OptumRXrepetitive and consistent denial of drugs tier 3 and above

Review updated:

OptumRX will typically fill your prescription for tier 1 and tier 2 drugs (some requiring "prior authorization") without too much hassle but once you hit the tier 3 drugs they will reject a doctor's prior authorization the first time around requiring you to contact the doctor to submit an "appeal". This of course adds a few more days to what you've already had to wait on and there is no guarantee that this "appeal" will be approved any more than the original authorization. I fail to understand how a mail-order pharmacy can understand the medical needs of a customer better than a physician who has known the patient for years. A licensed physician should need nothing more than to submit the originally requested "prior authorization" and the pharmacy should accept it.

Jan 19, 2017
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  • Lo
      Jun 03, 2019

    I have been through hell with this company and recently received a letter stating I needed a PA as they keep canceling the ones submitted. No matter what PA is requested it has been denied absolutely the worst company I have ever had to deal with.

    +1 Votes

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