Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:02/11/2025

  Type:Delivery Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  The insurance company Vivio has repeatedly kept me from getting cancer medication for several years now. Everytime I call for a refill there is a delay and an excuse that causes the medication to be delivered late almost monthly.They are currently telling me that in order to receive my medication that I must apply for a copay card from the drug manufacturer.I have to apply for coupons to use my insurance?

  Business Response

  Date: 02/23/2025

  Dear Better Business Bureau,

  We would like to clarify a few points that may provide some context to the situation.

  Firstly, VIVIO is not an insurance company. Instead, we serve as an administrator for the self-insured employer whose health plan you are on. As such, we operate according to the guidelines and structure established by your employers plan.

  Regarding the use of a copay card from the drug manufacturer, this process is in place as discounts provided by the manufacturer are considered a reduction in the price of the medication. Consequently, the plan only pays the net cost of the drug, which factors in these discounts. Furthermore, it is important to note that any reduction in cost achieved through these discounts is passed on 100% to the plan. This, in turn, results in lower premium costs for both the plan and its members, benefiting everyone involved. Please note that the member is not obligated to sign up for the copay card program, but the plan will only pay the net cost of the drug as described above.

  We'd also like to highlight that VIVIO is a public benefit corporation dedicated to helping every person get the right drug at the right price. We do not benefit in any way from the circumstances youve described. Our goal is always to support patients and ensure they receive the medications they need, in compliance with the employers plan.

  We understand that this situation has been challenging, and want to assure you that we are committed to helping the member navigate this process if they require further assistance.

  Best regards,

  VIVIO

• Initial Complaint

  Date:02/11/2025

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Vivio ************** is a Pharmacy Benefits Manager that makes its money by delaying healthcare to the point that patients and providers simply give up trying to get the needed medications. I wrote a prescription for my patient and was notified I needed to submit a prior authorization (PA). I spent about 20 minutes completing all the details in their request for more information only to be told at the end that I could not submit and instead have to call and speak to a representative at Vivio Health, the parent company. When you call, you are put on hold until you give up. I I work in a busy clinic, this is an inexcusable waste of time and it is by design. Vivio knows providers cannot spend this amount of time on hold and this is why they make the process this way. Companies like Vivio are the reason why the United States spends more money per capita and has some of the worst health outcomes. I was placed on hold for 47 minutes today (2/11/25) before someone answered and when I complained that this was unacceptable and requested a supervisor, they hung up on me. They advertise "driving better health outcomes" which is nonsense. They reduce costs for insurers by denying patients needed health care and it is criminal.

  Business Response

  Date: 02/11/2025

  Better Business Bureau,

  Thank you for reaching out regarding your concerns.

  First and foremost, it's important to clarify that VIVIO is not a Pharmacy Benefit Manager (PBM). We are an administrator for large self-insured employers, and we receive a per-member fee similar to a software licensing fee. Our value to our customers lies in providing the Right Drug for the Right Person at the Right Price. Any statements suggesting that delays lead to higher revenue for us are patently false.

  Regarding the specific points raised by ******************************************************* mentioned spending 20 minutes completing requested information and submitting it via an online portal. We do not have an online portal, so we are unsure what she is referring to.
  Parent *************************** stated that she had to call the parent company. VIVIO Health does not have any subsidiaries or parent companies; we operate as a single entity.
  Wait ************************* suggested that we intentionally increase wait times to discourage providers. We acknowledge that our wait times have been higher than normal, and we are actively implementing measures, including aggressive hiring, to address this. Our goal is to resolve this issue as quickly as possible, and any delays are certainly unintentional. Moreover delays don't benefit us in any way, rather they drive up member/provider dissatisfaction. 
  Healthcare Costs: Ms. ***** mentioned that high healthcare costs in ******* are due to companies like VIVIO. While it is true that the **** spends significantly on healthcare, the majority of healthcare dollars are retained by providers of healthcare services, including hospitals and pharmaceutical companies of which we are neither.
  Call **************************** claimed that we hung up on her. Our records indicate that our concierge team member repeatedly said 'hello' without a response from Ms. ****** suggesting a technical issue.
  Denied Care: Ms. ***** accused us of denying care and reducing costs for insurers. Our employer customers are not insurers. Our concierge team member attempted to call back the number on the caller ID, but it did not work. Further efforts using ****** to find a match to the incoming number led to a call center which had no knowledge of the original call as they said that they had a large number of clinics that they worked with.

  Immediately after receiving Ms. ******* email complaint, our team promptly reached out via email and phone, eventually connecting with her. She expressed a desire for compensation for her wait time and mentioned plans to work with *************************** directly, a company that we are unfamiliar with.

  Unfortunately, we do not have enough information about the member in question to resolve this matter and don't have confirmation that the member is covered by an employer plan that we administer.

  Should Ms. ***** choose to follow up, she can contact us via phone or email. We are also happy to provide all call recordings if necessary.

   

  
  

• Initial Complaint

  Date:01/21/2025

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  When my daughter's information was moved over to this specialty drug management program my phone number nor my husband's information was provided in order to get her set up for a very important medication that keeps her out of the hospital. This company kept telling us different amounts and giving us different pharmacy's while making us spend $360 for one week of medication then $530 for not even a full week the very next week. This company says they see these amounts on our health plan deductible, but our actual insurance shows that we paid out of pocket for these claims. There is something wrong with their system and they refuse to acknowledge it and make it right. There was a manager named ******** that said we would be getting a refund for the $360 and now other managers are saying we are not getting a refund because we were undercharged and that was the issue with why one week we got more pills for less, so they would not be holding to that managers word. The back and forth has had stress extremely high in our household worried that we were not going to be able to afford my daughter's medication and end up split up in the hospital as we had several times the year before getting her this medication. There has been no accountability and they just keep saying that they will coach their team, but that does nothing to right everything we were put through. The many many phone calls (25 to be exact) with over eight hours spent on the phone trying to get them to care. Managers did not get involved until I sat on the phone and demanded to speak to one for five minutes on 1/15/25 otherwise I doubt we would have ever gotten to a manager. There is not real care that they are holding actual lives in their hands because I know a lot of specialty medications can mean life or death with people. If a business has found a solution then they should make sure it is an actual solution before calling the consumer to make sure it is viable not to put them through stressful whiplash.

  Business Response

  Date: 01/31/2025

  Dear Better Business Bureau,

  Thank you for bringing this matter to our attention. At VIVIO, we are a mission-driven organization dedicated to ensuring that everyone has access to the right medication at the right price. We sincerely apologize for any confusion or distress caused in this instance, and we deeply care about making healthcare affordable and accessible for all.

  Upon reviewing the case, as a courtesy we have already issued a refund for the purchase in question. We understand that the member is on a high deductible plan of their own choosing, and we are simply administrators for the plan. As per the plan's rules, all costs were in compliance and accurate.

  To provide further assistance, we identified an alternative supplier that offered the medication at a lower cost, despite not being contracted with us. We facilitated the transaction with this supplier to ensure the member received the medication at a more affordable price.

  We apologize for any part we had in the challenges that this situation has caused the member and their family. We continuously retrain our staff, and this situation has been added to our roster for review on how we can better serve our members.
  

  Once again, we apologize for any inconvenience caused and are here to support our members in any way we can. Please feel free to reach out if there are any further questions or concerns.
  

  Sincerely,
  ****** ****, CEO, VIVIO, ************

  Customer Answer

  Date: 01/31/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***************