’s concerns as expressed in Complaint ID [redacted].Upon review of this concern, we confirmed that Ms. [redacted] was sent two orders of [redacted]® for her son. One order was sent on June 24, 2015 and the second order was sent on July 15, 2015. This was due to CVS/caremark receiving a duplicate order which was placed on a future fill. A return mailer was requested on August 4, 2015 for the July order and issued to her on August 7, 2015 to allow her to return the medication for credit.  Her file will be given a credit of $150.00 credit when the medication is received back in our filling facility. Additionally, upon review of Ms. [redacted]’s interactions with our 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 our customer care team with whom Ms. [redacted] interacted.   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, “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 866-[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, Date of Birth, and the medication in question of the member in question.

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. 
It is correct that CVS Caremark make a payment refund of the $852 indicated in their message.  However, it is NOT true that CVS tried unsuccessfully to contact me several times to resolve the payment issue. In fact, I called CVS no less than 5 times regarding this issue, with each call lasting about 45-60 minutes.  On both Dec. 14th and Dec. 23rd , I spoke with a CVS representative and directed them to apply this prescription to the Health Savings Account (HSA) card that I have on file with them. In each instance, I verified that sufficient funds were available in the account at that time.  However, in each of these cases, the payment was not made for several business days, after which time the account balance was reduced by other (delayed) payments. On 12/28, I provided CVS with my personal credit card number, again stressing urgently that the payment would need to be made before the end of the year, in order for the charges to be billed against my 2015 health care deductible.  However, despite CVS' own policy to process the Rx charge within 2-3 days of the authorization, when I called them back on 1/3, it had still been neither charged nor shipped.  Only on the last phone call of 1/6 was I able to learn that the charge had been adjusted to account for CVS' untimeliness.  In fact, it took CVS 5 business days to process and ship the medicine, after the authorization to use my personal credit card had been given.The level of frustration involved in dealing with the incompetence and unprofessionalism of this company is beyond anything I have ever experienced, with either another mail order prescription business or any other firm. I accept the resolution of this case due to the partial refund provided, but wait with dread for the next time another prescription fill requires such considerable time and effort to be completed. I will be reporting this experience to my corporate HR office, so that they are aware of the poor service they are getting for their money.
Regards,
[redacted]
 
 in the account

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]YOU SENT THE COMPLAINT TO THE WRONG PLACE CVS/CAREMARK MAIL ORDER NOT SOLVERSCRIPT     PLEASE RESEND TO THE PROPER PLACE Revdex.com?????????

I verified per the [redacted] tracking information, the package was considered undeliverable as addressed; therefore, the package was being returned to sender.  I contacted [redacted] Customer Service and UPS Customer Service who both state the package was returned to us on June 2, 2015. At this time, we are attempting to locate the package in house. I spoke with [redacted], Ms. [redacted] daughter and [redacted], and advised of this information. We advised we will follow up with her next week. [redacted] did understand and did not request any further assistance at this time.  Once the request has been completed, we will respond to the Revdex.com with the outcome.

May 16, 2017
 
Revdex.com of Eastern MA, ME, RI, & VT290 Donald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705
Complaint ID: [redacted] / [redacted]...


                                        ...⇄
To whom it may concern:
 
CVS Caremark administers the prescription benefits portion of the health plan for [redacted] Idaho, of which Mr. [redacted] is a member. This letter is in response to the correspondence we received from your office on May 5, 2017. Thank you for the opportunity to address Mr. [redacted] concern as expressed in Complaint ID: [redacted].
 
We have reviewed Mr. [redacted] concerns regarding the amount that he was being charged for his order. We verified that Mr. [redacted] order was submitted on April 28, 2017 via Caremark.com website. Mr. [redacted] order was held due to a payment issue which caused delays and prevented the order from shipping. Mr. [redacted] was only charged a $50.00 copayment and was not charged a shipping fee for the order. Mr. [redacted] was refunded his $50.00 copayment for the order. Additionally, expedited shipping is $23.00 for overnight delivery and $17.00 for 2-day delivery for a complete order and not per item. Mr. [redacted] order was mailed on May 5, 2017 via [redacted] Overnight delivery. Per the [redacted] tracking # [redacted] the order was delivered on May 6, 2017 at 10:28 am. Furthermore, we have reviewed Mr. [redacted] telephone interactions with our customer care team and it was verified that our customer care team followed the correct process.   
 
We value our members and we 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. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at 1[redacted].
 
Sincerely,
 
 
[redacted]
Member Advocate

February 25, 2016
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
[redacted]
Complaint ID: [redacted]
To whom it may concern:
This letter is in response to the correspondence we received...

from your office on February 17, 2016. Thank you for the opportunity to address Ms. [redacted]’s concerns as expressed in Complaint ID: [redacted].
In review of Ms. [redacted]'s concern, we have confirmed that a member of our specialty pharmacy team has made multiple attempts to contact her to assist in resolving the billings matter referenced in her complaint. Our specialty team has advised that the charges in question have been reversed and are available for use should Ms. [redacted] need to utilize them. Ms. [redacted] can contact our specialty team directly at [redacted] or [redacted] do discuss this matter further should she have any further questions or concerns.
We sincerely apologize for any frustration or inconvenience that Ms. [redacted] experienced. We 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 Ms. [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 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]

Dear Sir or Madam,
Thank you for giving us the opportunity to address the beneficiary’s concerns regarding his prescription drug benefits offered by [redacted] Insurance Company’s Medicare Part D Prescription Drug Plan (PDP). This letter is in response to your correspondence received on June 20,...

2016.
Sincerely,
[redacted] Insurance

May 6, 2015
 
 
 
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
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 many health plan and offers services thru our specialty pharmacy.  This letter is in response to the correspondence we received from your office on April 13, 2015. Thank you for the opportunity to address Ms. [redacted]' concerns as expressed in complaint ID: [redacted].
 
In reviewing Ms. [redacted]’ concern, it was determined there was an error when filling Ms. [redacted] prescription.  Although our Specialty pharmacy did verify coverage at the time Ms. [redacted]’ prescription was received by her physician on August 28, 2015, it is procedure to re-verify benefits once our pharmacy fills the medication; we have confirmed this was not done.  Our specialty pharmacy has been in contact with Ms. [redacted] to inform her we have credited her account and as of April 16, 2015 her account now reflects a $0 balance.
 
We sincerely apologize for any frustration or inconvenience that Ms. [redacted] experienced. We value Ms. [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 Ms. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at ###-###-####.
 
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] . 
Dear Mr. [redacted]Thank you for your continued efforts in assisting a member.According to the plan benefits – 30 day supply would be billed at $25, and 90 day supply be billed at $50 for the medication in interest.  This is clearly stated at the CVS Caremark website for my particular plan, [redacted].  I am attaching the benefits and copayment information that were downloaded from the CVS Caremark website for your reference.If [redacted] cannot assist me, the member, to retrieve and to help refund the overcharged copayment, in this case $25, I would then request [redacted] to provide me further appealing channels / contact information so that I can discuss this case further with other appropriate personnel regarding the overcharged copayment.Thank you for your assistance.Regards,
[redacted]

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].  
Again, CVS has not stated specifically as to why the medication was rejected.  As I stated in the original complaint, when I spoke with a CVS/Caremark representative, she stated that the contested medication, in the CVS/Caremark guidelines was not an appropriate medication for a yeast infection, which is contrary to both the National Institute of Health and Mayo Clinic findings.  As well, no alternative medication was proposed (as far as I know, there are none).  As a result, the CVS/Caremark policy appears to be that I should suffer with my condition, untreated, until a time that I would not be able to function, as both the medication was denied, and no alternative was proposed.  In essence, a flat denial of any medical treatment.   I have yet to receive a specific reason as to why the medication was denied, and/or an alternative that would treat my condition with reason(s) why an alternative would be suitable.  Again, no alternative was ever proposed. In regards to the statement above in regards to contact.  I did receive two phone messages from "[redacted]" from CVS who never identified what his position was (clerk at the store, President of the company?) with CVS/Caremark.  He simply stated that the case was being appealed (again, no specific reason as to why it was denied initially, or an alternative) and that I could contact him via phone, if I wished, but it was not necessary as it was going through appeal.  I am not a physician, and I have already stated what I found via research, the relevant support in the NIH and Mayo Clinic, so I find that further discussion would be fruitless as it is in appeal.   In addition, I would appreciate contact via email at [redacted] versus phone conversations while I am at work.  This way I could have a more precise record as to what is going on. Again, I would like to know the precise reason why the medication was declined, and why CVS/Caremark thinks it is wise that my infection continue without providing an alternative as per its apparent standing policies.  "Attempts to contact Mr. [redacted] directly and provide updates on his request for coverage have been unsuccessful. To date, Mr. [redacted] has not returned our calls." This is from CVS/Caremark, and no requests were made to return calls.  "[redacted]" simply stated that it was being appealed, and I could call if I wished to in order to add something, which I did not.  Again, this was made during work hours where I cannot pick up the phone, and I wish for further contact to be made via email, and a phone number provided should I have questions.     Attempts to contact Mr. [redacted] directly and provide updates on his request for coverage have been unsuccessful. To date, Mr. [redacted] has not returned our calls.
Regards,
[redacted]

January 4, 2016
Revdex.com
[redacted]
Complaint ID:  [redacted]
To whom it may concern,
CVS/caremark administers the prescription benefit portion of the health plan for [redacted], 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 the concern, it was confirmed that the [redacted] prescription drug plan does requires prior authorization in order for the medication in question to be covered. Our records reflect that Mr. [redacted]'s prescribing physician’s office contacted our authorization department on December 22, 2015 and the authorization request was submitted and approved the same day. Our pharmacy was able to process and ship the medication in question and we confirmed it was delivered to Mr. [redacted].
We sincerely apologize for any frustration or inconvenience that Mr. [redacted] experienced. We value him as a customer and 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 additional questions or concerns, I may be reached at [redacted].
Sincerely,
[redacted]
Member Advocate