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Old 11-08-2015, 01:52 PM   #21
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...

I'm sensing in this whole discussion a failure to recognize the difference between ordering an authorized refill and ordering a refill where doc needs to be brought into the loop to provide an authorization.
...
And I might be missing that as well (though I think I've got it).

In my case, the Doc sends a 'new' 'script every 6 months. It is for a 3 month supply, plus a 3 month refill. Six months later, I have to see the Doc for a 'new' script, rinse repeat. I say 'new', because it is almost always the exacts same 'script as the previous one, so not new meds or new dosage or anything, if that matters.

So it sounds like the OP got caught up in needing the Doc brought in the loop for the refill, which should go smoothly, but adds an 'opportunity for error' and certainly adds a delay.

Although I'm not sure that needing the Doc to authorize a refill would be much different than just getting the new 'script filled? I guess maybe, since the Doc would initiate the new one, and the pharmacy is initiating the request for authorization?

But either way, best to allow more time. Since I've never had a problem, I can't comment on how good/bad their customer service resolution process is.

-ERD50
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Old 11-08-2015, 01:57 PM   #22
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I loathe ES. My husband was having trouble getting a refill, so I called. The representative told me that "the doctor hasn't called in the refill". I asked if she was sure the doctor hadn't called in the refill and she replied that she was. I said, "Well, that's really strange, because I'm the doctor and I'm quite certain that I have called in that refill twice already this week." They still made me go to the doctor's line and call it in for a third time, but miraculously that worked. This method may not work for everybody, unfortunately.
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Old 11-08-2015, 02:02 PM   #23
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Although I'm not sure that needing the Doc to authorize a refill would be much different than just getting the new 'script filled? I guess maybe, since the Doc would initiate the new one, and the pharmacy is initiating the request for authorization?
Say doc wanted to see you again to check how you're doing on the drug before authorizing an additional six months? He gets a request from the drug provider to authorize additional refills. He tells them no or just doesn't respond hoping that will trigger you to make an appointment and come in. Delay, delay, delay.......

Or doc gets a pile of refill authorization requests from drug providers and his staff needs to pull patient files for review by him for each one? Doing this vs servicing the folks actually coming in for appointments would and should be secondary. Delay, delay, delay......

While I've had my doc sometimes respond promptly to mail order drug house requests for prescription refill authorizations, I've also had him fail to respond or respond "no" without explanation, as forwarded to me by the mail order drug provider. Once he just wanted to see me and do a blood test before continuing me on the prescription. Once his office said they never got the request for the refill authorization while the mail order house claimed they sent it. Blaah, blaah, blaah......

I just go in every six months and get a new prescription. At 68, I've always got something to discuss with him at that frequency. If nothing else, just the subject of how I'm doing with whatever issue the prescription drugs are supposed to be helping with. Medicare + a supplement makes these visits free to me and I don't think seeing my GP twice a year is excessive.
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Old 11-08-2015, 07:57 PM   #24
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I had Express Scripts for years. I think it was Medco before that, and now on Prime Mail (and another change next year, it looks like!). Never had a single problem with any of them. One key, I think, is that at least in more recent years, my Doc had a 'direct line' to electronically transfer the info to ES. By the time I got home, I'd usually have an email from ES saying the order was being processed.

Previously, they faxed them in from the Doctor's office, and that seemed to work as well.

In either case, I would just 'click' on-line to order the refill when it was available, and it showed up ~4~5 days later. I need a new 'script from the doc every 6 months, and get one auto-refill on that.

Even the time there was a shortage of one med due to a mfg problem, they sent a one month supply, and automatically sent me the remaining 2 months when production caught up. No hassle for me at all.



To be honest with you, I would not cut it anywhere near that close the first time I ordered a refill from anyone. Things can always get delayed, they might need more info, there might be a temp shortage, or even lost in the mail. I don't even cut it that close now, even though I know I'm set up properly in the system and I've never had a problem. Stuff happens.

Considering the mail might take 3-4 days, and processing could take a couple days, and then there are the non-business days, you really are only allowing less than a week buffer in there. That is too short to correct any problem that might arise. Why not order 4-5 weeks ahead?

-ERD50
I had an existing 30-day supply, so I can't order a refill before I have received the supply I want to actually refill. In retrospect, 2 weeks was not enough this time but for the previous drug's refill, it was even though I had a similar snag. So, even despite that authorization snag, and now on the lookout for it in case it happened again with the more recent drug, I did not expect things to actually get worse this time. How could I know they would cancel the original order and start a new one which set me back over a week?
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Old 11-08-2015, 08:47 PM   #25
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I have CVS Caremark mail order and I was very surprised how efficient they are. The only glitch I had was when I needed doctor's authorization for a refill and they sent an email and left a voice message stating they had not received it from the doc. I called doctor's office and everything went smoothly again. I would heartily recommend CVS Caremark.
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Old 11-08-2015, 08:48 PM   #26
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I just called ES and the rep was helpful, as long as everything plays out the way she said it would. First, she authorized a 5-day supply I can pick up at my local pharmacy at no charge
I hope you have better luck with this than I did. My local pharmacy said "I wish they would stop telling people that!" Somehow, their "authorization" never made it to my pharmacy.
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Old 11-08-2015, 09:56 PM   #27
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When I was in private practice, ES would fax me a prescription request and I would fax it back and get a fax confirmation. But well more than half the time they would say they never got it - 2-3 weeks later when patients would call me to say they didn't get their prescriptions. I stopped faxing to ES and gave my patients paper prescriptions after this happened too many times and told them to mail it in themselves. That seemed to work only slightly better.


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Old 11-08-2015, 09:56 PM   #28
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I've been using ES for about 3 years and have NEVER had an issue. Even when there was confusion about refill/New script, they fixed it with no issues. I think the key is to have a doc that uses the online system and not phoning it in. For the most part, when my doc writes a new script, I have an email from ES saying it's being processed before I get out to the parking lot.

Sent from my mobile device so please excuse grammatical errors.
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Old 11-08-2015, 10:00 PM   #29
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Interestingly the problem I had was getting the local Wal-Mart to make contact with my Doctor to authorize the new refills. Found it works better to just call the Doctors office for a new scrip. (He does electronic prescriptions so they need to know where to send them). Interestingly on Express Scripts Medicare part D plan, they just charge a bit more for a 3 month supply if you buy it locally. Of course several of my medications fall on the Wal-Mart $10 list so before I reached 65 I just paid directly.
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Old 11-09-2015, 04:54 AM   #30
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When I was in private practice, ES would fax me a prescription request and I would fax it back and get a fax confirmation. But well more than half the time they would say they never got it - 2-3 weeks later when patients would call me to say they didn't get their prescriptions. I stopped faxing to ES and gave my patients paper prescriptions after this happened too many times and told them to mail it in themselves. That seemed to work only slightly better.


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Interesting comment at least to me. One of the items I w*rked on was a home grown fax product it used a popular 3rd party product to drive the fax and would integrate into our system. Faxes would sometimes get lost for a variety of reasons, mostly because the APIs had no return codes to indicate failure. I recall this vendor used to claim that 30% of all faxes were lost, they never provided a source for that stat. We joked it was 30% of faxes that went through their software.

But if it's only slightly better with paper that kind of says it's maybe not the fax.
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Old 11-09-2015, 07:02 AM   #31
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We originally had Medco. When the merger with Express Scripts took place, there was an immediate fall off in service and changes in policy. They suck!
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Old 11-09-2015, 07:08 AM   #32
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I have CVS Caremark mail order and I was very surprised how efficient they are. The only glitch I had was when I needed doctor's authorization for a refill and they sent an email and left a voice message stating they had not received it from the doc. I called doctor's office and everything went smoothly again. I would heartily recommend CVS Caremark.
Good to know. I'm still pondering decisions for open enrollment, and it looks like most of the FEHB plans are using Caremark.
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Old 11-09-2015, 07:21 AM   #33
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My mother used Medco, merged into Express Scripts. They really were impossible to deal with, we were unable to get some medicines replaced in a timely manner after some went missing. I went to the local Target, much to my surprise, the cost was lower for every one of her prescriptions and the Target pharmacy people were much easier to deal with.
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Old 11-09-2015, 07:29 AM   #34
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This has been my experience with ES.

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DW and I have had ES for over 15 years with no troubles other than the " press one for Spanish, etc." The only trouble I have had with prescriptions is that ES prefers prescriptions be sent via email or fax. My family physician's policy is written or phone order prescriptions, so I have to be right on top of my physician's a$$, I mean staff, at refill time as not to screw up ES prompt service.
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Old 11-09-2015, 08:29 AM   #35
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We've used ExpressScripts for many years (they are the default with Tricare) and never had a problem that wasn't easily resolved.

A few months ago, they were even nicely proactive. DW has a permanent maintenance med and it was soon going to be time to renew it for another year. ExpressScripts contacted her doc on their own to ask if it was OK to renew it. The doc said yes, the scrip was renewed, and they called DW to inform her that she didn't need to ask the doc for the renewal.

I call that excellent service.
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Old 11-09-2015, 08:46 AM   #36
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I'll add that my previous comments saying I've never had a problem with any of the mail-order pharmacies was not meant in any way to be dismissive of the problems the OP or others have experienced. I know it's frustrating when you run into problems, and especially when it's tough to get resolution to those problems.

But one point I meant to make is that it might not make sense to try to jump ship due to this problem. I'm pretty sure you will find both horror stories and satisfied customers among all the places. I don't know if there is any wide-ranging customer satisfaction surveys out there, but I'd trust those more than anecdotes on either side (including my own - maybe I just got lucky?).

-ERD50
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Old 11-09-2015, 08:47 AM   #37
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I've learned not to count on the drug provider / doc communication link to get this done. Each of those two will always point the finger of blame at the other when communications breaks down. When I run out of authorized refills for a prescription, I contact doc myself.
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I've used Medco/Express Scripts for quite a few years as well, with I think 4 different insurance companies. Thee were some communications issues between docs and the mail order pharm in previous years, but I'd say that has been resolved in the last 3-4 years. I think it may have more to do with the ability of the doc to submit info on their terms, i.e. using Electronic Health Records Software that plays nice with their systems.
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Old 11-09-2015, 09:07 AM   #38
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I had a few problems with ES a few years ago, but they've all been worked out. I think most of the problems have been getting the doctors offices system to talk with the ES system. Haven't had a problem in a while now.


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Old 11-09-2015, 10:43 AM   #39
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BCBSNC uses Prime Therapeutics. Seems about the same marginally acceptable level of service as Express Scripts or Medco (used both of them when on megacorp plan).

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...and gave my patients paper prescriptions after this happened too many times and told them to mail it in themselves...
This is the route I try to use. And when I mail it, I use a tracking number. I print postage with tracking number using https://www.paypal.com/shipnow btw, which I think is great. Usually costs less than a buck and a half, and might get your letter a little more focus. Besides, you've can say it was delivered to X address at 12:42PM Thursday when you have the annoying do-nothing reps on the phone.
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Old 11-09-2015, 11:00 AM   #40
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No problems with Medco/Express Scripts, yet...
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