MedImpact Healthcare Systems Inc

Review: A lyrica prescription purchased 01/06/2016 is not showing as part of my 2016 deductibles and out of pocket max, making the next prescription full price and unaffordable. Their records inaccurately show the purchase date 12/29 and as part of 2015 plan. I've called 4 times to try and get them to correct their records,offered to fax the receipt, provide an actual printout from the pharmacy of the fill history, and even put them in direct contact with the pharmacist that submitted the original order to correct it.

They've misled both myself and the pharmacy multiple times, and last indicated one of the reasons they couldn't correct the issue was because of one of the previous correction attempts they asked us to do (reversal and resubmittal of prescription in question. While I asked to speak with a manager I was not allowed, the last person helping me said her name was '[redacted]' and she had spoken with a manager, indicating the only thing I could do was pay for the meds full price and file a paper claim for reimbursement- there is no other possible method of resolution.Desired Settlement: I'm not interested in paying for and/or getting reimbursed for someone's else's mistake, let alone waiting while they review and arbitrarily decide on the matter. I am currently going through withdrawals from my medication, and I just want them to immediately correct their records so I can afford my next prescription. Specifically that is the $307.38 I paid for the Lyrica with a "Date & Time Sold /Fill Status" of 01/06/2016 @ 03:54PM PST, of which MedImpact has in their records for the month of December- a correction needs to be made to have it applied to January and the 2016 year. I have consented recorded conversations where they acknowledge the error and the pharmacists involvement in resolving this but will not correct their records, citing the only recourrse is their internal paper claim reimbursement process.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the member.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the member.

Consumer

Response:

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. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Consumer

Response:

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. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: I had been turned down for a prescription of Cialis for my BPH and NOT for an erection. When it was refused In March 2015, Medimpact requested a justification letter from my Physician Dr. [redacted]. After his letter to Medimpact, I was sent a letter to my house from Medimpact which stated, Medimpact will honor my prescription for this for one year ending in April 2016. I received only two months of Cialis. When I went back to my pharmacy for my third order, it was refused by Medimpact stating their formulary had changed in June 2015, therefore Cialis was not on their list any further. I phone them, and the rep. stated I would continue to receive it and that they would honor the prescription until April 2016, as they originally stated in their letter to me. She stated since I was already approved for the one year, Medimpact will honor my prescription at least until 2016. I would hope they would not do this with other patients especially if it is a needed medication for survival. My major complaint with Medimpact is; they said they would honor my continued prescription until 2016 but have taken it away just because their formulary had changed.Desired Settlement: For Medimpact to honor their commitment to me until April 2016 as they initially stated they would. Several request were made by me and my Doctor on this issue.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Review: This is just one of the MANY problems I have had with this company since starting my insurance plan with them on 1/1/2014.

1. After going to fill my prescriptions, I realized that I am being charged a different amount every month for my medications. I know that I am on a high deductible plan and so my costs are higher than most pay with insurance. I just do not understand why the cost varies from month to month, with every prescription. The companies website has a RX price finder, why are these prices not the same every month? I looked up my costs in January before filling my first RX. Why are the costs now different, and continuing to increase each month?

I just got off the phone with a "customer representative" who I'm pretty sure I have spoke with before. This representative is very unhelpful, rude, and takes so long to basically not end up helping me anyway. I was on the phone with her for over 25 minutes and when I told her I needed to go take care of my children and wanted to know how this issue would get resolved and my questions get answered, she put me on hold for approx. 10 minutes until I just finally hung up. I hate to bad mouth the employees at Med Impact, one of the representatives was helpful. But I guess that doesn't make their percentages look very good when I have probably talked with about 10 employees now.

2. My second issue is one that I have been asking to be resolved and addressed for about two months, still no word or apology.

Back in January I was denied by Med Impact for my generic birth control RX that I have been taking for the past 8 years. No explanation other than I needed to try 3 different medications before they could approve my Generic birth control. Well my doctor filled out a form requesting that the medication be approved for me and once again I was denied. I was sent a denial letter, with no explanation as to why it was denied. On this denial letter there was a phone number (###-###-####) listed multiple times. This was the number given to call and file an appeal, to call if you need help understanding the denial, and for appeals contact information. The crazy thing about this number is that when I called it (and I did call it multiple times) it connected me to an automated system that was basically a scam attempting to obtain my credit card number. Seriously, the first time I called I "won a trip to the Bahamas", the second time I "won a $100 voucher to fine retail location". All I needed to do was give my credit card number to pay the "$1.99 activation fee". Luckily I was smart enough not to give out my credit card number. I looked up the number for Med Impact on the back of my insurance card and it was one number off from the one printed multiple times on my denial letter.

Obviously there was a typo. I brought this up to Med Impact 3 times on different dates. I asked what they were going to be doing about their mistake, I was given no answer. I also notified my employer about the letter and scam phone number I was given. Who knows how many of the other employees at the large company I work for were given this false number too. I have never heard anything back from Med Impact about this problem. I never received an apology and notification about the issue via mail either.Desired Settlement: 1. First off, I would like an explanation as to why I am being charged different amounts every month for the same medication, dose, strength, and quantity. Nothing has changed at all with the RX I am filling, why are the prices changing?

2. Second, I would like to know what is being done to address the wrong information (phone number) given to all Med Impact customers who were denied a claim. Was this intentional? Customers can't file an appeal if they aren't given the right phone number to do so. I want a formal apology and I want it clearly documented as to how Med Impact will notify all those sent the wrong phone number of the issue and corrected with the right information.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Review: MedImpact is a pharmacy benefit manager who makes money be making it difficult or impossible for patients to obtain medications prescribed by their docot or immunizations. The company has refused to pay for a Hepatitis immunization despite it being a contractual benefit paid at 100 percent without deductions of copays. My pharmacist, Doctor and myself have been unable to get MedImpact to follow their own formulary, medicare regulations, and contractual obligations.Desired Settlement: 1. Immediately authorizes the proper payment for AAHepatitis immunization required by their own policies, medicare regulation and statute.

2 That MedImpact \offer an apology for making me go to great length to get what is clearly due me.

3. That MedImpavt conduct kin house training of pharmacy tecjs on their obligations to clients and that such trraining include a Medicare representative

Consumer

Response:

PLEASE BE ADVISED THAT AS A RESULT OF YOUR EFFORTS AND OTHERS THE

COMPANY DID APPROVE THE IMMUNIZATION I ASKED FOR BUT

IT SHOULD NOT HAVE TAKEN 3 WEEKS TO GET WHAT I AM ENTITLED TOO. I STILL

BELIEVE THEY SHOULD RECEIVE TRAINING FROM

ON THE RULES AND REGULATIONS. THEY SEEM TO PRACTICE DISCOURAGING

UTILIZATION AS A MEANS TO SAVE MO9NEY. AS A PHARMACY BENEFIT

MANAGER THEY SHOULD BE IN THE BUSINESS OF SEEKING LOW COST PRODUCTS NOT

IN THE BUSINESS OF DENYING LEGITIMATE UTILIZATION

OF PHARMACY BENEFITS. SOME PEOPLE PROBABLY ACCEPT THEIR ILLEGITIMATE

DENIALS AND THEY COUNT ON THAT. IT IS WRONG AND I HOPE YOU GIVE THEM AN

APP0APPROPRIATE BAD RATING FOR THIS PRACTICE.

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. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: MedImpact, Inc. manages (or mismanages) our healthcare pharmacy plan. My plan requires that I receive a Prior Authorization (PA) for virtually all first-line medications for Multiple Sclerosis (MS). And this PA now requires chart notes from my doctor - detailing the other MS drugs I've tried and failed (even though MedImpact already has this information as they have managed our pharmacy plan throughout my trial of all of the different drugs).

I have been trying to get a new RENEWED PA for a drug I've been taking for several years. This has been an ongoing and unresolved issue for more than three weeks. My doctor's office has called MedImpact and faxed to them the required documentation multiple times. Thankfully, these calls and faxes have been well-documented by my doctor, his office staff and IT staff.

MedImpact denies receiving any of this documentation - in an apparent effort to delay or deny providing the coverage that we pay for.

I have now been without medication for thirteen days. And MedImpact is no closer to approving the PA than they were when I started this process more than three weeks ago.Desired Settlement: MedImpact needs to perform the work for which they are paid by our plan. They need to stop denying that they did not receive documentation that was faxed to them, and for which delivery receipts document. They need to IMMEDIATELY approve and issue my Prior Authorization.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.

Review: My physician prescribed a medication that I urgently need and Medimpact required a prior authorization. This was done, but then the medication was denied requiring proof of several other medications having been tried before. This information was provided but Medimpact representatives tell me they did not receive this document. For nearly three weeks, a person suffering a serious mental condition has been denied treatment through a labyrinthine bureaucratic process at Medimpact that is less efficient and more infuriating than a day at the DMV. I've made nearly a dozen phone calls to Medimpact, my Doctor and pharmacy trying to coordinate the prescribing of this medication. This company's process is literally putting a person's life in danger and I doubt that I am the only one. The cost of the medication is what I am sure is the driving force behind this bureaucratic nightmare. Apparently the almighty dollar is more important than the well being of the unlucky individuals burdened with this PBM. During next open enrollment, I will find another PBM and encourage everyone I work with to do so. Perhaps if I suffer liver damage through an attempt at self medicating because Medimpact is blocking my treatment I would have grounds for a lawsuit? I am not actively suicidal, but I were, I would leave a note for my family instructing them to bring suit against this horrible PBM for their delaying, denying and obstructing the medical treatment of a person suffering an illness that is potentially life threatening.Desired Settlement: approval of the medication prescribed to me by a licensed DR in a timely manner.

Business

Response:

MedImpact Healthcare Systems, Inc. is in receipt of the complaint and successfully resolved the complaint directly with the consumer.