It is no secret that I have been a big proponent of Botox for migraines. It was the only thing that helped me control my migraines when they got so bad that I was suffering from them on an almost daily basis. Unfortunately, I only received one round of Botox for migraines before my insurance lapsed due to a job change. I am currently awaiting approval for the treatment to restart under our current insurance plan; but let me tell you a little story about what happens when your insurance company takes the liberty to charge you for a treatment you never received.
In June of 2012 I received my first Botox treatment and it was meant to be re-administered every three months. Late August of 2012 I called the doctor's office and requested the reorder. I knew at the time that my husband would be changing jobs and that our insurance would be lapsing on October 15. I informed the doctor's office of this. I called the office every week through mid October to inquire about the Botox order and was told that it had either not yet been ordered or had not approved by the insurance company. By the last conversation, I told them it was too late and the order would have to be cancelled.
Many months later I began to get bills from Optum Rx (previously Prescription Solutions) for $105. I had never used Optum Rx, so I never opened most of the letters I got from this company. I didn't know at the time that they were previously Prescription Solutions. By the time I opened the letters, the debt was in internal collections. Well, unfortunately for me, my new insurance company, in their infinite wisdom, has chosen Optum Rx as their mail order provider for all my convenient prescription needs. And now Optum Rx has placed a hold on my account because of this $105 debt.
I called Optum Rx and very clearly stated that I am NOT validating this debt, but I am inquiring to find out what it is about. Guess what? It was about the Botox treatment I never received. Say what? I told the lady on the phone the whole story, but she could have cared less because, after all, she has a designated script to stick to. She has to get me off the phone to get to the next caller. She said because the Botox was under my name and was shipped to my doctor, it was my responsibility. End of story.
Two Problems with that:
1) I cancelled the order.
2) Prescription Solutions had a policy that they had to have my verbal permission to act on my behalf in order to ship a controlled substance. How do I know this? Because I had already been through the procedure once before. AND because they called me exactly one time to try to get my permission for said shipment. I missed the call and it had gone to my voice mail. That prompted me to call my doctor's office to reiterate that I no longer had insurance and to cancel the order. Why do I remember this? Because I went off on them about having had two months to do their job and having done it very poorly.
The Optum Rx lady suggested I call the doctor's office clear up my debt but that the hold on my account would still stand. So I told her that I would never choose by my own free will to ever use Optum Rx as a mail order prescription company. I hate mail order services and much prefer my local Walgreens. Yeah, I said that.
So I called the doctor's office and they called me back the next day. She was very nice and genuinely sounded concerned, especially after I told her the story about they had dropped the ball and that I was now seeing someone else (it not me, it's you). She read my file notes to me. According to what the insurance company told them, they tried to contact me multiple times and due to nonpayment from the patient (me), they were unable to ship the Botox.
What?!?! Hold the phone.
If you consider calling me once and leaving me one voice mail, contacting me multiple times, then yes, you contacted me multiple times. In June of 2012, when I had my first Botox treatment, I paid for it happily. Of course, I also recall giving the company handling this controlled substance my verbal permission to act on my behalf. It was procedure because the FDA regulates Botox shipments. I also remember Optum Rx (then Prescription Solutions) leaving me that one message seeking my permission to ship the Botox. They never got my permission to ship anything. It may have my name on it and may have been shipped to my doctor, but I never gave them my permission. So it is really my responsibility? And here's the kicker.
Wait for it...
My doctor's office never received a shipment of Botox with my name on it. What they did receive were a bunch of nasty notes from Optum Rx saying that I am a patient that refuses to pay for services.
Services Optum Rx claims to have rendered. Services I never received. Services my doctor's office can prove they never provided me. Not to mention a now missing box of Botox. I bet the FDA would love to hear that.
So to update my little story, Optum Rx requested my contact information on Friday, October 4, 2013 for customer service to be able to reach me. They haven't reached me yet... I'll let you know how it goes when they do. Till then, I'll keep posting Bad Medicine if you'll keep sharing it because as a stroke patient, I know how important it is to keep to my medication supply in stock.
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