Defiance Sewing Center

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below After speaking with Crystal Lat length about my claim she requested additional documents A separation letter from my employer, a termination of coverage certificate from the health insurance company showing dates of coverage, and my last pay stub All were sent yesterday I still have no medication or response from the Lilly company Additionally I sent all the documentation required with my initial application and am surprised to find they are wanting more and more I request to be enrolled in the program as quickly as possible and Crystal L give me a call Regards, [redacted]

We received the patient’s insurance termination letter and proof of income, and he was enrolled on 10/19/The patient called on 10/for an update, and at the time we were still awaiting his additional documentationWe will give the patient a call to provide an update and inform him of the enrollmentPlease let me know if there are any other questions or concerns

A representative from Lilly spoke live with the patient Action plan: Patient will call HCP with new FAX number and have application sent She will let the Lilly representative know once application has been faxed and Lilly will have call center pull and expedite review and shipment order placement Shipment will be sent RUSH A goodwill voucher will be coordinated for Cymbalta mg Patient will receive a call from The Lilly Answers Center regarding this Patient is aware that she will need a prescription from her Drfor voucher to be able to work

Lilly’s Patient Assistance Programs work to meet the needs of as many patients as possible, based on available resources and established criteria Last year, the Lilly Cares Foundation served more than 160,patients through the Lilly Cares Program The Lilly Cares Patient Assistance Program was designed to help those patients who are not eligible for Medicare Part D and have no insurance or for patients who are eligible for Medicare Part D and have enrolled in a Medicare Part D program Our program very specifically covers Medicare Part D patients, and that criteria has been consistent since our program was launched in At this time, the patient who raised the question does not meet program criteria, as she is eligible for Medicare Part D but has not enrolled in a plan We appreciate the feedbackIt is always important to us to hear from patients as we continually review our programs The Lilly Cares Foundation

We have communicated with the customer today, explained the benefit, and he was
satisfied with the outcome. We spoke to him twice today, once to get a
bit more information so we could finish our research into the issue, and again
to relay the results

We’ve reached out to our partners at Lilly Cares who helped us
do some digging regarding this complaint. Here is a summary of what we
found:
After Revdex.com Complaint
Lilly Cares agent reached out to this patient to clarify
necessity of documentation
requested prior to an enrollment decision being
rendered for his case. The patient explained that he is now uninsured
(insurance terminated in May)Lilly Cares is currently waiting for additional
income documentation and the insurance termination letterLilly cares has faxed the HCP, spoken with the patient, and left
a voice message for the HCP regarding the verification of insurance
information
Finding:
The patient is partnering directly with a Lilly Cares
Administrator at this time to reconcile documentation program requirements
Once required documentation is received, an enrollment decision will be
rendered

We were able to honor the voucher based on the expiration date and the fact that the patient was able to download this voucher from the website. The patient provided proof of expiration date by sending in the voucher and also letting us know when it was obtained (Dec 10th). This aligned
to the expiration date being Jan 29th

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me After phone calls this morning, they are replacing the pens
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. Thank you for you help!! It is well appreciated
Regards,
*** ***

Background:
We researched the complaint and identified the TLAC agent did follow the appropriate TLAC guidelines on product replacements/refunds.  The agent was able to work with the patient to get their device functioning.  Unfortunately, the patient had left the pen in a drawer for...

2-3 weeks so was no longer able to be used due to the in use period for Forteo.  Since the pen was functioning, we would follow the process of a goodwill voucher vs. a product replacement voucher.  The replacement that we made in October was for a similar situation so is why the goodwill voucher was used at that time.  We allow for 1 goodwill voucher per year based on our guidelines.
 
Definitions:
Goodwill replacement voucher: A voucher issued to a pharmacy on behalf of a consumer when the product has been rendered unusable due to admitted human error, (e.g., aberrant temperature), or when a consumer reports a LODE
Product replacement voucher: A voucher issued to a pharmacy on behalf of a consumer to replace product because of a PC (where troubleshooting is unsuccessful)
 
Resolution:I was able to work with the Forteo brand director to get approval for an additional goodwill voucher for the pen listed below.  A TLAC supervisor,  called the patient this morning and notified her that we will allow for this pen to be replaced using the additional goodwill voucher and she was transferred to the Lilly Voucher and Coupon Center to process.  We are also working with her to get set up to get additional product training.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. If  what said, "Eli Lilly and  Opus Health, an override was processed and the claim was paid in the amount of $208.26.  The patient will receive reimbursement in the next billing cycle which falls on the 30th." and I receive the payment I will be satisfied. 
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID[redacted], and it is correct and they have honored the offer settling this issue to my satisfaction. 
Regards,
[redacted]

A representative from Lilly spoke live with the patient. 
Action plan:
Patient will call HCP with new FAX number and have application sent
She will let the Lilly representative know once application has been faxed and Lilly will have call center pull and expedite...

review and shipment order placement
Shipment will be sent RUSH
A goodwill voucher will be coordinated for Cymbalta 60 mg.  Patient will receive a call from The Lilly Answers Center regarding this.    Patient is aware that she will need a prescription from her Dr. for voucher to be able to work.

This patient’s claim was initially rejected because it was
submitted beyond the 90 day timely filing period.  After a discussion
between Eli Lilly and  Opus Health, an override was processed and the
claim was paid in the amount of $208.26.  The patient will...

receive
reimbursement in the next billing cycle which falls on the 30th. 
 Opus Health left a voicemail for the patient on 5/20/16 to provide him
with a status update on the claim. The patient returned the call and was
appreciative.

We received the patient’s insurance termination letter and proof
of income, and he was enrolled on 10/19/16. The patient called on 10/18 for an
update, and at the time we were still awaiting his additional documentation. We
will give the patient a call to provide an update and inform him of the
enrollment. Please let me know if there are any other questions or concerns.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
After speaking with Crystal L. at length about my claim she requested 3 additional documents.  A separation letter from my employer, a termination of coverage certificate from the health insurance company showing dates of coverage, and my last pay stub.  All were sent yesterday.  I still have no medication or response from the Lilly company.  Additionally I sent all the documentation required with my initial application and am surprised to find they are wanting more and more.  I request to be enrolled in the program as quickly as possible and Crystal L give me a call.
Regards,
[redacted]

Lilly’s Patient Assistance
Programs work to meet the needs of as many patients as possible, based on
available resources and established criteria.  Last year, the Lilly Cares
Foundation served more than 160,000 patients through the Lilly Cares Program. 
The Lilly Cares Patient...

Assistance Program was designed to help those patients
who are not eligible for Medicare Part D and have no insurance or for patients
who are eligible for Medicare Part D and have enrolled in a Medicare Part D
program.  Our program very specifically covers Medicare Part D patients,
and that criteria has been consistent since our program was launched in
2008.  At this time, the patient who raised the question does not meet
program criteria, as she is eligible for Medicare Part D but has not enrolled
in a plan. 
 
We appreciate the feedback. It
is always important to us to hear from patients as we continually review our
programs.
 
The Lilly Cares Foundation

I've
been doing some research to figure out what happened with this record and here
is what I could find.
 
During
the online submission, the customer is required to enter the veterinary
hospital name but not the purchase location. This information is captured from
the receipt by...

our data entry team but this failed to occur since scanned
images received had very poor quality. Please see attached screenshots for
reference.
 We have overridden the invalid reason and the rebate under trk# [redacted] is now valid
for an $80.00 Visa prepaid card, it should be mailed within 15 business days.
 
Please
let us know if you have any further questions.