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OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. Our high-quality, integrated services deliver optimal member outcomes, superior savings and outstanding customer service. We are an Optum company - the world's largest provider of integrated health services.
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I have been using OptumRX for over 5 years and have found no problems with my prescriptions nor with their Customer Services. I truly cannot understand all the negative responses that appear on the comments.
We have had nothing but positive experiences with OptumRx thus far. Prescriptions are arriving on time. They even called us to let us know we did not have to call back for meds that would be able to be filled at a later date as they would be set to auto refill. They have seemed very knowledgeable and have answered all our questions. They were also very nice to talk with over the phone.
Our doctor is used to approving prescriptions for OptumRx from his other patients and approved it right away, so maybe that is why some reviews are so negative if their doctors did not approve quickly, or maybe OptumRx has improved recently based on negative feedback. We almost cancelled after reading all the negative reviews but are glad we did not because now my mother can get her meds for free and also delivered. I hope they continue to provide us with the same great service as they have been. They even told us when the delivery was shipped and when it should arrive and thus far have been correct.
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I notice that a lot of complaints are about ordering over the phone, I do all of my ordering online without ever having a problem. I had to call up once to order and it took a couple of minutes, however I have had a couple of problems with other thing. My advice, ORDER ONLINE.
To be blunt...OptumRx needs to close. They are the worst specialty pharmacy I have ever dealt with. I have 20+ years of experience dealing with them. CVS...no issues whatsoever. Walgreens...no issues whatsoever. OptumRx...a freaking disaster! Where do I start? Let's see:
1) Worst customer service of any pharmacy I've ever been to (specialty or otherwise). Most of the reps are rude. They hang up on you randomly. Their automated system is a joke (hangs up on you, takes forever, leads you in a loop sometimes, etc.).
2) They don't even know how to read a prescription. Case in point: My doctor sent them a prescription that has a starting dosage for two months, then a maintenance dosage beyond that. I saw the prescription, and it's clear. I don't work in that field, and I had no issues seeing that. Optum, however, kept telling me they only had a prescription for the maintenance quantity. It took 2+ days of phone calls to get them to call my doctor to straighten it out. Even better...after they finally spoke to my doctor, rather than calling me to set up my prescription, they sat on it. Mind you, I had called no less than 10 times to get this set up. I had filed a complaint with their management as well as United Healthcare's management (UHC is my insurance provide...and oh, they happen to own Optum). I was told by management from both places that as soon as they had the info from my doctor, someone would prioritize it and call me. Didn't happen.
3) They don't even know what they've done in their own system. Example: They had my old address in the system. No big deal, just change it. Ha...right. I asked them several times to do so. I was told it was done each time. And each time I called back, they referenced my old address. Even better...when I log into their website, the address was correct. So their internal systems don't even communicate properly. Another example: I finally was able to get my delivery set up last night. This after several weeks of back and forth. They have now called me three times since. Each time I have either picked up or called back. And each time, it's because their system doesn't realize I've already scheduled the delivery. How can it not know??? This isn't simple case of the system needing to catch up.
When I spoke to United Healthcare (UHC), the manager even indicated that OptumRx was a problem. He went as far as to say he's heard it over and over. He indicated they somehow had gotten better (not sure how, but whatever), but that they were still a mess. If you know this, fix it. I'm sure he isn't the only one hearing it. And based on all the reviews I see online (avg of just over a 1.0...which means everyone hates them), the company is either blind or more likely doesn't care.
I am forced to use OptumRx. Probably because they are the cheap option for my company. The manager at UHC confirmed that they do offer other specialty pharmacies, but that with the plan they offered my company, I'm not able to use them. So I'm screwed. I've relayed my issues internally to my company, but as we all know things like that either never change or take forever to change.
The crazy part...this medication can be expensive, and it has no generic (it should, but again, big Pharma has made it so they don't have to). But I'm considering an alternative way to get it. Even if it means coming out of pocket for a bulk of the cost, which would put me in the poor house. But I'd rather do that and have it and not be in pain rather than continually get the run around by OptumRx.
I could go on and on, but you get the idea. Because of the lack of proper access to options and healthcare, people like me have to fight and fight just to get a freaking medication. It shouldn't be this hard. But big Pharma being in the pockets of so many politicians (both sides, so don't make it like I'm one way or the other) is making average Americans like myself have to waste time, money and stress to get something that should be simple. In closing...if you have another option...ANY other option, use it.
I believe the purpose of OptumRx is to cancel perceptions. Claiming that prior authorization on a pre-exiting order.. My first medication ORX would not grant PA. I decided to go generic MED based on their recommended medications that is approved and in their formulary. ORX denied it blaming my MD did not complete PA paperwork. The paperwork she completed was wrong, she needed their paperwork. It could not be mailed only faxed to her office.
She called and several faxes later ORX agreed to pay for only half the prescription order. ORX will only pay for the immediate release and not the extended release. Claiming that the RX release required PA and the MD only submitted half the paperwork. PA is needs submitted for each individual med. Even though they are the same medication, one is fast acting and the other one is slow acting. DUH. So said I will pay out of pocket. 200 dollars a month for a med they recommended on their approved generic med list. As a matter of fact...ORX said I would have to fail 3 generic meds before they would authorize this med from their approved ** formulary. 1.5 years later paying out of pocket. I have surgery...and now these ** will not pay for meds directed by my surgeon. They need PA.
Are you kidding me. This is the silliest Medication company. I feel like I'm in some crazy movie where your insurance company wont pay for treatment for a new illness ORX will pay for only these disorders and you have to prove you need treatment. While claiming YOUR DOC did not submit the paperwork needed THAT proves you need treatment for THIS condition. The goal is to pin your doctor and local pharmacist against one another in Hopes that you blame them and never get reimbursement because you are tired of fighting. Ultimately you shut up and pay OOP.
In the midst of a pandemic, fear of traveling to a pharmacist or doctor's office, praying that no one calls the cops because you are infuriated about OPTUMRX reimbursement tactics, only asking for what is promised to you and paid for. OhioHealth. I am left with shut up and pay up. Shame on OPTUMRX, they know what they are doing and that is providing paying customers with subpar care.
This is the WORST company/pharmacy I have ever needed to use for a prescription. Had it not been requested by my Doctor I would have changed the pharmacy after my first phone call. *They are extremely unorganized, I had to call them several times and ask that they call my Doctor several times only to reconfirm what we had already discussed in previous calls. *Their automated phone service would call me multiple times in a row and when I picked up, no one was there, not even a machine. *When I would call for a status, the robot on the phone would hang up multiple times in a row. *I had to schedule and reschedule several times with my Doctor because my prescription (shot) kept never being mailed for my appointment. This pharmacy does not have their ** together! Do not use them!
My insurance always pushes for getting my medication thru this pharmacy; I have never have a shipment of my medicine on time, there's always an issue with either filling out the Rx; it is a extremely frustrating, time-consuming experience. So hard to deal with them. They approve an override after they can't figure out where my medication is and when my local pharmacy calls, they don't honor it. They have the worst customer service of any company I have to deal with.
I have been told that everything that seems to be the fault of OptumRx is actually the fault of not one but both of my doctors. I have also been told that the doctors must fill out a faxed form and return it within 5 days or the order will be canceled. They have already canceled one order. They claim they will not mail a form to a doctor. They say fax only. When they do cancel an order they email you an 'order has been canceled' email with no contact information on the order. All it says is OptumRx. For them to expect a health care provider to respond to anyone in 5 days is to not be aware of how the world normally works.
We have not used this service in many years. Out of the blue we rec'd a refund for 'member overpayment'. Did anyone else receive an 'overpayment refund'???
In trying to call the 800#, there is no location available in the state the check was issued from. I have repeatedly searched for admin offices and/or other states they might be doing business in and I only find a number in California.
Upon speaking to the service agent to ask if this indeed a valid check (thinking fraud in order to get people's bank account info on endorsed check$), she had no clue about refund checks. I asked her to please look up our account because certainly there M.U.S.T. Be notation on the account if there is a refund issued. She stated she saw nothing and no notation of any kind since our account was inactive.
After spending time with her on the phone, she said that accounting reviews had been done and anyone owed a refund was given one if OptumRx thought they had overpaid. I find this incredulous. How and why would any reputable company issue refunds and not inform phone clerks/service rep$ about such an event in order to answer caller inquiries appropriately.
Today 611/2020 I received a text that a refill was shipped. I did not authorize the shipment and billing of Medicare. As a retired Pharmacist, this is illegal. I called Optum. It is impossible to speak with a Pharmacist. I was on hold for over 10 minutes. The lady said my DR authorize the refill. Which is a total fabrication. I have an appointment with the Physician on 6/24 and he was to reduce the dosage for a different strength. The person cut me off after I mentioned it was illegal to ship a medication without informing me. I cannot use the strength they shipped. I was dividing the pills I have now. This company puts profit ahead of patients. I am complaining to medicare and contesting the payment with my credit card.
OptumRx (formerly Prescription Solutions) Company Information
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