OptumRx (formerly Prescription Solutions)

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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Consumer Complaints and Reviews

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This business acts like it is run by teenagers in their basement. Can not deliver their product correctly or on time. Maybe we need to talk to Geoffrey Fieger and see if we can get a response. They are going to hurt people. I logged on and another person's scripts appeared. Can you spell HIPAA?

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What the hell did the state of Michigan go with this company, had to get more approvals for meds that I have been on for 10 years. Plus I have trying to use their Website for two weeks. Keeps says try again later. WHAT A JOKE.

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First, this company no longer covers my migraine medicine; however, OptumRx failed to notify me of this change in coverage. Second, my physician wrote the script for brand name only and OptumRx was processing the order for shipment at a whopping $1650.00. I caught the mistake and notified the pharmacy to stop the order. I contacted doctor's office and they sent in another script while I was on the phone for the generic (which I had already researched on OptumRx's website for $84.00). OptumRx called and left me a voicemail that my order required my attention, so I called (not immediately), and they wanted to verify my address, which they do often. I asked why (since they have my correct address on file). This time, the rep states "the computer wants us to verify it".

She then said the generic prescription would cost $1,000. I said, "no way", I researched it and it costs $84.00. She puts me on hold a couple of times, and the next thing I know I am talking to another rep. I asked what happened, and Teresa said "well, she wasn't really familiar with your plan, so I am going to help you". She proceeds to do whatever they do, and tells me the script will be $1650; I said "no - my physician's office sent in a script for the generic and it costs $84.00." Teresa says "well, we didn't get that script (that was 5-6 days ago). Do you want us to contact your physician's office?" I said yes. Tonight, I checked their website and it states that the request to contact my physician's office may take THREE weeks! THIS IS RIDICULOUS!!! I pay $600 a/yr for OptumRx prescription insurance and this is the service they dish out! I am definitely getting another plan next year.

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I have been forced to use OptumRx by my insurance co UnitedHealthcare, otherwise, I pay full price for my prescriptions. I have emotional and depression issues and my medicine helps me function. I sent in my original prescription hoping the authenticity would not be in question. It's been over two weeks now and I have made three phone calls inquiring about the status of my order. Mind you, I did so after checking online, something was off, which was why I called the first time. I was given lip service and told that I would receive my medication in a few days!

A few days later, I checked online again and saw that it was pending... Again, I called and was told they would ship it overnight! A few days later, I receive an email informing me that there will be a delay! I go online to check my status a third time and it was nowhere to be found! So I call... Again! The excuse this time was that they have tried to contact my Dr's Office for verification and couldn't reach this office! What? Whatever happened to a doctor's prescription being authentic enough... Especially the original? So I call my Dr.'s Office, left them a message about the situation. In 15 minutes, they returned my call and told me that they spoke to the pharmacist and it was settled.

That was four days ago... Still no medicine! Went online to check on the status... Wow, pending response it says! I have no idea what to do anymore. But I feel so bad for my family because I can't function and I need this medicine. Medicine I have been taking for many years now. I am going through withdrawals and it isn't pretty! If anyone has a choice out there, I would run away from this company.

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These people are awful! I have cancelled doing business with them because of their mistakes and ineptness, and they are still charging my credit card. I have had to call my credit card company AGAIN to dispute the charge. It doesn't matter how many times I call OptumRX, they don't take care of the problem. Also, they mailed medications and charged our credit card when we did not request the medications. I had to demand a return label to send them back. All of this takes multiple phone calls and my personal time because I had to make a trip to the post office.

I rather just go the pharmacy and pick up the medications--at least there are no mistakes. DO NOT DO BUSINESS WITH OPTUMRX! Never, again! Their customer service is substandard because the reps promise to take care of the mistakes, and they never do. DO NOT REGISTER YOUR CREDIT CARD WITH THESE PEOPLE! I only wish I had read the 1,000+ reviews before I ever called the first time. Buyer Beware!

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We were turned over to these incompetent folks after my husband's company switched Insurance companies on Jan. 1st, 2017. They have been NOTHING BUT AWFUL to deal with since then. My husband has had a kidney transplant, so he truly CANNOT miss his anti-rejection meds. I started calling this pharmacy on Jan. 3rd to get the transfer of his prescriptions going. 7 days later, I was still arguing with them, getting different answers from each new person I spoke to, and still not getting any prescriptions transferred. We finally had to have his Dr. call the prescription in to Wal-Mart, and pay out of pocket for the expense since our Insurance denied it because we didn't use OptumRx!! How hard is it to call and get 4 prescriptions transferred from his Doctor, to them??? Apparently pretty darn hard. They are incompetent, not helpful and not well trained.

I think I have invested well over 20 hours talking with these people. To the point I have been in tears because I was so angry. I have made a formal complaint to my husband's company. I had to call them again today after I re-ordered a prescription through their online ordering site last night. I called to verify the order today, and they said "We don't show any reorder online". UGH!!! Another hour on the phone with them today. I absolutely cannot stand this horrible company. I was relieved to see that I am not the only customer of theirs who has had issues. RUN AWAY from this pharmacy if at all possible. If you are stuck with them, like us... Good luck! I feel your pain.

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My daughter had a bilateral mastectomy and went through reconstruction, which by the way failed, in 2015. She suffers from post mastectomy pain syndrome. She has tried multiple pain as well as trigger point injections. This company has denied her medications based on the following: no current diagnosis of back injury and the latest, no current diagnosis of breast cancer with life expectancy of 2 years. How pathetic is this? Thankful she doesn't at present have ANY cancer. What kind of background do these people have and the criteria set up is ridiculous to say the least. CHANGES NEED AND MUST BE MADE!!!

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I finally got my doc to send prescription for two meds to OptumRx instead of local pharmacy. She said it would be filled in a few days. A week later, I got a letter from OptumRx saying there was a problem with my account and I had to call. I noticed that they misspelled my name. I called. After tedious voice mail, I finally got to a person who said I had to call my prescription insurance provider to correct my misspelled name, but insurer had it right. Called US Healthcare, took a long time, but thankfully had an intelligent person. He had to put me on a 3-way call with OptumRx to get them to correct the spelling of my name. Took forever, but it was done. Again, got a relatively smart person. Really, the process to correct some stupid typing error by whoever there entered my info delayed everything by a week.

Then I was out for a day, and when I got back at night, I found a message from OptumRx that the first time they mail a prescription, one has to confirm. All those phone calls did not constitute a confirmation! I called in today, Sunday. The last time I talked to them, on Thursday, one med was supposed to arrive tomorrow. I ran out on Saturday. This is not good! So I called to confirm. Took forever to get through to someone. Voicemail wouldn't get me to a person until I refused to answer irrelevant questions. Took this customer service person forever to get my prescription rolling. It won't be here for another 5 days, she told me. A week without meds. Not good. What an unbelievably incompetent company. Good thing my meds are not for high blood pressure, because I know mine is up!

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Bad customer service - incompetence. Last week I contacted OptumRx to order a tier three injectable medication I have been taking for over 45 years. I asked for the total co-pay and was told $131 for a 90 day supply. I agreed with the price, gave them a c/c # and hung up. On Monday 1/30/17 my wife called me from work and asked if I had authorized OptumRx to take $433 out of our account because that is what they had taken. Of course I told her no but I had agreed to a $131 co-payment and I would call them and straighten it all out.

I called OptumRx again and explained that I had not authorized $433 but only $131 co-payment. They gave me reasons. I then cancelled the order and asked them to refund my money because of the possibility of overdraft. They told me it would take 24 to 48 hours to get the money placed back into my account. I told them it was unacceptable, hung up and called UnitedHealthcare. I described the situation to a representative at UHC and he contacted his supervisor and they called OptumRx together. Within 4 hours we had our money back.

That was the good news. Unfortunately, on Friday 2/3/17 OptumRx again took $433 out of our account and when I called them they said the order was in processing and there was nothing they could do to stop the order and refund our money. I then asked for a supervisor to plead my case and after waiting for an hour on the phone was informed that they have no supervisors on staff after 5:00pm on Friday and I would have to wait until Monday for a phone call. At this point, with no money, no medication and, like everyone else who has written a review on this blog, feeling extremely frustrated.

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The State of Michigan changed to OptumRx pharmacy beginning Jan. 1, 2017. I refill one script online that carried over from previous provider that has refills remaining and a week later I get a call that my prior authorization was denied. I called because I had no clue what prior authorization. Took 5 calls, one was disconnected to find out the only thing I could do was have my dr. Appeal OptumRx decision not to give me my meds I have had prescribed to me for 3 years now and worked so well for my horrific neck pain. Other meds I tried did not work. What right do they have to stop my dr. Authorized meds that have no generic. And you are not suppose to stop these meds. I am panicked. What is going on here??? And I could not speak to anyone re this decision???

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I am with the state of Michigan retirees (public schools). I have gone through Medco, Express Scripts, OptumRx now Briova and Walgreens specialty. I have nine different prescriptions eight with OptumRx and up till yesterday have used Walgreens specialty for a special medicine for a rare blood disorder. They have been outstanding. I called them yesterday and they said they no longer can serve me... must be Briova. The cost has gone up to $15,300 for a 30 day supply. With a detectable of $1800. Walgreens specialty have supplied this medicine for two and a half years for a detectable of $40.00. I cannot stop this medication... I can bleed to death. I called early this morning and they said they would call me back. That was nine hours ago???

I ordered the other eight medicines from Optum on Monday with a deductible of $446.00 which I paid... I have been reading the reviews for the past couple of hours (all negative). What is going on with this company??? I only have eight days left and I am out!!! It says not to stop this medicine for any reason... I need some help with this matter (please).

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OptumRx is denying all my medications. Optum denies doctors' requests for branded medications for patient. I show bad reaction with some generic medications, Optum does not accept it. They want me to get some other medication, even I accept to pay full cost out of my pocket. I have hard time to get branded medications from Optum, they deny all of them. Optum is the worst company I have ever had. Please consider before you chose this company. This company and Health Net are scam and cheating consumer. Watch out.

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Thoroughly disgusted with OptumRx. Don't have list of all my meds. Failure to order meds I completed. Being disconnected from rep. Difficult to complete transactions. Slow to deliver meds. Never had this problem with Novixus. Why was Novixus discontinued???

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After struggling with severe and frequent migraine headaches for 30 years, finally my neurologist and I found treatment that has allowed me to work and stay out of the emergency room. For three years, I have been healthy using medicines that are pretty expensive. Thankfully my insurance covered them. Then at the first of 2017, along comes OptumRx to ruin my life. For 3 weeks now I've been on the phone, on hold repeatedly for up to 30 more notes every time, trying to reason with people who know nothing and have no intention of helping me. The company's "system" seems designed to delay, confuse and send consumers in blind circles. When I ask, repeatedly how to get my medication approved, they refuse to give me information that will give a good outcome. My poor doctor has spent hours with these fools filling out papers with repeated denials. They are cheap, rude and border on criminal being their tactics.

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THE worst customer service I have ever dealt with and the sad thing is I am tied into this for a whole year. Where shall I start. The rep I got last night talked to herself throughout the entire call about what she was doing. "When I type too fast the computer doesn't like me." "I have that done now. I will go over here and do this. Good that is done." etc. She took my credit card number and did not charge my medications to it.

Next day I receive email from OptumRx to contact them because they can't process my order. Plus there were two orders on hold. Apparently the rep created two orders and order twice and forgot to delete one. Today I called to try to straighten this out. This rep did charge my card, then sent me to Webtech to help me with navigation. I didn't need that. I asked her why my screen still showed two orders and hers did not (she said), so she sent me flying over to Webtech for navigation, instead of investigating. That person wanted someone else to deal with the problem when it was actually her responsibility. Customer Reps don't know enough about their jobs. The ones I have talked to do not fix situations. They make things worse. I am so astonished that your company thinks that this is OK.

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I thought I'd give mail order a try because of the "convenience". With OptumRx it has been anything but convenient. First, they tell me that the doctor has not contacted them with a prescription for my meds. I have to contact him and set it all up. That's when I thought I'd just let it go. I already had a prescription at my local pharmacy and I thought it could just be transferred. It couldn't so I decided just to let it go. I'll just forego OptumRx and keep things as is. I get my monthly supply from my local pharmacist as usual.

The next month I go to refill and the pharmacist says he can't because I got it refilled elsewhere. A couple of days later an OptumRx package shows up in my mailbox. And don't even get me started about it being the wrong thing (generic instead of brand -- thyroid medicine). That part is still unresolved. I have to pay out of pocket this month and next until my insurance clears the hold. It has been so frustrating to talk to any customer service rep when I call.

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I mailed in 12 prescriptions along with the required order form. After two weeks I checked on the scripts and learned they hadn't even been processed yet. I attempted to call several times and wrote two different emails. After the third week of no action I asked them to return the prescriptions so I could have them filled elsewhere. It took them eight days to respond to that request and so far I have yet to receive the scripts. This company is 100% incompetent and they are not to be trusted with anyone's life dependent prescription drugs. This is the worst meal-in pharmacy ever!

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So the company I work for has OptumRx for our prescriptions. WRONG MOVE!!! Last year I had to convince this stupid company insulin in the US has NO GENERIC!! It took 3 month for them to realize I was right and they were wrong. I did get letters telling me stuff wouldn't be covered this year. No letter for anything and guess what. None of my diabetic meds are covered, Insulin, tablets, test strips NOTHING!! I had my doctor send a prior authorization to the insurance company and the insurance company told me I have to now appeal the denial but most likely they will not approve it. I told the agent if I am put in the hospital then I am getting a lawyer because I am tired of this **. This is the worst insurance company EVER!!

I deal with insurance all the time so Prior Authorizations are common but to tell me once again I have to have generic insulin and generic ** is stupid. It isn't made you idiots. I have type 1 diabetes. The ** has helped me a lot. I have lost a lot of weight and the insulin has been decreased, the insurance company should be happy I am not going to the er or going to the doctor more than I need to because my sugar is way too high. If I am put in the hospital and miss work, worst of all scare my child because I am in the hospital I have all the paper work from the prior authorizations where my doctor told them this is a medical necessity you know so I don't die!! If you or your company are looking at this for your prescription needs DON'T. Find another insurance company!!

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OPTUMRX customers are asked to call 1-888-279-1828 if they are seeking assistance. When you call, you have to go through a lengthy series of questions asked to you by the OPTUM automated voice machine. Then, if you get to speak with a human, the human may not understand your question, and you may not understand what the human is trying to say. That is because you are speaking with someone in the Philippines whose native language is Tagalog, not English. Good luck!

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CalPERS required its members to switch to OptumRx for prescriptions as of 1/1/2017. Our prescriptions were to supposed to transfer over seamlessly from Caremark but not a single one did for me and several for my husband never did. This required us to contact multiple doctors and request new prescriptions. I have been trying repeatedly for the entire month to enroll myself and my husband online and set the other one up as an account manager.

The website doesn't work most of the time and when my husband can actually log on several of the tabs and buttons do not respond. I have never been able to log on and he has been unable to set me up as his account manager after repeated attempts online and after multiple CS reps have told him. They were mailing the paperwork out for him to sign. I have spoken to at least ten different C/S reps who have all told me different reasons for myself not being able to log on, mostly that their website is overwhelmed with all the inquiries.

Why does CalPERS change to a new online pharmacy when they can't insure that the website will be able to handle the volume? This has happened every five years when CalPERS' contract with their existing online pharmacy provider's contract expires and they change to another provider but this time really takes the cake. I would have rated OptumRx a zero but was forced to give them one star.

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My husband and I are new to OptumRx. It is our only choice through employer insurance. Changing prescriptions has been very difficult. They have sent emails about my orders to my daughter-in-law's account (no we don't live together, have the same email or street address or phone numbers) and I have received emails address to her. Isn't that a HEPA violation?

It has taken multiple calls to get prescriptions approved and then the delivery dates are 2-3 weeks out. They suggested that my docs call a local pharmacy and order enough of each prescription to get me by. That was done, but then the pharmacy had to call and argue with OPTUMRX because they said I couldn't get a refill until 3 months later. To top it all off, our prescriptions have doubled and in some cases tripled in cost. I finally got one prescription order okay, but they placed a hold on it because they didn't know if the credit card I had given them was the one I actually wanted them to use.

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I don't know how this company with such a bad customer experience, no problem resolution skills, and very poorly trained employees is still in business. I had to make at least 5 calls to refill 1 prescription, was disconnected multiple times, employees were unprepared to take any customer information or answer any questions.

Since communication by phone was close to impossible, I finally created online account and tried ordering online, which was equally frustrating - the price that displayed and I paid, increased by $620 after I placed the order! Since no one was able to explain how after I authorized the payment, the payment changed I canceled the order and would prefer to pay more but not to use this awful company again ever!

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I have been calling Briova to get my husband medication since the beginning of January. I keep getting the same answers. "We need to get your doctors approval." I call the doctor's office they say "we called it in", but "I'll call again". I call Briova, they say "We need prior authorization," I tell them I talked with the doctor's office, they say wait 2-3 days and "call us back". Today is January 26, 2017, no medication for my husband. The same answers from Briova. He is now approaching his second missed dose. The right hand doesn't know what the left hand is doing. I have talked with many different people from Briova, each one gives me a different phone number or tell me I have the wrong number. I don't know what to do! If I had a choice I would not use this pharmacy, I would not recommend Briova or OptumRx to anyone.

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Only 26 days into the year with my prescription drug program. Two medications I tried to get and both are DENIED. One is a medication I have been on for over 3 months. And, now, this company declines it. Why do I pay insurance if nothing will be covered? Who is the drug company to say what medications I need/don't need? My Dr. prescribes things for a reason. Then they ask for prior authorization. My Dr. jumps through hoops to do that and it is STILL denied! I am BEYOND aggravated. This is completely unacceptable!

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My insurance plan (United) just switched to this evil organization of completely incompetent buffoons. As of Jan 1, they were my mail order company and I was promised a seamless transition via a lovely letter from said buffoons. I have had to call 4 times already to get my prescriptions refilled (heart medication). Each time I call, I get another conflicting story. These people flat-out lie to you. Today I received 1 of 7 prescriptions, apparently I need my DR. to call yet again for the others. Two nights ago they told me something completely different. This company is so bad they make Comcast look like a premier customer service outfit. Unless you need **, you probably die using these people.

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I think OptumRx has the worst customer service with regard to the well being of the patients they serve. My spouse has been on several medications for RA. They are denying the next in line med to prescribe by his physician. They send paperwork to us to fill out regarding information the physician can only complete. Optum states they call the physician, the physician says they didn't. They say they did and so on and so forth. For a month now this has been going back and forth and the patient is suffering for it. What do they care, pick up the phone and call the physician. They are so incompetent. Where is the compassion for their suffering patients. I have never been so infuriated by their lack of communication, respect and compassion for the customers they serve.

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Left on hold for 25 minutes each time I was transferred. I was transferred 3 times because either representative did not have an answer or didn't want to do the work. Very very frustrating. Issue never resolved. Not sure who I have to work with. So disappointed this is our new insurance. Hope they hit it for a bargain because it's not worth a penny!

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A phone order was placed on 1/10/17 for several prescription medicines. Customer service rep acknowledged the order and repeated the list of meds to be shipped. A price was given and we were told the order would be shipped within three days. 8 days later on 1/18/17 the order was received less one critical blood thinner. Another phone call to OptumRX customer service and we were told that she could not tell why the medicine did not ship but that she would immediately ship out that order overnight and we would certainly have it by 1/20/17. No meds on 1/20. No meds on Sat 1/21. No meds on Monday 1/23 but we did get a letter saying that the drug was not covered by the plan and that we could file for an exception. We had been on that med for a year and OptumRX had contacted the Doctor on the first RX to get that out of the way.

I called OptumRX customer service and was met with a customer service representative named BECKY that took no responsibility for their failure to ship the drug. "We were given a paper when the exception was originally filed that stated an expiration date." It was our responsibility to know that the exception had expired. It was not the responsibility of OptumRX to get the exception nor to notify us that the drug was not being shipped.

OptumRX had our phone number in their computer. They had our email address. They had the Doctor's name address and phone number. But they called no one and shipped no drug. Meanwhile the critical blood thinner required was provided only through a special 75 mile trip to the heart doctor's office for one week of samples. They are almost gone and of this writing, no drugs are being shipped. To get them shipped, I must contact the Heart Doctor and have him contact the pre-authorization department at OptumRX and then if they approve, they will ship it.

This is not the first time that this incompetent organization screwed up the shipment but I do think it will be the last. I may have to pay more at the local pharmacy, but I will not have to deal with an organization that is so disorganized and so uncaring. I got the feeling that it would be of little concern if one of their customers died because they couldn't get their medicine.

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As an adult, I have been taking medication for ADD for over 3 years. When I went to pick up my monthly prescription at the pharmacy, I was told there was an issue with my insurance and that they were unable to fill my prescription. I immediately contacted OPTUM and was told that my psychiatrist needed to fax a pre-authorization form to OPTUMRx before my prescription could be filled - this was the FIRST time I had heard anything about pre-authorization being necessary (although OPTUM claimed it has been a policy for years). Needless to say, my psychiatrist faxed the pre-authorization form to OPTUM asap and was informed it could take 24-72 hours to approve...that was 5 days ago and I still do not have my medication!

After following up daily, I was informed yesterday that it could actually take up to 7 business days unless my case is considered urgent and that the medication is vital to my health. Well, yes it is...as it affects my overall ability to function at work, at home, and in my daily activities as a parent. I am astonished by OPTUMRx's lack of professionalism and blatant disregard for the well being of its members (patients). It is extremely unsafe to put patients like myself in a situation where they go for DAYS without their PRESCRIBED and AUTHORIZED medication(s). My psychiatrist is submitting an expedited appeal so hopefully things will be resolved by today as it is negatively affecting my life. Bottom line, be prepared to go without your medication for an extended period of time - regardless of the negative impact it may have on your overall functioning.

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I have read all of the other complaints and AGREE 100% with all of them. The pharmacy denied me medication because I did not meet the criteria to take it but in fact I had met the criteria and OptumRx had even filled the criteria medication. After lying about this for 3 months it finally got approved. In a different year so instead of 0 copay 2016 its now $400. I am being punished for this dysfunctional company of OptumRx. How can pharmacists get away with this?

Expert Review

ConsumerAffairs Research Team

The ConsumerAffairs Research Team believes everyone deserves to make smart decisions. We aim to provide readers with the most up-to-date information available about today's consumer products and services.

OptumRx is a healthcare management company that offers pharmacy benefit management solutions to organizations across the healthcare industry. Their pharmacy solutions include home delivery services, member engagement, pharmacy management and specialty pharmacy management.

  • Member engagement: OptumRx focuses on educating its members through personalized tools and 24/7 support. Their mobile application lets members refill or renew home delivery prescriptions, locate a pharmacy and find generic drug prices and discounted prices. OptumRx also gives its members the option to receive text messages to remind them when to take their medications.
  • OptumRx home delivery: The OptumRx home delivery service includes free standard delivery to United States addresses and territories. New prescriptions will arrive within 10 business days, while refills will arrive within seven business days. Members can create accounts with OptumRx, select their medications and place orders. OptumRx will contact primary care doctors and licensed medical professionals for approval as needed.
  • Pharmacy benefit management: OptumRx pharmacy benefit management solutions focus on optimizing its members’ health through monitoring and engagement. It teaches members about safe medication use and cost-effective treatment options.
  • Specialty pharmacy management: OptumRx helps specialty pharmacies by identifying trends in specialty care and creating clinical programs to help alleviate costs. Their website includes resources on specialty conditions, one-on-one video consultations with pharmacists and information on how to increase adherence to specialty drugs.
  • Accreditation: OptumRx holds multiple accreditations with URAC, including one for specialty pharmacy services, pharmacy benefit management and drug therapy management. They are also accredited by VIPPS and the NABP.
  • Best for organizations needing pharmacy benefit management solutions.

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OptumRx (formerly Prescription Solutions) Company Profile

Company Name:
OptumRx
Website:
https://www.optumrx.com/RxSolWeb/mvc/home.do