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For physicians, medco loves wasting your time.
Prior Authorization For Medication - Complaint
Review by kshin77 on 2012-05-22
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As a prescriber I have dealt with Medco for a number of years. Though most of the reps are generally congenial, the company is very difficult to deal with and seems intent on wasting other peoples' time in an effort to limit the medications they have to pay for.
For instance, I regularly spend 20 minutes on a prior authorization call. I repeat my name and information, including phone and address (which they seem to never have on file), then give all the patient information (which they seem to never have on file) to get sent a form to fill out and fax back. The form (sometimes they will ask you over the phone) asks questions like: What is the diagnosis of the patient? Did you correctly make the diagnosis for the patient? Are they taking another medication in conjunction with that one?
For instance, I regularly spend 20 minutes on a prior authorization call. I repeat my name and information, including phone and address (which they seem to never have on file), then give all the patient information (which they seem to never have on file) to get sent a form to fill out and fax back. The form (sometimes they will ask you over the phone) asks questions like: What is the diagnosis of the patient? Did you correctly make the diagnosis for the patient? Are they taking another medication in conjunction with that one?
Comments:
Posted by Alain on 2012-05-24:
From some of the reviews I've read both here and on other sites, it almost seems that Medco is not so much about helping the patient/customer, but more about not covering prescriptions to save the client (usually an employer) money. They certainly seem to have some efficiency problems. Thank you for giving us a physicians perspective on their service (or lack thereof)!
Posted by Inside Info on 2012-07-20:
Although the process seems daunting, don't be put off by the bark. Once you get a representative on the line INSIST that you complete the prior authorization by phone.
The security to insure that you are actually from a doctors office or indeed a doctor wanting to complete a prior authorization, is ridiculously low. All that the caller has to do is 1) Verify patient info Name/DOB/Name and strength of the Drug. 2). Doctor info: Dr Name/Address of Practice/ Phone and Fax Number. 3). Answer questions that are so easy to guess at that a first grader could probably do it.
It really is that easy, there is NO security questions that are asked to prove that a doctor or doctor office is actually doing this. In other words let me really spell this out....as long as a patient had the above info, AND SAID, that they are dr bob or nurse nancy or ma mike they could call in their own prior authorization.
I know this because I was a prior authorization rep for medco, many times I was surprised at the lack of security in this regard, but even though I suspected that I wasn't talking to the doctor's office, the response I got was, it is not your job to question the caller. If the caller says they are from the doctor's office, they are from the doctor's office.
For Prior Authorizations are probably handled by Apac Customer Services as can be seen here:
http://www.apaccustomerservices.com/our_company/news/medco_honors_apac_with_vendor_appreciation_award_for_second_year_in_a_row/
And a majority of the prior authorization calls are taken at the cedar rapids center. They can be reached directly at this phone number: 319 896 2900
The security to insure that you are actually from a doctors office or indeed a doctor wanting to complete a prior authorization, is ridiculously low. All that the caller has to do is 1) Verify patient info Name/DOB/Name and strength of the Drug. 2). Doctor info: Dr Name/Address of Practice/ Phone and Fax Number. 3). Answer questions that are so easy to guess at that a first grader could probably do it.
It really is that easy, there is NO security questions that are asked to prove that a doctor or doctor office is actually doing this. In other words let me really spell this out....as long as a patient had the above info, AND SAID, that they are dr bob or nurse nancy or ma mike they could call in their own prior authorization.
I know this because I was a prior authorization rep for medco, many times I was surprised at the lack of security in this regard, but even though I suspected that I wasn't talking to the doctor's office, the response I got was, it is not your job to question the caller. If the caller says they are from the doctor's office, they are from the doctor's office.
For Prior Authorizations are probably handled by Apac Customer Services as can be seen here:
http://www.apaccustomerservices.com/our_company/news/medco_honors_apac_with_vendor_appreciation_award_for_second_year_in_a_row/
And a majority of the prior authorization calls are taken at the cedar rapids center. They can be reached directly at this phone number: 319 896 2900
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