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“Humana/Rightsource incompetence caused unnecessary...”

★☆☆☆☆

written by on 25/05/2013

As authorized by a signed Consent Form, I order medications on-line for my 92 year old Mother from RightSource via mail order delivery under their Medicare Part D plan. I live in Virginia, she lives in Ohio. On December 6, 2012, I ordered a routine refill of 6 generic prescriptions my Mother has been taking, and RightSource has provided, for the past 3 years. Usually these orders are processed within a day or two and received by my Mother in less than 7 to10 days. Two weeks after the order was placed my Mother received a letter telling her to order refills as she would be running out soon. I called RightSource and explained the refill had been ordered weeks ago and was still showing an "In Process" status. (Obviously, the left hand doesn't know what the right hand is doing at RightSource or the refill notice to my Mother would not have been sent.) Spoke to about a dozen Customer Service Representatives and their managers/supervisors, usually after interminable delays while on hold, but none of them could tell me why the order was on hold or offer a way to resolve the problem. Finally gave up on RightSource and called Humana. Couple of Humana Representatives said they didn't understand why the order couldn't be processed and one promised an expedited shipment that would be delivered to my Mother on the Friday or Saturday before Christmas. When that didn't happen another Humana Representative said he could take care of it and the medicine would be delivered by the Monday before Christmas...guess what...it never happened. Unable to fulfill their obligations, Humana agreed to transfer the prescriptions to a pharmacy near my Mother. The pharmacy (large national chain) filled the prescriptions but charged copays that added up to about $75. Humana/RightSource refused to reimburse my Mother for her out of pocket costs that were incurred because of their incompetence. Filed a claim with Humana's Grievance and Appeal Department that was denied. Followed that with an Appeal of the determination with the same department. That was also denied for nonsensical reasoning centering on Tier 1 and Tier 2 drugs, none of which was relevant. Humana/RightSource refused to acknowledge or directly address the fact that it was their inability/incompetence to deliver the prescriptions that caused my Mother to incur the costs. This is a shameful, inexcusable, and deplorable way to treat a member who is housebound and whose sole income is a small social security check. Before posting this review, I sent a certified letter to the CEO of Humana giving him one last chance to fix their mistake. Received a call from a Humana spokesman saying the CEO had read the letter and told the spokesman to express his apologies but he could not provide restitution because it was prohibited by Medicare. The spokesman then said the reason for the non-delivery of prescriptions was because they were installing a new system and it had a lot bugs and their people weren't familiar with it, plus they were in the midst of their new enrollment process. This is further evidence of their incompetence and bad judgment. As a computer professional who has overseen many computer system changes both for hardware and software, I know from experience that you don't cut over to a new system until you have run both systems in parallel through a couple of business cycles and eliminated the bugs in the new system. Moreover, you do not install a new system at the height of your busiest business cycle. Finally, you normally don't install a new system over the Christmas - New Year season. Based on my experience, I strongly recommend against buying Humana health insurance plans or their mail order pharmacy WrongSource, oops meant RightSource. It appears that Humana/RightSource has successfully beaten my Mother out of $75, hope they enjoy their victory but it won't begin to cover the cost of lost business that this rating will generate, not only on this site but YELP, many others.

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