Complaints

This profile includes complaints for Prime Therapeutics LLC's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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Prime Therapeutics LLC has 4 locations, listed below.

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  Prime Therapeutics LLC

  2900 Ames Crossing Rd Eagan, MN 55121-2498

• 

  Prime Therapeutics LLC

  PO Box 64812 Saint Paul, MN 55164-0812

• 

  Prime Therapeutics LLC

  3030 Lexington Ave Saint Paul, MN 55122

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  Prime Therapeutics LLC

  8400 Normandale Lake Blvd Suites 500-800 & 1000-1100 Minneapolis, MN 55437

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:06/15/2023

  Type:Service or Repair 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.

  The Policy when entered clearly stated that my medication was refillable at 70% or 28 days. They changed policy before the end of the current term. This is a practice that is barred in *******. They need to revert back to The 28 Day Rule and if they want to change it after my policy expires December 31st, 2023 they can whilst I can choose a new provider. As of now I cant exit the policy and they cant change the rules/procedures midyear.

  Business Response

  Date: 06/21/2023

  This notification is in regard to the Better Business Bureau Complaint Case #*******. Due to this concern addressing protected health information (PHI) and the protections of the **************** Portability and Accountability Act (HIPAA), we are unable to respond directly to you without a signed and valid Authorization of Release of Information ****** If provided with an *** granting you access to the complainant's PHI, we would be able to provide a response. Please note, since your letter provided a copy of the member's correspondence and/or a description of the issue, we attempted to contact the complainant directly.

  
  On June 16, 2023, June 19, 2023, and June 21, 2023, we attempted to contact the complainant, but the calls were unsuccessful. In order to address the complainant concerns, they are encouraged to contact member services with the number provided on the back of their insurance card. 

  Customer Answer

  Date: 06/24/2023

   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.

• Initial Complaint

  Date:05/08/2023

  Type:Service or Repair 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.

  Starting in Jan 2013 I have been trying to get a reimbursement check for my usual monthly medications for the months of ********* 2022. I cant tell you how many times I have filled out the reimbursement form ( the same form I have been filling out for the past 20 years) only to be told I am filling out the wrong claims form. I have mailed the claims form to the ************* location w/out any issue up until now. The lady from BCBS tells me the form I need to fill out & complete needs to be sent to the ****** ** location , so I did that and that got rejected because I didnt write in the amount of days for each medication I was prescribed so back to the pharmacy I go to get a print out from the pharmacy with all the info needed only to be rejected AGAIN because the pharmacist didnt sign the print out. Now I have been talking to my coworkers and everyone says they have been submitting their claims to the ************* address and all they submit is their receipt (we both use the same pharmacy) for each med. Thats what I have always done but now it seems to me that you guys want me to jump through ***************** in order to get what I have always gotten before. Please explain because no one I have spoken to in customer services can tell me why I have to do all these extras when no one else with the same ins has to.

  Business Response

  Date: 05/09/2023

  This notification is in regard to the Better Business Bureau Complaint Case #*******.Due to this concern addressing protected health information (PHI) and the protections of the **************** Portability and Accountability Act (HIPAA),we are unable to respond directly to you without a signed and valid Authorization of Release of Information ****** If provided with an *** granting you access to the complainant's PHI, we would be able to provide a response. 

  
  Prime Therapeutics is not delegated to handle the complaint.Please note, since your letter provided a copy of the member's correspondence and/or a description of the issue, we have forwarded the complaint to the complainant's appropriate plan to address directly. 

  
  

• Initial Complaint

  Date:05/02/2023

  Type:Service or Repair 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.

  This company is subcontracted by my health insurance *********** They determine wether or not I get approved for my medication. They have continously deny my medically necssary medication. All the approraite documents have been submitted over the course ogf five months. All I get is a run around. My requests have gone through prior authorization, then to appeals, and finally peer review several times. My doctor has made many attemps to call and have been placed on hold for long periods of time. The last alternive I was giving was that my Doctor would have stand by a phone for the next five days between a three hour window period and that they would call to speak to her. As I am sure you can understand that is ridiculous request. My doctor can not spend that time to speak on my behalf. she says she has exhusted the amount of time dealing with this. I am left with no medication feeling ill every day all because this company who is subcontracted by my health insurance to deny me coverage. I make my payment every month. I gather all documents request and I still get denied. It's unfair that these companies are hired to give people like me the run around. It all comes down to the insurance companies do not want to pay.

  Business Response

  Date: 05/25/2023

  Dear ******************,
  Thank you for contacting Prime Therapeutics LLC (Prime). We received your concern where you stated you are not pleased with the prior authorization (**) denials for ***. Specifically, you stated all the appropriate documents were submitted and the requests were denied, and you need your medication.
  
  We understand you are not pleased with the ** denial for *** and would like to fill the medication using your pharmacy benefits. In accordance with your pharmacy benefits determined by Florida Blue, certain medications are a part of a ********************** Program and *** is a part of the program. This program requires your doctor to complete a PA form. The information provided by your doctor will be reviewed to determine if your medication will be covered by your pharmacy benefits.
  
  After review of your account, the ************************** confirmed the requests submitted were appropriately reviewed and denied. Please note, appeals are handled directly by Florida Blue, and they approved the appeal on May 3, 2023, which is effective from May 31, 2023, through Nov. 03,2023. The starter does appeal was approved on May 15, 2023, and is effective from May 15, 2023, through May 30, 2023. Our records show, *** Pharmacy successfully processed a claim on May 17, 2023.
  
  Please note, if this plan remains active prior to the expiration date of the ** your doctor may submit for renewal up to 30 days in advance.
  
  We evaluate all concerns that are brought to our attention, and we will keep record of yours for future reference. Thank you for giving detailed information about your experience. If you have further questions or concerns,please call Prime at ************. Our ************************** is available 24 hours a day 7 days a week.