Business Profile

Health and Wellness

Express Scripts

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Important information

Customer Complaint:
Better Business Bureau has received a pattern of complaints against Express Scripts. Complainants allege billing issues, difficulty obtaining a prescription, and poor communication with the company.

Complaints

This profile includes complaints for Express Scripts's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

1,544 total complaints in the last 3 years.
558 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:07/08/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Express scripts received my 3 Rx from the dr May 6 2022. Without notification, Express scripts cancelled the meds I’ve taken for 22 years without notification as well as 2 other Rx. These meds are necessary to keep me alive. Instead, the bug-filled express scripts website has outdated and unused meds with no way to update or archive. Calling is a fools errand. Texting for help leaves you in limbo, and no way to send. Express scripts is attempting to not fill prescriptions and save money by denying care and hurting patients. This is not a prescription company but a criminal enterprise designed to protect the money of the stockholders. it is reprehensible that this country allows criminal behavior in healthcare with no oversight. Attached is proof of cancellation.
Business Response
Date: 07/22/2022
July 22, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** *****
Attn: Dispute Resolution Department

Re: Dr. ******* ****** / # ********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by Dr. ******. As a result of your letter, Express Scripts reviewed Dr. ******’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

Dr. ****** expressed concern with challenges receiving her medication from Express Scripts Pharmacy. Dr. ****** ordered medication on May 10, 2022 and outreach was made to the prescriber’s office to secure new prescription; however, the order was cancelled due to no response from the prescriber’s office and notification was sent to Dr. ******. As a result, Express Scripts Pharmacy contacted the prescriber’s office, secured a new prescription on July 12, 2022 and shipped the medication via UPS Next Day Air that was delivered on July 14, 2022.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************ ****** ******** ********* **************
Customer Answer
Date: 07/22/2022
Complaint: ********

I am rejecting this response because:

I had to track down express scripts. I contacted both express scripts and the drs office.
Express Scripts, as evidenced by this response, has Taken no Personal responsibility for inaction. There was no contact of the doctors office nor myself.
As a patient of the drs office for 22 years and a physician myself, I am sophisticated enough to follow up. this could’ve cost a patient who is not familiar with Inaction and dismissal by insurance companies and third-parties their life.
This response shows how Little express scripts cares for their clients. The response is inadequate.

Dr. ******* ** ******
Initial Complaint
Date:07/08/2022
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
02/05/2022 $34 Express-Scripts is charging us for a 90 day supply of KETOSTIX REAGENT STRIPS 50ct, but filled the prescription for a 15 day supply. And the order had the correct address on the package but we never received it. So they are overcharging us for a prescription we never received. I contacted Express-Scripts on 3/18/2022 after noticing a balance on our account and shared with them that I never received the package. They informed me that it had been shipped back to them. The package must have been delivered to the wrong house in the neighborhood. But Express-Script never notified us, of it's return. During this time we had picked up over-the-counter KETOSTIX REAGENT STRIPS at a local pharmacy because we were completely out. They proceeded to say they could resend it but couldn't credit the account. I told them not to reship it because we no longer needed it and explained that they were also overcharging us for the prescription. They were charging us the price for a 90 day supply and only filling the prescription for a 15 day supply. I explained that this was unethical and fraudulent. They said they still couldn't credit the account even though we didn't receive the package (there was proof of this because they had it in hand) and we had to still pay the 90-day supply price even though we were only getting a 15-day supply. On 3/22/2022, I had a new prescription sent to our local pharmacy and paid 7.80 for a 90-day supply that's a 26.50 difference. No one has been able to send me documentation that states the customer is responsible for a medication that is never received and is required to pay a 90-day price for a 15-day supply and I can't find this anywhere in our enrollment documents.
Business Response
Date: 07/26/2022
July 26, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** ***** ***** ******* ********** **********

Re: ***** ******** / # ********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by Ms. ********. As a result of your letter, Express Scripts reviewed Ms. ********’ concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

Ms. ******** expressed concern stating her son did not receive a medication and requested a refund. The prescription in question was received, on February 5, 2022, that was filled correctly for a fifteen day supply based on the prescriber’s request. The medication was shipped on February 9, 2022; however, the package was returned to Express Scripts Pharmacy on March 8, 2022. As a result, Express Scripts Pharmacy contacted Ms. ******** to reship the medication yet she declined; therefore, no credit is warranted.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at (800) 871-4663.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Customer Answer
Date: 07/26/2022
Complaint: ********

I am rejecting this response because: I have a note on my account stating that NO medications should be filled and shipped without my consent. I never gave my consent for this medication to be shipped. The prescription was written incorrectly and according to the medication pricing link on our account: *************************************************************** a 1-month supply of this medication is not even available (see screenshot attached for proof). Yet, again another reason why the prescription should not have been filled.
To make matters worse Express-Scripts never contacted me of the medication's shipment and return as stated in my previous complaint. I contacted them on March 18, 2022 when I noticed a balance on my account for the amount of $34.00.
To recap, I am rejection this response because:
1. I never authorized the medication to be filled and shipped.
2. I am being charged a 30 day supply price for a 15 day supply (which is not even available to order according to your site).
3. I never received the medication, it wasn't until I noticed the charge on my account that I saw something was wrong.

Sincerely,

***** ********
Business Response
Date: 08/03/2022
August 3, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** *****
Attn: Dispute Resolution Department

Re: ***** ******** / #********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by Ms. ********. As a result of your letter, Express Scripts further reviewed Ms. ********’ concern and would like to take this opportunity to respond.

Ms. ******** indicated that her issue is unresolved since she stated that she did not authorized Express Scripts Pharmacy to dispense the medication in question and was charged $34.00 for a fifteen-day supply. As stated in our previous correspondence, the prescription in question was received on February 5, 2022 that was filled as prescribed. According to Ms. ********’ prescription plan guidelines, she is required to pay a $34.00 copayment, regardless of the quantity, at mail-order; therefore, she was charged correctly and no credit is warranted.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Customer Answer
Date: 08/06/2022
Complaint: ********

I am rejecting this response because as stated in my previous complaints:
- the prescription wasn't delivered correctly; as show in the original screen shot I provided. Express Scripts has documentation that it was sent back to them from someone else. We never received this medication.
- there is a note on Edwin's account that says we must consent to every prescription before it's shipped. We did not consent to this medication because the prescription was wrong. It should have never been shipped in the first place!
- Express Scripts is charging us for a 90 day supply but apparently only filled a 15 day supply. As shown in my previous screenshot their site won't even let you order anything under a 90 day. Why would you fill a prescription for 15 days when your site says you can't?
And as for our prescription plan guidelines that says, we're required to pay a $34.00 copayment, regardless of the quantity and regardless of receiving the medication, can you please provide documentation of this? I can't find this guideline anywhere in my prescription plan enrollment documents.
If you can provide this information, as stated in my original complaint, I will be more than happy to comply and pay the $34.00.
Sincerely,

***** ********
Initial Complaint
Date:07/08/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have had to contact Express Scripts (mail order pharmacy) to refill my medication 4 times now and it's still unprocessed. I had no refills left so I called them a few weeks early before I would need the medication to ensure I would get it before my vacation. They said they would process it early (~6/27/22) (about a week earlier than the regular refill time). Every time I call them there's a new reason they can't process and seemingly the reason was avoidable if they took the time to put patients first. However, the worst offense (from today's conversation) was they said I contacted them to cancel the order, which I never did. Why would I cancel the order and keep calling to refill the medication? The name of the medication is fexofendadine 180 mg. Even though I do not seek any compensation or refund ($0 co-pays), I feel compelled to have BBB mediate to hold Express Scripts accountable for quality improvement so this experience doesn't keep happening to me or other patients. I am requesting a senior manager or director to contact me to discuss this issue.
Business Response
Date: 07/22/2022
July 22, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** *****
Attn: Dispute Resolution Department

Re: ****** ***** / # ********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by Mr. *****. As a result of your letter, Express Scripts reviewed Mr. *****’ concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

Mr. ***** expressed concern with challenges receiving his medication from Express Scripts Pharmacy. Mr. ***** requested a renewal on June 27, 2022, outreach was made to the prescriber’s office to secure a new prescription; however, the office did not respond. Mr. ***** contacted Express Scripts Pharmacy for the status of the order yet the representative mistakenly cancelled the order in error. As a result, Express Scripts Pharmacy contacted the prescriber’s office, secured a new prescription and shipped the medication via UPS Next Day Air that was delivered on July 13, 2022. We apologize for any inconvenience this may have caused.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************ ****** ******** ********* **************
Customer Answer
Date: 07/25/2022
Complaint: ********

Although I appreciate that I eventually did receive my medication in time before my expected travel (due to the complimentary expedited shipping) I am rejecting this response because:
1) There is no explanation why a prescription renewal request was not sent before 6/27/22 (when I called weeks in advance to discuss this refill request).
2) No explanation for representatives giving me inaccurate information (resulting in me asking to speak with a supervisor more than once) or why Express Scripts feels it was acceptable or unacceptable I had to call in at least 5 times (over the course of weeks) to get a medication refilled and just barely received the medication in time. The patient shouldn't have to put forth this much effort for a medication refill. Clearly there are multiple process break downs.
3) The root cause analysis is superficial and does not include a corrective and preventative action plan. Basically, I want Express Scripts to investigate and acknowledge every misstep and tell me what they plan to do about it so this doesn't happen to anybody again.

4) There is no explanation why Express Scripts was waiting on a pre-authorization for a brand name fill when I received the generic in the past and Maryland permits generic substitution. When I discovered they were doing this I personally requested the generic substitution.

I also filed a complaint with the Maryland Attorney General's office to ensure this matter is taken seriously.

Sincerely,

****** *****
Initial Complaint
Date:07/04/2022
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Hello, I have 2 insurance providers on file with express scripts. I’ve assigned one of them as the primary. Express Scripts has incorrectly charged my secondary insurance, telling me that I have an outstanding balance of roughly $200. Had they not made the mistake and charged my primary insurance, my balance would be less than $30. I’ve called twice and had two email exchanges with them. No one seems interested in helping me resolve the issue. They’ve stopped shipments of all prescriptions I have on file with them. Can you please help me in getting this resolved? Their act of holding my prescriptions will become a problem very soon, as I have only a few weeks worth left. I’m fine with paying the correct outstanding balance, not the balance that is a result of a mistake on their part. Thanks in advance, **** *****
Business Response
Date: 07/22/2022
July 22, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** *****
Attn: Dispute Resolution Department

Re: **** ***** / # ********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by Mr. *****. As a result of your letter, Express Scripts reviewed Mr. *****’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

Mr. ***** expressed concern stating Express Scripts Pharmacy filled two prescriptions under the wrong plan and requested a refund. Mr. ***** is eligible under two active accounts, Blue Cross Blue Shield of Western New York and South Carolina Public Employee Benefits; however, there was no identification number on the prescriptions in questions. As a result, the prescription was processed under the first active account listed, BCBS of Western New York.

In an effort to resolve, a notation was placed on Mr. *****’s account to fill all future prescriptions under his South Carolina Public Employee Benefits account as requested. Additionally, a one-time courtesy copayment credit in the amount of $198.07 was applied to Mr. *****’s BCBS of Western New York account, on July 11, 2022, resulting in a $0 balance.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************
Senior Manager, Executive Correspondence
Initial Complaint
Date:07/03/2022
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Accredo is a pharmacy who fills my daughter's prescription drug ****** on behalf of Express Scripts. During refill of this drug ******, they charged an unfair, deceptive, extremely high price of $4701 for 1 single dose of ****** injection. I mentioned very clearly that I would not pay more than the customary amount that I previously paid for last 1 year which never exceeded $150 for a single dose of ******. They mentioned a single ****** dose costs $11,452 and after my insurance deductible, I have to pay $4701. This appears to be price gouging. Also, it violated the 'No Surprises Act' since I never agreed to pay more than the previous charges of the same medicine. I request to investigate this company for surprise extremely high prescription medical bill charge to the consumer. Called Accredo several times and reviewed call transcripts with ****** ***** (extn ******) where it was clear that I never agreed to pay more than the customary amount that I previously paid for last 1 year which never exceeded $150 for a single dose of ******. ***** ***** (**** ******) from billing said if I didn't accept the charge then they would remove the charge. Later they denied it. ******* (**** ******) from *** said their representative would call back after review by management but they never called back. They changed facts, they lied, etc. They are forcing to pay me $4701 for a single dose of medication and my daughter requires this ****** injection 4 times in a year. Request to remove the $4701 billing charge or adjust the charge to what I previously paid which never exceeded $150.
Business Response
Date: 07/22/2022
July 22, 2022

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by *** ***. As a result of your letter, Express Scripts reviewed *** ***’s concern and would like to take this opportunity to respond.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. Express Scripts’ home delivery pharmacy provides home delivery of prescription medications to beneficiaries of the pharmacy benefit plans sponsored by the clients. These services, contracted by the plan sponsors, satisfy the plan sponsors’ goals of providing a cost-effective, seamless and clinically appropriate benefit for its patients.

*** *** expressed concern stating Express Scripts specialty pharmacy, Accredo, charged a higher copayment for his daughter’s medication and requested a refund. *** *** has a deductible that must be satisfied; therefore, he has a $5,701.41 copayment for the medication in question. In reviewing the scheduling call, *** *** was quoted the $5,701.41 copayment and would be responsible for the remaining balance that is not covered through the ********* ********** ******* ***** on file. The *** covers up to a $1,000.00 per three months; therefore, leaving his daughter with a balance in the amount of $4,701.41. Additionally, *** ***’s plan sponsor is enrolled in Out-of-Pocket Protection Plan for specialty medication; therefore, the *** will not apply to the deductible.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ***** *********

Sincerely,

Customer Answer
Date: 07/25/2022
Complaint: 17516644

I am rejecting this response because:
Just because somebody has a deductible that does not give the Insurer(Express script is administering on behalf of BCBS Anthem for prescription) and pharmacy (Accredo - also part of Express Script - conflict of interest) duo nexus a right to extract money for the deductible amount producing an unfair, deceptive, extremely high price for a drug. I had the same deductible last year and same drug was administered to my daughter last year and I didn't had to pay $5,701.41 copayment last year. My insurance, deductible and this drug have not changed from last year. The last year they didn't charge to extract money from my deductible and this year they are extracting. I had the option to not order this drug from Accredo if their Agent had not misguided me during the order. Their agent mentioned that she expected that the final charge the same amount which I previously paid which was not more than $150 once the order get processed. She had no idea what the final charge would be before everything was processed. I clearly mentioned during that call that I can only order if it doesn't exceed $150 and I can't pay if it is more that that. I request you ask the company to produce the full unaltered call transcript and arbitrate the issue.

Sincerely,

Arnab Dan
Business Response
Date: 08/03/2022
August 3, 2022
Attn: Dispute Resolution Department
Re: Arnab Dan / #********
Dear Sir/Madam:
I am in receipt of your letter regarding a complaint filed by *** ***. As a result of your letter, Express Scripts further reviewed *** ***’s concern and would like to take this opportunity to respond.
*** *** indicated that his issue is unresolved since he was required to pay a deductible for his daughter’s medication. According to *** ***’s prescription plan guidelines, there is a $5,700.00 yearly deductible that must be satisfied. As a result, *** *** was quoted a $5,701.41 copayment and was advised he would be responsible for the remaining amount not covered by the Copay Assistance Program. The *** covers up to a $1,000.00 per three months; therefore, leaving his daughter with a balance in the amount of $4,701.41.
I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at (800) 871-4663.
Sincerely,
***** ************
Senior Manager, Executive Correspondence
Customer Answer
Date: 08/05/2022
Complaint: ********

I am rejecting this response because:
The latest response from business is nothing but a repeat of the previous response. She did not address the specific points mentioned in my complaint which are
1. I had the same deductible last year and same drug was administered to my daughter last year and I didn't had to pay $5,701.41 last year. My insurance, deductible and this drug have not changed from last year. The last year they didn't charge to extract money from my deductible and this year also it should not change. I never paid more than $150 for this drug last year.
2. Just because, someone has a deductible $5700, that should not give Accredo (Pharmacy) and Express Script (Insurance) duo [Accredo pharmacy is also part of Insurance Express Script] right to unfairly charge the full deductible amount for one dose of a drug in the context of satisfying one's annual deductible.
This will not resolve if the business repeats the same response without addressing specific points from the complaint. I request you ask the company to produce the full unaltered call transcript and arbitrate the issue.
Sincerely,

***** ***
Initial Complaint
Date:07/01/2022
Type:Delivery Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have been attempting to get my MS medication for over two weeks. Constantly on hold and getting a run around. I need this medication to be able to continue working. Now a representative from the pharmacy said they called and left a message but claim I didn’t call back. I have called many times. They contradict themselves continuously. Trying to put the blame on me instead of admitting they are wrong. And they get rude when you base facts.
Business Response
Date: 07/14/2022

July 8, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** ***** ***** ******* ********** **********

Re: ****** *** / #********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by ****** ***. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.

Ms. *** expressed concern with being unable to obtain their medication from Express Scripts’ specialty pharmacy, Accredo. Accredo received a prescription from the prescriber; however, clarification was required from the prescriber to confirm the dosage of the medication in question. Once clarification was obtained from the prescriber, the prescription was processed and scheduled to be delivered. The medication was delivered on July 6, 2022 via FedEx.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************ ****** ******** ********* **************
Initial Complaint
Date:06/28/2022
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
From the very first time I had Remicade infusion medication sent to my home, I had nothing but issues with the extremely poor customer service from ********************** and **********************. Today I received a notice from a debt collection agency for non payment of $87.04 for an Epinephrine pen that was sent to me without my consent or approval. I already had this device on hand at that time and did not need another. This had happened to me many times before with Epinephrine pens, as Accredo and Express Scripts does not confirm with their patients before sending out medication. After several hours of phone calls between December 2020 and January 2021, I was told that I would not have to pay for the Epinephrine pen from 12/19/20. Without any further notice that a balance was due, which I could have disputed as I was told I did not have to pay, I was sent to collections on 6/28/22. This is what I would consider fraud and is now a derogatory **** on my credit that I request to have cleared up immediately. Express Scripts and Accredo can take a quick review of my payment history and see that all payments due were always made on time and sending me to collections is very unprofessional and unreasonable, especially with no communication prior to that action.
Business Response
Date: 07/18/2022
July 11, 2022

Better Business Bureau Serving Eastern ******** and Southern ********
**********************************************************
Attn: Dispute Resolution Department

Re: ********************* / #********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by *********************. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services,including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.

Mr. **** expressed concern as his account was sent to collections, for an outstanding balance, for a medication secured from Express Scripts Pharmacy. Express Scripts Pharmacy dispensed a medication, to Mr. ***** on March 13, 2020 that had an $87.04 copayment. The balance was referred to a collection agency on December 19, 2020 as it went unpaid.

In an effort to resolve, an adjustment was completed for the entire amount of $87.04. The collection agency was notified that ************* account has been paid in full.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.

Sincerely,

**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 07/19/2022
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

*********************
Initial Complaint
Date:06/28/2022
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
The original date of claim reimbursement was 05/16/22 and have since filed 2 more claims (one on 05/24/22 and the 3rd on 06/17/22). First time was rejected because the *** number was incorrect and they gave me the correct number to use. Second time I used the *** number they provided and it was denied. I was told the *** number needs to be written on the receipt - which is what I did. The third attempt was rejected. All 3 attempts came back with a denial because the *** number wasn't provided. Now they are telling me that the 1st *** number was correct and need to file a 4th claim for reimbursement.
Business Response
Date: 07/21/2022
July 20, 2022
Better Business Bureau Serving Eastern ******** and Southern ********
211 ***********, Suite 2060
***********, ** 63102
Attn: Dispute Resolution Department
Re: *************************** / #********
Dear Sir/Madam:
I am in receipt of your letter regarding a complaint filed by ***************************. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.
By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.
********************** expressed concern with not receiving reimbursemrnt for his out-of-pocket purchase as there was missing information on his claim submission. According to Mr. ********** prescription plan guidelines, the medication in question is excluded from coverage. The federal mandate requires over-the-counter tests to be covered that are self-taken and self-read by the individual; however, the product ********************** submitted for reimbursement uses trained, virtual proctors. Express Scripts received Mr. ********** direct claim reimbursement submission, which included the National Drug Code (NDC), and it was correctly denied due to this NDC requiring a ******* to administer the test.
I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.
Sincerely,
**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 07/22/2022
Complaint: 17494502

I am rejecting this response because:

I do not accept your response. I administered the test myself and verified the results myself. In addition the *** number(s) were provided by you and were in the drop down list when filling out the claim. The purpose of the US government passing legislation regarding the reimbursement of Covid19 test that were purchased is to provide relief to the consumer in these trying times. I have invested over 2 months of my time in this claim process with nothing but misinformation or lack thereof. I will not accept nothing but the reimbursement to me in the amount of $162. In the event you should choose to "walk all over me" because I am just one insignificant customer to you - I will pursue legal action. I realize in the grand scheme of things that for a big company like yourselves $162 is nothing but for a single parent like myself - every dollar counts.

I sincerely hope you choose customer service and doing the right thing.

Sincerely,

***************************
Business Response
Date: 08/10/2022
August 4, 2022
Better Business Bureau Serving Eastern ******** and Southern ********
211 ***********, Suite 2060
***********, ** 63102
Attn: Dispute Resolution Department
Re: *************************** / #********
Dear Sir/Madam:
I am in receipt of your letter regarding a complaint filed by ***************************. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.
By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.
********************** expressed concern with the denial of his reimbursement request for his out-of-pocket purchase since the product submitted was an exclusion from the federal mandate. In an effort to resolve, Express Scripts is providing an override to allow this product to be covered for the requested dates of service. This will take approximately **** business days to complete. A refund check will be issued to ********************** upon completion.
I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.
Sincerely,
**********************************
Senior Manager, Executive Correspondence
Customer Answer
Date: 08/10/2022
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

***************************
Initial Complaint
Date:06/28/2022
Type:Delivery Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
My husbands medication dose was increased over a month ago they expected him to double the dose we already had but we called 3 weeks ago Because we were going to be out of meds they told us to get meds from our doctor not due for 2 weeks to refill so we got the dose from his doctor for last week . Script was to be filled 6/22 never filled told us it would go out Monday because it is refrigerated and we would get it Tuesday. Never sipped yesterday, talked to them today may have it next few , told to ask my doctor if they have extra or call for a short supply to local f pharmacy. No one at this company is held accountable for this . It has happened several times to us with different meds. My husband is on several meds that are very expensive. My employer made this our only option unless we use a local pharmacy that is much more expensive. Someone needs to hold them accountable for their poor service . All we get is I’m sorry nothing I can do.
Business Response
Date: 07/08/2022
July 7, 2022

Better Business Bureau Serving Eastern Missouri and Southern Illinois
*** ** ********* ***** **** ***** ****** ** ***** ***** ******* ********** **********

Re: **** ***** / #********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by **** *****. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with “core” pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.

Mrs. ***** expressed concern with her husband not receiving his medication from Express Scripts Pharmacy. Express Scripts Pharmacy requested a new prescription from Mr. *****’s prescriber since Mrs. ***** indicated there is a dosage change on the medication in question. On June 16, 2022, Express Scripts Pharmacy made outreach to the prescriber, via fax, for clarification on the dosage. The prescriber did not respond to the initial outreach; however, a new prescription, with the correct dosage, was received on June 23, 2022. The medication was delivered on June 30, 2022.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at ###-###-####.

Sincerely,

***** ************ ****** ******** ********* ****************** ** *** *******
Customer Answer
Date: 07/12/2022
Complaint: ********

I am rejecting this response because:the company had gotten my husbands new script on May 4th so there was no need for them to contact the physician for a clarification of dosage. Like I said previously they had recently sent us a supply of trulicity so the previous dose was 1.5 mg a week , it then increased to 3 mg / week on May 4th. We double the dose till we were down to 2 weeks left and we were not going to have enough for the dose on 6/21 . I contacted them on 6/14 they told me I needed to contact the doctor to get an adjusted script to give me more than 90 days or me to see if the doc could give me a sample dose( which is what I did for the dose due on the 6/21). Then a message was sent that we would receive the next shipment by July 4th which still left us without a dose for 6/28 . Called again on 6/24 since the med never shipped on 6/23 the website said processing. They told me couldn’t ship over weekend it would ship on Monday ( this was after being on the phone with a hour again..I t never shipped on Monday called again Tues on the phone again over an hour to get the script sent ( my husbands dose was due that day) they said it would get sent and we should receive it Wednesday . And that we should get our doc to send a script to local pharmacy to get a short supply because they couldn’t get it to us that day. The local pharmacy couldn’t fill it because Express scripts already did. The med finally got here 6/30 2 days after his dose was due. Basically my point is the new script was sent May 4th they should have sent us the increased dose well before the end of June. Their response is totally incorrect in regards to their actions.

Sincerely,

**** *****
Initial Complaint
Date:06/21/2022
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am on Humira for Ulcerative Colitis. Due to the cost of the medication, I have copay assistance though Abbvie, the manufacturer of the drug. They cover the rest of the cost that Express Scripts doesn't cover so I am left with $5 each month. I received a $652 **** from Accredo (the pharmacy of Express Scripts) with a note to call Abbvie. Abbvie says that my copay assistance has been exhausted. When they did some digging, it is because Express Scripts has been covering less and less of my medical costs each month. The isurance specialist at Abbvie talked to 14 people from Express Scripts and Accredo and no one, even supervisors, were able to explain why this is happening. I was told that Express Scripts uses the company SaveOnSP, who is currently being sued by ***************** for charging copay assistance and customers the same amount, but not reporting to the customer that copay assistance has paid.It sounds like something illegal is going on with Express Scripts/Accredo and I need help.
Business Response
Date: 07/15/2022
July 1, 2022

Better Business Bureau Serving Eastern ******** and Southern ********
211 ***********, Suite 2060
***********, ** 63102
Attn: Dispute Resolution Department

Re: *********************** / #********

Dear Sir/Madam:

I am in receipt of your letter regarding a complaint filed by ***********************. Express Scripts carefully reviewed the complaint along with its internal records and respectfully provides the following response.

By way of background, Express Scripts administers prescription drug benefit plans on behalf of plan sponsors. Express Scripts provides plan sponsors with core pharmacy benefit management services, including third-party claims processing, formulary administration, benefit plan communications, and other similar activities. In this capacity, Express Scripts is not acting as a health care provider or insurer, but serves to administer benefit plan designs and formularies in accordance with rules provided by the plan.

**************** expressed concern with his billing for a medication he is receiving from Express Scripts specialty pharmacy, Accredo.

**************** has a Copay Assistance Program (***) listed as secondary insurance on his Accredo account. The primary insurance was billed, as well as, the *** on Mr. ******* file. Mr. ******* primary insurance does not allow claims paid by the *** to apply towards the plans accumulators such as the deductible. Mr. ******* *** paid for the majority of his 2022 shipments; therefore, the dollar amounts were removed from their accumulators. *** partially covered the copayment from his primary insurance for his May 2022 shipment leaving him with a $652.39 responsibility. *** funds have been exhausted for 2022.

I trust this letter has been responsive to your request for information regarding this complaint. If you have any questions regarding this matter, or desire any further explanation or information, please contact me directly at **************.

Sincerely,

**********************************
Senior Manager, Executive Correspondence

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