WTF Wednesday: Why Doesn’t Caremark Care?

Sometimes fact really is stranger than fiction. I mean, stuff that you couldn’t dream up if you tried. Stuff that results in a lengthy blog post that absolutely demands a number of ALL CAPS and italics instances, as well as a record number of f*cking curse words to convey my frustration. Demands.

I have whined before about the requirement that I use a specialty pharmacy; there is always some kind of problem. The other day, I had two pieces of mail. One was a refund check from Caremark, for $130 in co-pay overpayments. The other was a thick stack of collection notices from…bet you’re catching on…Caremark.

First of all, WTF? Second of all, I pay all my bills on time. But I am extra vigilant about things like my health insurance premiums and drug co-pays. For obvious reasons. So the overpayment didn’t surprise me; I make a payment every time I order meds, just in case. Then I get a bill and typically pay that too. Because the last thing I need is even more drama from Caremark. But despite all that, they have still managed to f*ck this up. Royally.

Prepare to turn this puppy up to 10

Prepare to turn this puppy up to 10

I call the debt collector first, assuming even they will be easier to deal with than Caremark. They are stumped and tell me to call Caremark. I tell the woman I would rather stick a hot poker in my eye than call them, and she seems to be empathetic, but still unable to help me. She does however give me the number she uses to call billing, in an attempt to get me straight through. It was an act of kindness.

I call her number for Caremark billing, where the auto-attendant strongly, repeatedly, encourages me to leave a message and hang the f*ck up. No. Not gonna do it. Standing tough (well, sitting tough), I wait and wait and wait. After nine minutes I finally get an alleged human. I try to explain the situation but she cuts me off and tells me she can’t do anything until she gets my info, blah blah blah. After two minutes that seems like a lifetime, she comes back and tells me they don’t have me in their system. I go on a rant and she decides to check again, under the name I actually gave her rather than the wrong name she wrote down. Voila! There I am.

I explain everything and get a heavy sigh. SHE is annoyed with ME. Then she places me on hold for another five minutes. Literally.  When she finally comes back she claims she has a solution! Something so brilliant that it required consulting with her supervisor, which explains the long wait. Her triumphant moment is…I should deposit the check and then pay the credit collectors. I said “you’ve got to be kidding right? You’re not actually suggesting I do this?” Crickets. I tell her this sounds like the solution that works best for her, by putting the problem back on me, and my account will still be a mess. I ask to speak with her supervisor. Hold AGAIN, only to be told she is happy to put me in his voice mail.

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I leave an admittedly lunatic rant voice mail for the supervisor. I finally hang up and notice I missed a call while I was sitting on hold. It was CAREMARK. Calling me to refill my prescriptions.

Fine. I call the refill number back and jump through all the usual hoops to get the three meds refilled. On the very, very off chance that she can help, I explain my collections/overpayment problem to the pharmacy rep. She suggests I call billing. I tell her I did. She suggests I ask to speak with a supervisor. I tell her I did. Crickets.

Running out of options, I call the number on the letter that came with the check.. It is a general, ten tier phone tree about ALL medications Caremark f*cks up services. Has nothing to do with billing or overpayments. I sit through the phone tree and eventually get through to a human.  I go through the whole thing again and she of course puts me on hold. She finally comes back and says “my reimbursement team will not accept your call. This is a billing issue.” Are you f*ing kidding me? Am I being punked? I lost it. I mean I full on went batshit crazy. I reminded her that I am the actual customer and that I want to speak to someone empowered to solve this problem. She tells me she will transfer me to her “escalation team.” More hold. Minutes on end. She comes back to tell me the escalation team will not accept my call because this isn’t their department. I’m not kidding you. That’s what she said. Then she offered to transfer me to billing. I offered to slash my wrists instead, as that seemed to be the only way to solve this problem. Well, for me anyway.

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Unbelievably, the supervisor from billing actually calls me back. Makes all pretense that he is going to be helpful right before he spectacularly proves he is not going to help me. And although he has called me, and I have left him a detailed message about the problem, he makes me go through the whole thing again just so he can of course PUT ME ON HOLD for a good amount of time before coming back and saying he has no idea who sent the check or why, but if I want to avoid credit reporting on my “overdue” co-pays, he is happy to take my credit card number and call the balance back from the collection agency.

I take a breath and decide to try another angle; I address the issue of insurance fraud. As in, if you are double billing me and can’t figure it out, then you are probably double billing my insurance company as well. He tells me he can print a statement of all the payments ever made by me and by my insurance company. I point out that is not helpful since clearly there is another department somewhere that has different records that DON’T MATCH. He says that would be my responsibility to research.

Controlling myself enough to use my inside voice, albeit dripping with sarcasm, I suggest that perhaps he take responsibility for researching? Just a thought. Clearly a novel concept for him. He pauses then in a last ditch attempt to get me off his back he tells me it could take a week or more for him to figure out. I tell him that’s just fine. He is clearly pissed now. Yeah buddy, well me too.

Now I am on an absolute mission. Ride or die. I try to find a number for corporate headquarters. I can’t get a human, even when I look up investor relations and the annual report. Just another customer service email. So I send them this whole story. And this is the response I got:

Dear Ms. Hirsch:

Thank you for contacting CVS Caremark. We strive to provide quality customer care to every one of our plan participants.

We show that your medication is handled by CVS Caremark’s Specialty Pharmacies. For specialty billing information, please contact our specialty pharmacy directly at 1-800-237-2767 for immediate assistance. Specialty pharmacy representatives are available from 6:30 AM until 8:00 PM CST, Monday through Friday. Specialty Pharmacy has their own website which you may access at www.cvsspecialty.com/.

Should you need additional assistance, please respond to this e-mail or you may contact Customer Service at 1-800-241-3371. We appreciate the opportunity to serve all of your prescription benefit needs and to help you better manage your health.

Surely I’m being punked, right? Tell me this isn’t real.

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As what appears to be my final recourse I have filed a suspected fraud complaint with my insurance company, which they will likely do absolutely nothing about. But I want a record of this clusterf*ck so I don’t get in trouble down the road for depositing the f*cking check, which I guess is what I’m going to have to do.

I am mad as hell and would very much like to NOT TAKE IT ANYMORE. But I’m screwed, because I have absolutely no choice but to use this pharmacy and watch them rake in thousands of dollars a month for being incompetent a**holes.

I’m trying to recall why I ever stopped drinking, and consider consuming large quantities of alcohol when I remember I’m already on enough drugs.

So WTF Caremark? WTF?

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14 Responses to WTF Wednesday: Why Doesn’t Caremark Care?

  1. Carol Ferenc says:

    Unbelievable! I’m so sorry you have to deal with this, Jill. No one should have do deal with jerks like that. It sounds like it’s resolved now but if this ever happens again, you’ve gotten a lot of good advice here.

    • Jill Foer Hirsch says:

      There will always be something with them, no doubt. I just hate feeling helpless in these situations. I spent my career being the person who got sh*t done, even when it didn’t seem feasible. I took a lot of pride in that. So this feeling of not being able to resolve a problem just really sucks, on top of the obvious inherent aggravation.

  2. Pam Waits says:

    Ugh – this is horrible! I’m glad it’s resolved but who knows when it’s going to happen again? Wouldn’t you just love to tell them you won’t accept their incompetence because it isn’t your department? No kidding – WTF!!!

    • Jill Foer Hirsch says:

      I did tell the guy that if I had ever, ever in my career told anyone I wasn’t going to accept their call, or that something wasn’t my department, I would have been fired on the spot. In 25 years I’ve never worked in a place where that wouldn’t be so far out of the realm of possibilities. When I was an accounting manager people came to me to report that their car had been dented in the garage, or if they were blocked in, because my department happened to be the place where they picked up their monthly passes. So you know what? My department, for all intents and purposes, became the frackin’ parking department, because that’s just what you do. My staff developed a lovely relationship with the parking garage folks. 🙂

  3. YIKES!!! I could feel my blood pressure rising just reading about your situation. I can only imagine what it was doing to you at the time. Glad this is getting resolved but sorry you had to go through all this to get there.

    • Jill Foer Hirsch says:

      Thanks Ellen. Like Kate, and my mom, I really worry about people who aren’t able to fight back for themselves. I get pissed and will go to all lengths to fix things, but if I was too sick (which I am at times but luckily not frequently!) to make these calls, or easily intimidated, etc. I would be really screwed. It’s especially infuriating because by the very fact that it is a specialty pharmacy you know that your customers all have chronic illnesses that are in some way debilitating. So you’d think they would go out of their way to be helpful. Sigh.

  4. I saw in the comments that you got this resolved. Glad to hear it, it’s hard enough to be ill, but to be ill and have to deal with this much BS is intolerable.

    You should ask them for an EOB for all the charges, and really look at it. I know it’s the last thing you want to do, but it will keep you aware of what’s going on.

    In my last job, I did medical billing, as I billed the insurance company. The call center people all are judged on how quickly they resolve problems, not on how well- they are often useless. However, one thing to do is to ask for the “call reference number” (you know, “this call may be monitored for training purposes” etc) so if they tell you something and don’t do it, you have proof. Trust me, they are recording.

    Another thing is that you can do, is contact your state insurance commission, or threaten to do so.

    Then there is small claims court, where you name the supervisor etc, this works best when the company is out of state, however, I don’t remember the details of that particular gambit, it’s been over a decade since I did that job.

    • Jill Foer Hirsch says:

      The reference number is a great idea; I know they are always recording. I review my EOBs pretty carefully, but Carefirst doesn’t send them for pharmacy reimbursements. I’m sure I could get them on request, but hopefully this doesn’t come up again!!

  5. Harriet Schneider says:

    I like Kate’s ideas. She and I think alike. Imagine this happening to someone incapable of handling this??? I hope it’s straightened out now.

  6. Diane Prokop says:

    T

  7. Jill Foer Hirsch says:

    Thanks Kate. I thought of the consumer tv folks too, but in a reversal of fortune, the billing supervisor has now, finally resolved this. I will probably have to blog an addendum or something because it just happened. I think the insurance fraud angle got them thinking. Cause they don’t want any problems with the gravy train. Of course they are at odds…Carefirst would prefer if I just crawled in a hole and died, would save them a lot, but Caremark hopes I live forever on super expensive specialty drugs. Some days I myself am torn between the two options. 🙂

    Thanks for the hugs! I’m feeling them!

  8. Hmmmm…Do you have a local news station that takes on weird customer service issues? We have 2 stations in Philadelphia. They usually cut through a lot of the crap because well…it’s going to be on TV. Sometimes newspapers will have a department that investigates bad cs too but you probably thought of that too. The problem with a lot of this stuff is it happens to people who are not well. It’s enough to do you in which wouldn’t be good because they do need you alive. That’s the only way they can make money off of you. *hugs* So sorry.

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