Business Profile

Health and Wellness

Express Scripts

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Important information

Customer Complaint:
Better Business Bureau has received a pattern of complaints against Express Scripts. Complainants allege billing issues, difficulty obtaining a prescription, and poor communication with the company.

Complaints

This profile includes complaints for Express Scripts's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

1,554 total complaints in the last 3 years.
492 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

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:08/23/2022
Type:Billing 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.
On 28May22 I purchased a much needed prescription from *** ********. I have an insurance plan with Express Scripts, but I did not have my Express Scripts insurance card on me at the time of purchase so I paid the full amount of $33.44 for the prescription. I filed a reimbursement claim with Express Scripts as I have a plan with them and this prescription would be mostly covered under their plan. However, they denied my claim simply because I didn't have the insurance card on me at the time of purchase. I filed an appeal as well, and they maintained their rejection of my claim. It does not seem fair at all to deny a customer this reimbursement simply because they did not have a paper card stating they were covered. I was incredibly ill at the time of the prescription purchase so I was not going to delay obtaining that prescription simply because I did not have my insurance card on me.
Business Response
Date: 09/09/2022

I am in receipt of your letter regarding a complaint filed
by *** *********. As a result of your
letter, Express Scripts reviewed *** *********’s concern and would like to take
this opportunity to respond.

By way of background, Express Scripts administers
prescription drug benefit plans on behalf of plan sponsors. Express
Scripts provides plan sponsors with “core” pharmacy benefit management
services, including third-party claims processing, formulary administration,
benefit plan communications, and other similar activities. Express
Scripts’ home delivery pharmacy provides home delivery of prescription
medications to beneficiaries of the pharmacy benefit plans sponsored by the
clients. These services, contracted by the plan sponsors, satisfy the
plan sponsors’ goals of providing a cost-effective, seamless and clinically
appropriate benefit for its patients.

*** ********* expressed concern stating Express Scripts
Pharmacy denied his request to secure reimbursement for an out-of-pocket
expense and requested a refund. The
direct claim in question, dated May 28, 2022, was processed based on the amount
approved versus the amount submitted in accordance with his prescription plan
guidelines. As a result, the amount
approved of $6.44 was applied to *** *********’s copayment resulting in $0.00
reimbursement.

I trust this letter has been
responsive to your request for information regarding this complaint. If you have any questions regarding this
matter, or desire any further explanation or information, please contact me
directly at ***** ********.

Sincerely,

Senior Manager, Executive Correspondence
Customer Answer
Date: 09/12/2022
Complaint: ********

I am rejecting this response because there is no indication why Express Scripts did not reimburse me. I have an Express Scripts account and simply did not have my card on me at the time of the prescription purchase.

Sincerely,

*** *********
Initial Complaint
Date:08/20/2022
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.
Express Scripts has failed to respond to any online claims or queries for claims. They have continued to deny claims for frivolous reasons (e.g. requiring physical address of online/virtual pharmacy on receipts) and ignored all online submissions submitted over the past few months. Instead of responses to questions on how they are working to correct deficiencies with online services, I get a scripted/automated reply to visit my local installation for printed forms. The same forms are online for easy download indicating their outdated automated response is at least a decade old and obsolete. Forms mailed in are a roll of the dice with some processed with others denied for minor administrative details (Patient's name not legible) despite having the same master receipt that was previously accepted. *** entities need to do a better job for their members!!
Business Response
Date: 09/09/2022

I am in receipt of your letter regarding a complaint filed
by *** ******. As a result of your
letter, Express Scripts reviewed *** ******’ concern and would like to take
this opportunity to respond.

By way of background, Express Scripts administers
prescription drug benefit plans on behalf of plan sponsors. Express
Scripts provides plan sponsors with “core” pharmacy benefit management
services, including third-party claims processing, formulary administration,
benefit plan communications, and other similar activities. Express
Scripts’ home delivery pharmacy provides home delivery of prescription
medications to beneficiaries of the pharmacy benefit plans sponsored by the
clients. These services, contracted by the plan sponsors, satisfy the
plan sponsors’ goals of providing a cost-effective, seamless and clinically
appropriate benefit for its patients.

*** ****** expressed concern stating Express Scripts continues
to deny his request to obtain reimbursement for out-of-pocket expenses. Upon review, Express Scripts has not received
or denied any direct claim on behalf of *** ******. As a result, outreach was made to *** ******
to secure additional information; however we have been unsuccessful in
reaching him. As a result, direct claims
forms were mailed requesting *** ****** to complete and return for processing.

I trust this letter has been
responsive to your request for information regarding this complaint. If you have any questions regarding this
matter, or desire any further explanation or information, please contact me directly
at ***** *********

Sincerely,

Senior Manager, Executive Correspondence
Initial Complaint
Date:08/17/2022
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.
Express Scripts has left me without my anti depressant medication for several weeks now !! say it has been shipped like three weeks ago called and and wanted help so they sent another refill still no meds say it in a town a hundred miles from me this has ben weeks .Called them and asked to go to local pharmacy and they switched my presciption .Went to local pharmacy they wont fill for another month because Express Scripts says they shipped mine for the month !!!! So i called Express Scripts to find out why They said i could purchase a few out of pocket from local pharmacy !!! So here i sit without meds for another month !! Dont know what recourse to take *****
Business Response
Date: 09/02/2022

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed
by *** ******. As a result of your
letter, Express Scripts reviewed *** ******’s concern and would like to take
this opportunity to respond.

By way of background, Express Scripts administers
prescription drug benefit plans on behalf of plan sponsors. Express
Scripts provides plan sponsors with “core” pharmacy benefit management
services, including third-party claims processing, formulary administration,
benefit plan communications, and other similar activities. Express
Scripts’ home delivery pharmacy provides home delivery of prescription
medications to beneficiaries of the pharmacy benefit plans sponsored by the
clients. These services, contracted by the plan sponsors, satisfy the
plan sponsors’ goals of providing a cost-effective, seamless and clinically
appropriate benefit for its patients.

*** ****** expressed concern stating he did not receive a
medication from Express Scripts Pharmacy. The medication in question was shipped, on August 5, 2022, via the
****** ****** ****** *******; however, the order was lost in transit. As a result, another order was shipped on
August 12, 2022, via the ****** ****** ****** *******, that was delivered on
August 18, 2022. Additionally, the
prescription in question was transferred to ********* ******** per *** ******’s
request.

I trust this letter has been
responsive to your request for information regarding this complaint. If you have any questions regarding this
matter, or desire any further explanation or information, please contact me directly
at ***** ********.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Customer Answer
Date: 09/06/2022
Complaint: ********

I am rejecting this response because:I was still without meds for two weeks !!! They shoud overnight in these situations --*****

Sincerely,

***** ******
Initial Complaint
Date:08/17/2022
Type:Billing 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.
^6/2022 My husband was on a co-pay assitance program thru *******. The funds ran out but they still sent more medicine. leaving a $1,600.00 balance. We offered to send the prescription back but they would not take it. We cannot afford to pay this and they dont care. They said we should have kept track of it. They said we have to pay it. How can we if he was on a assistance program to begin with. He now has a co-pay assistance program thru ******.
Business Response
Date: 09/02/2022

I am in receipt of your letter regarding a complaint filed
by *** ******. As a result of your
letter, Express Scripts reviewed *** ******’ concern and would like to take
this opportunity to respond.

By way of background, Express Scripts administers
prescription drug benefit plans on behalf of plan sponsors. Express
Scripts provides plan sponsors with “core” pharmacy benefit management
services, including third-party claims processing, formulary administration,
benefit plan communications, and other similar activities. Express
Scripts’ home delivery pharmacy provides home delivery of prescription
medications to beneficiaries of the pharmacy benefit plans sponsored by the
clients. These services, contracted by the plan sponsors, satisfy the
plan sponsors’ goals of providing a cost-effective, seamless and clinically
appropriate benefit for its patients.

*** ****** expressed concern stating her husband received an
invoice from Express Scripts specialty pharmacy, *******, and requested a
refund. The prescription in question was
ordered, via the automated system; however, it did not provide a copayment
amount even though *** ****** Copay Assistance funds were depleted.

In an effort to resolve, a one-time courtesy copayment
credit in the amount of $1,622.18 was applied to *** ******’ account on
September 1, 2022, resulting in a $125.92 balance.

I trust this letter has been
responsive to your request for information regarding this complaint. If you have any questions regarding this
matter, or desire any further explanation or information, please contact me directly
at ***** *********

Sincerely,

Senior Manager, Executive Correspondence
Customer Answer
Date: 09/20/2022
THANK YOU!! We have been trying for months to get this resolved.
Initial Complaint
Date:08/15/2022
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.
I went to fill my prescription at the local pharmacy and I was informed that Express Scripts had denied payment and that it would be refilled for $430 for a 1 month refill. Express Script had previously filled the prescription for $25 for a 1 month refill at the same local Pharmacy.I called Express Script and the agent said this was quote "Punishment" charge. She used the word, not me. That I would have to switch Express Script home delivery for 3 months worth costing $120. So basically I am now paying 60% more for the same prescription. There were no phone calls, email, or mail that I would get charged $430 for the refill as punishment. I can no longer go to my preferred local pharmacy. Express Script never explained why I was being "punished" for taking my medicine. There is no explanation of Punishment charge on their website. Lastly, this prescription must be refrigerated or it starts to break down in the heat, so I have valid concerns with the delivery via mail.
Business Response
Date: 08/29/2022

August 27, 2022

Better Business Bureau Serving Eastern ******** and Southern ********
**********************************************************
Attn: Dispute Resolution Department

Re: *********************** / # ********

Dear Sir/*****:

I am in receipt of your letter regarding a complaint filed by ***************** As a result of your letter, Express Scripts reviewed Mr. ******* concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

**************** expressed concern stating he was required to pay a $430.58 copayment for the medication in question at his retail pharmacy. According to Mr. ******* prescription plan guidelines, he can fill the medication three times at the retail pharmacy before his copayment increases; therefore, he was assessed the appropriate copayment for his fourth retail fill. As a result, **************** will need to use Express Scripts mail-order pharmacy in order to pay his standard copayment.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 08/29/2022
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,

***********************
Initial Complaint
Date:08/15/2022
Type:Billing 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.
I contacted Express Scripts about getting a 90 day prescription for the drug ********. I was told that the price was unknown until the RX was submitted by my medical provider. So on July 26th I recieved an email stating "please confirm your shipping address". So I called express scripts and the representative told me the amount would be $125 for the RX. I told her to cancel it because it was too expensive. She told me no problem she would cancel it and told me she would forward my account bill to Accounts Recievable to get corrected. I called in again on August 11th and was told that my account still showed $125 balance and after telling a different representative about my case she said she would forward it to AR again. I have not heard anything back from the company as far as correcting my $125 balance. I am not responsible for a RX that i did not approve and they sent it anyways. I told them to cancel it and they never did. Why am i being billed for a product I never agreed to ship.
Business Response
Date: 08/29/2022

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by *** ******. As a result of your letter, Express Scripts reviewed *** ******’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

*** ****** expressed concern stating Express Scripts Pharmacy dispensed a medication that she did not order and requested a refund. The prescription in question was received on July 21, 2022 from the prescriber’s office; however, address verification was required. As a result, *** ****** called Express Scripts Pharmacy, on July 26, 2022, to cancel the order yet the order could not be stopped as the medication already processed and shipped on July 26, 2022.

In an effort to resolve, a one-time courtesy copayment credit in the amount of $100.00 was applied to *** ******’s account on August 22, 2022 resulting in a $0 balance.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Initial Complaint
Date:08/11/2022
Type:Billing 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.
Express Scripts insists we have our dr write meds for a 3 months supply at a time, and that we fill it through them. They claim they will be cheaper. They have a page on their website to check pricing for meds at a local pharmacy vs them. I have Ciclopirox shampoo. It said it would be $10 for ONE bottle at the local pharmacy and that it would be $20 for THREE bottles through Express Scripts. I had my dr write the script for 3 bottles and send it to Express Scripts. Express Scripts proceeded to send me only ONE bottle, and charged my account $20 for it. This is rx # ************. I sent Express Scripts an email and told them there was no way I was paying $20 for ONE bottle when they were supposed to send me THREE bottles for that price. I said "you need to either send me my other two bottles and NOT add another charge to my account, or else you need to drop the amount I owe on my account to $6.67 since that's what $20 divided by 3 is." They wrote back and said they informed a pharmacist to send me the other two bottles, and that "An order is in process for the quantity that was shorted." That was a week ago, August 4th that they said that. Today their automated email informed me that they just sent out ONE more bottle instead of the TWO I was shorted, and they charged my account another $20. This new bottle is rx # ************. It should have been the same rx # but it's not. So now they have my account total of what I owe as $40, for TWO bottles total, when I'm supposed to have THREE bottles and it's only supposed to be $20 total for those THREE. They are LYING on their pricing page, and they are NOT doing what they said they would do in their email to me. I will NOT pay $40 for TWO bottles when they said it would be $20 for THREE bottles. I want them to drop the amount I owe on my account to $13.33 instead of $40, because when they say THREE bottles will be $20 total, that brings them to about $6.66 per bottle, and they sent me only ONE bottle two times.
Business Response
Date: 09/01/2022
September 1, 2022

Better Business Bureau Serving Eastern ******** and Southern ********
**********************************************************
Attn: Dispute Resolution Department

Re: *************************** / # ********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by ******************. As a result of your letter, Express Scripts reviewed Mr. ******** concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services, including third-party claims processing, formulary administration,benefit plan communications, and other similar activities. Express Scripts home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

****************** expressed concern stating Express Scripts Pharmacy dispensed one bottle instead of three bottles and requested a refund. According to Mr. ******** prescription plan guidelines, the medication in question is covered for a maximum quantity totaling 120ml within a rolling 21 day period or 360ml within a rolling 63 day period. A new prescription was received, on July 22, 2022, for three 120ml bottles; however,the quantity was reduced to one bottle based upon the directions. As a result, ****************** called Express Scripts Pharmacy for the three bottles; however, one bottle was shipped in accordance with Mr. ******** prescription plan guidelines since he secured one bottle on July 21, 2022 at the retail pharmacy and another bottle on July 22, 2022 from Express Scripts Pharmacy.

In an effort to resolve, a courtesy copayment credit in the amount of $10.00 was applied to Mr. ******** account on August 19, 2022 for the original order. Additionally,another copayment credit in the amount of $10.00 was applied to the account on August 25, 2022 for the second order.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 09/01/2022
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution will be accepted by me due to the fact that they will not do what I asked for pricing and will not admit to their screwup.

Sincerely,

***************************
Initial Complaint
Date:08/10/2022
Type:Billing 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.
I have contacted the company numerous times in regards to a bill that they continue to send me that is not accurate. They continue to send me a bill when I have spoken with ******* and this is not accurate at all. I have contacted the company multiple times and gotten nowhere, no help, or resolve. Or talked to anyone who seems to understand the situation and how poorly this reflects the company. I have asked to speak with supervisors and for callbacks and was told this was taken care of and yet here another bill arrives. First and foremost they need to submit this to my insurance company which they have not done. Second, they have submitted to my insurance company three different times claiming 60 injections each time. I started these injections in November 2020 and ended them in March 2022 doing two injections a month. This equals out to a total of 32 injections. Yep they have build my insurance company multiple times at 60 injections each when I have only had 32 since starting them… and are now trying to send me a $38 bill for another two injections for March . I called and requested they send me proof for all injections they billed my insurance company for to which they never did it was never received. I was told they would submit this bill to insurance months ago yet I just got another bill in the mail from them again even though my insurance has paid them well over the amount of injections I have actually had. At this point it seems like there is some insurance billing fraud going on here by this company and it’s now trying to trickle it down to the patient and bill me for something they’ve already gotten payment on and should be billing to insurance.
Business Response
Date: 09/02/2022

I am in receipt of your letter regarding a complaint filed
by *** ********. As a result of your
letter, Express Scripts reviewed *** ********’s concern and would like to take
this opportunity to respond.

By way of background, Express Scripts administers
prescription drug benefit plans on behalf of plan sponsors. Express
Scripts provides plan sponsors with “core” pharmacy benefit management
services, including third-party claims processing, formulary administration,
benefit plan communications, and other similar activities. Express
Scripts’ home delivery pharmacy provides home delivery of prescription
medications to beneficiaries of the pharmacy benefit plans sponsored by the
clients. These services, contracted by the plan sponsors, satisfy the
plan sponsors’ goals of providing a cost-effective, seamless and clinically
appropriate benefit for its patients.

*** ******** expressed concern stating she received an
invoice in the amount of $38.00 from ******* and requested a refund. *** ******** was charged the correct
copayment that was dispensed on March 9, 2022 in accordance to her prescription
plan guidelines. Prior to the March
shipment, claims were billed towards *** ********’s medical benefits; however,
******* is now required to bill *** ********’s pharmacy benefits based on
changes according to her prescription plan guidelines.

I trust this letter has been
responsive to your request for information regarding this complaint. If you have any questions regarding this
matter, or desire any further explanation or information, please contact me
directly at ***** ********.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Customer Answer
Date: 09/06/2022
Complaint: ********

I am rejecting this response because:

Because my current plan is ******* prime remote and this medication was authorized, prior authorized through the medical side not the pharmacy side. This medication has zero co-pay and if you review the documents submitted the first time insurance has already paid for these injections multiple times well above What has been sent out to me as a patient I only did these injections for less than a year and insurance has been billed multiple times at 60 injections each time when I only do two a month there has been some insurance billing fraud as this is in accurate and the company refuses to provide documentation of where all these injections went that they billed for.

Sincerely,

******** ********
Business Response
Date: 09/27/2022
September 27, 2022
Better Business Bureau Serving Eastern ******** and Southern ********
211 ***********, Suite 2060
***********, ** 63102
Attn: Dispute Resolution Department
Re: ********************************* / #********
Dear Sir/Madam:
I am in receipt of your letter regarding a complaint filed by ********************. As a result of your letter, Express Scripts further reviewed Ms. ********* concern and would like to take this opportunity to respond.
******************** indicated that her issue is unresolved stating the medication in question should have been billed to her medical benefits and requested a refund. As previously discussed, prior to the March shipment, claims were billed towards Ms. ********* medical benefits; however, Accredo is now required to ****************** pharmacy benefits based on changes according to her prescription plan guidelines. In an effort to resolve, a one-time courtesy copayment credit in the amount of $38.00 was applied to Ms. ********* account resulting in a $0.00 balance.
I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.
Sincerely,
**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 09/27/2022
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. I would however like to add, when your representatives are calling to place orders and prior auths have been done via tricare prime remote on the medical side for these continued injections they should really advise patients of any changes instead of stating it looks like nothing has changed your copay is zero would you like to continue with the order, per the prior auth that was done on these injections with tricare prime remote on the medical side we have no copay or deductible for these.

Sincerely,

*********************************
Initial Complaint
Date:08/10/2022
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.
My doctor sent prescription refills to Express Scripts for my husband myself although they were directed to send them to our local pharmacy. I contacted Express Scripts on 8/9 and spoke with **** who canceled my order. He never once stated there was issue with canceling this order. Today on 8/10 I received confirmation midday that the order prescriptions were shipped. I contacted Express Scripts who told me that I would pay for the prescriptions even though I had canceled the order. I then spoke with **** who was a director at Express Scripts.
Business Response
Date: 08/29/2022

I am in receipt of your letter regarding a complaint filed by *** **********. As a result of your letter, Express Scripts reviewed *** **********’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

*** ********** expressed concern stating she received medications from Express Scripts Pharmacy that she did not order and requested a refund. The prescriptions in question were received, from the prescriber’s office, on August 9, 2022 and notification was sent to *** **********. As a result, the medications were shipped, on August 10, 2022, via the ****** ****** ****** *******.

In an effort to resolve, a one-time courtesy copayment credit in the amount of $53.14 was applied to *** **********’s account on August 25, 2022 resulting in a $0 balance.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Initial Complaint
Date:08/09/2022
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 keeps denying my prescription that I have been taking for years for absurds reasons, they try to defeat you so you give up and don’t use their service and they save money, it’s definitely an illegal maneuver since what do they want to authorize the medication does not make any sense, they want 2 blood test , it’s like asking someone to break the arm twice before helping them , one blood test shows low enough levels that justify the requirement of the medication, I never had any problem getting this medication from a different provider in the past with the same levels, this company keeps transferring you from one department to another making you wait 45 minutes or more at each time , trying to discourage you to keep trying, doing this people will choose to pay full price for their medication instead going through the pain of dealing with this company. I never experienced anything like this, these people are practicing a scheme to make tons of money not helping people and denying claims.
They don’t even transfer you to a manager or a supervisor, as soon as you ask they hang up on you.
I never experienced anything like this before.
Business Response
Date: 08/31/2022

I am in receipt of your letter regarding a complaint filed by *** *******. As a result of your letter, Express Scripts reviewed *** *******’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

*** ******* expressed concern with challenges receiving his medication from the retail pharmacy. According to *** *******’s prescription plan guidelines, the medication in question requires Prior Authorization (PA) to allow for coverage. *** *******’s prescriber initiated the coverage review, the PA was approved on August 25, 2022 and is valid until August 25, 2023. As a result, the retail pharmacy processed a successful claim on August 25, 2022.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ***** ********.

Sincerely,

***** ************
Senior Manager, Executive Correspondence

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