I'm sending this complaint and intent to take this issue to the insurance commissioner, channel 8, and the BBB if need be. I never had a problem with getting my rx filled and now that my husbands company decided to use this mail order plan I've had nothing but problems. My medication was denied at the pharmacy and I was told they have no information on why I would need to call caremark. The next day I was on the phone with caremark and spoke with a cs rep to get my mail order setup. I asked her how I would go about getting the meds I needed until the mail order went through. I also asked how the program works as far as my contract goes. There is an 8-10 day turn around time. I didn't have enough of meds to cover that time span. I was told by her to purchase the meds and submit a claim with the receipt. I was then transferred to the rep that sets up the account. Not knowing how this program works I called a few more times that day questioning how my scripts get to them and what information my doctors needed to fax over.
I purchased my script and paid $55.00 out of pocket. My claim was denied and only because I called to get a status update I was told my claim was denied. I didn't get a denial by mail or a phone called. It's amazing how when my credit cared didn't go through a rep was right on that and new how to get a hold of me asap. On 4/26/10 I spoke with Arturo P. Who was unwilling to help in every way. I'm a medical biller and worked for many insurance companies so I no calls are logged and I no how the systems works. I was trying to go through the dates with him of all the phone calls I ever made to caremark and that was like pulling teeth. I've never called caremark other then to get an rx over ride then to setup this account. It was not that difficult to get this information. It's very disheartening to think how unwilling people are to help someone in need who was given the wrong information. I will do everything I can to get the word out about how bad the customer services is and how unwilling your cs reps and managers are on giving help to someone. Also I will make sure to advise as many companies, doctors, and patients that your cs reps are not trained correctly and when a problems accrues the reps and managers try to blame you for not knowing your contract. Seeing as I got no documentation as far as my plan goes you would think that's what you pay cs for. Gina Gambardella 203-228-7346
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