ComplaintsforMedImpact Healthcare Systems Inc

Health Insurance

View Business profile

Need to file a complaint?

BBB is here to help. We'll guide you through the process.

File a Complaint

Complaint Details

Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.

Initial Complaint
11/14/2024
Complaint Type:
Service or Repair Issues
Status:
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.
I have had prescription coverage for the FreeStyle Libre 3 GCM for about a year and the FreeStyle Libre 2 for several years prior. Recently, the *** in my small town has been unable to fill the prescription for my CGM, continuously canceling the order, stating that the item is backordered from ****** for about the last three months. As an alternative, I contacted my physician to change to either a FreeStyle Libre 3 Plus or a Dexcom G7. When I contacted Dr. ******** *************** office at ***************, I was told that Dr. ************* would be out of the country for the last three months of the year, and I would need to wait until she returned to change my prescription. This glucose monitor is crucial for tracking and managing my blood glucose. Further inquiries to ************************** elicited a response from Shineky Nicarol *********, advising me to either try a different pharmacy or do finger sticks until the sensors are back in stock. Upon inquiry to Elixir / Medimpact, I was told I would need a "prior authorization" form to get a DexCom G7 covered, which is the same response they provide to every question. Elixir / Medimpact further stated that I would need "prior authorization" for the FreeStyle Libre 3, which Medimpact had already been covering for me for at least a year. This highlights that the customer service at ******************** is simply providing rote responses to inquiries. The pharmacists at CVS in **************, ** are completely unable to tell me when I will be able to get my CGM prescription filled, transfer my prescription to another CVS, or provide any information at all, and just keep canceling the prescription without explanation.
Business response
11/22/2024
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Name of consumer's employer or health insurer - MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers.
2. Date of birth or health plan identification number.
Sincerely,
MedImpact Healthcare Systems, Inc.
Initial Complaint
10/29/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
In April of 2024, I was diagnosed with a chronic autoimmune disorder. At the time, and through the present, the insurance provided through my employer utilizes MedImpacts *********** for all prescription related drug claims. The life saving drug I was prescribed and is in question, with insurance, is roughly $3,500-$4,000 per month. In order to assist with high co-pays, the drug manufacturer offers a copayment card to cover some of the costs, to the amount of $7,200 annually. Without my knowledge or consent, MedImpact (according to their own records), charged the full amount for 2 months to this copayment card, on my behalf, without providing me any benefit. MedImpact has a scheme, which was ruled illegal in Federal court in late 2023, where they collect the maximum amount of copay assistance without crediting the patient in any way (deductible, OOP max, etc.). This intentional scheme, designed to extract many thousands of dollars from the patient, in addition to the assistance provided for the patients benefit, making MedImpact thousands of dollars in profits on one patient and one prescription annually. Further, this is against the manufacturers terms of use for the copay card for more than $25 per claim - MedImpact sought roughly 150x that in reimbursements, while showing this does apply to a patients deductible, but only where convenient for the. Because MedImpact acted in this deceitful way, I am unable to receive alternative copayment assistance I would have otherwise been able to receive. I have had to source 6 months of medication - roughly $20,000 worth in insured cost - elsewhere. MedImpact is aware of this issue and each week and month I hear it will be solved soon.
Business response
11/04/2024
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:

1. Name of consumer's employer or health insurer - MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers.
2. Date of birth or health plan identification number.
3. Prescription number or name of medication(s), and date(s) of fill.
Sincerely,
MedImpact Healthcare Systems, Inc.
Customer response
11/05/2024

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********. This matter was resolved before the BBB sent it to the business, but after the complaint was filed. I appreciate the efforts put into this. I consider this complaint resolved.

Regards,

****** ****
Initial Complaint
05/09/2024
Complaint Type:
Service or Repair Issues
Status:
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.
My daughter got diagnosed with Lyme disease on 05/07/24 she was prescribed doxycycline on 05/09/24 I am still waiting for the insurance company to approve the urgent prior authorization that was submitted by the physicians office. I reached out to the insurance company and they wanted to know if any other treatments have been attempted and I explained that my daughter is allergic to penicillins and there is only two approved antibiotic treatments for Lyme disease and she is allergic to penicillins. So the only option is doxycycline. They said the information has to come from the physicians office and they do not care who calls that they have a process and they will not approve it until they see fit. Meanwhile my daughter is in excruciating pain with her joints and muscle pain, fever, headaches and extreme fatigue. There is absolutely no reason the government nor insurance companies should ever have a say in if and when a child should receive treatment that their physician sees necessary. They are none clinical people who do not know or understand how medications work or how important they are in this situation. There is no way they should be making such critical calls. My daughters life are in the hands of people who have no idea what they are talking about and are on some sort of power trip that they hold all the control if she gets her antibiotics or not. This is horrifying that such a process exists especially when it comes to a child and their suffering. Its disgusting. My children. Every child deserves so much better than this! I have attached the photo of my daughters tick bite which is textbook Lyme disease. What *** could this ridiculous insurance company require? What does the word insurance means anyway? It is a contract between me and my insurance company that they will provide the services I have signed up for which includes 100% pharmacy coverage?!? So I am super confused where the issues are here?
Business response
05/13/2024
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:

1. Health insurer information for the consumer -MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Member/Dependent First and Last Name
3. Date of birth or health plan identification number
4. Claim or prescription number, if available.
Sincerely,
MedImpact Healthcare Systems, Inc.
Initial Complaint
01/02/2024
Complaint Type:
Service or Repair Issues
Status:
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.
I have been trying to get birthcontrol refilled and I always get it from them no problem but a few months back they have made it really hard for me to get it refilled. I had the primary doctor's hospital contact them and they went off a mistake that my insurance made claiming that I wanted tri lo marzia when I always have been getting tri lo sprintec and said its not covered. Then they made it even harder and refused the prescription that my hospital gave them and the hospital and me have been trying hard to get it refilled. I would like it to get refilled and for them to stop being difficult and also apologize for this months of dragging for refilling the birth control and refund as well for the birth control that I am getting refilled for all of the trouble.
Business response
01/03/2024
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Health insurer information for the consumer -MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Member Full First and Last Name (if not provided on the complaint or is a dependent not named)
3. Date of birth or health plan identification number
4. Claim or prescription number
Sincerely,
MedImpact Healthcare Systems, Inc.
Customer response
01/03/2024
It was not resolved and I have not received the medication or refund
Business response
01/08/2024
Following up on the original response, MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Health insurer information for the consumer - MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Member Full First and Last Name (if not provided on the complaint or is a dependent not named)
3. Date of birth or health plan identification number
4. Claim or prescription number
Sincerely,
MedImpact Healthcare Systems, ****
Initial Complaint
07/14/2023
Complaint Type:
Service or Repair Issues
Status:
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.
a law pass where pharmacists will not take advantage of older people by sending meds or devices automatically, patients have the right to cancel shipments or better yet, patients have the right to approve of the meds or devices before they're sent. Medimpact is violating all of it, making confusing through texting, sending meds and devices without authorization from client, so tired. I'm talking hundreds of dollars, I will seek professional help cause I don't trust this website but for the record I want to secure myself, so sick of it,
Business response
07/17/2023
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Health insurer information for the consumer -MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Member Date of birth or health plan identification number
3. Claim or prescription number.
Sincerely,
MedImpact Healthcare Systems, Inc.
Customer response
07/17/2023
Health Provider: Blueshield of California.
DOB: 03-08-1960.
send OmniPods without request and authorization. texting confusing Example; I just received Humalog for 3 months about 3 weeks ago they keep on texting me to authorize a new refill. My Dr. ****** called on July 11th to change Humalog to Lamamir insulin pen and as of today I have not received it yet, I went to the Dr's ****** to complain, they call again and MedImpact reply that they need to verified my physical address every time they send this medicine but this information was not given to me or the ************* this also happen with the Dexcom G6 devices, it took about a month and many calls to get the devices. my concern is the lack of communications from the pharmacist, is very reactive rather than proactive. very upsetting and disappointed. I don't trust them and I know that every time is an uphill challenge to deal with them. I wish I had an option to pick another pharmacist.
Business response
07/25/2023
Thank you for giving MedImpact Healthcare Systems, **** (MedImpact) the opportunity to review this matter. Please note that MedImpact is a prescription benefit manager that administers prescription drug benefits on behalf of ************************* insurance plan. MedImpact is not a pharmacy and does not dispense or ship prescription drugs to members. MedImpact also does not text members regarding prescription drugs.

Based on the information provided by ************************** and available to MedImpact, it appears that ************************** is referring to his interactions with *****, a mail order pharmacy in MedImpacts pharmacy network. MedImpact reached out to ***** in an attempt to address and resolve the concerns noted in Mr. *********************

***** resolved the issue and ************************** received his medication on 7/19/23 and will contact him for notification preferences.

We trust that this resolves ************************** concerns, but if he has any additional questions or concerns regarding mail order prescription drugs from *****, he should reach out to the pharmacy directly by calling the phone number on his medication label.
Sincerely,
MedImpact Healthcare Systems, ****
Customer response
07/27/2023
thank you for the clarification however, when I get emails and texts, it seams that both identities are one, even when I complain about my prescription orders, when I go on line it states, "welcome to ***** Previously Med Impact I don't know who's who,
then, from their emails when I try to find out what this all about, there's nothing relevant to to the message when I click, no were to search on the menu, it just gives me info about my previous meds refills on the the website but nothing relevant to the message,
my main issue is the lack of orderly prescription follow through and transparency, if I call ***** ? Med Impact and explain my situation and ask them to please send only the meds that I need and approved of at a specific time and only when I approve of them they always agree and (pretend that all changes are corrected) until next cycle, then, here we go again, Meds on the mails, charges on my credit card, this is praying on elder people with no over site from BBB or Congress draining our savings,
I'm 63 years old, I can only imagine what people older than me go through, I will not give up!!
Initial Complaint
06/20/2023
Complaint Type:
Service or Repair Issues
Status:
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.
Medimpact has repeatedly giving me misinformation about my medication. Since 11-1-2022 I have spent over 100 hours on the phone trying to get them to just do their job. I am a traumatic injury patient that has had 14 surgeries and repeatedly they have denied me maintenance pain medication. They also refused acute pain medication after my hip surgery. They said I already had meds from pain management!! You cant take those meds after surgery until That Dr releases you back to pain management! They KNOW this!! Im The nice phone people know Nothing and the supervisor tried to fill an emergency 3 day script of opioids when that is not permitted . The supervisor should have know that !! You Cant pharmacy shop either like they suggested!!!! They should send the prioritization forms BEFORE they run out !! This company provides substandard care !! Ive been told by ************ Senior Benefits Analyst that she would no longer talk to me or help me in Any way I could take my problems to ******!!
Business response
06/27/2023
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
-Health insurer information for the consumer
-Date of birth or health plan identification number
-Claim or prescription number
Sincerely,
MedImpact Healthcare Systems, Inc.
Initial Complaint
05/02/2023
Complaint Type:
Customer Service Issues
Status:
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.
Date of interaction with customer service rep ********** 5/2/23 Tech called for cost override for a patient's prescription and by was informed by Medimpact service rep that medimpact does not do this.After providing PA number that had already been obtained by pharmacy (this information was not requested by rep but is known solution when they say that they cannot do this override), then rep retracted previous statement and said additional information was needed for him to submit for cost override. Rep then asked for more patient information than was necessary during call such as patient's height and weight and phone number which have nothing to do with the medication or cost override. Submitting formal complaint as this is an ongoing issue with medimpact rep conversations.
Business response
05/08/2023
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Health insurer information for the consumer -MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers.
2. Member full first and last name (if not provided on the complaint or is a dependent not named)
3. Date of birth or health plan identification number
4. Claim or prescription number.
Sincerely,
MedImpact Healthcare Systems, Inc.
Initial Complaint
02/08/2023
Complaint Type:
Order Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Ive been trying to get reimbursed since oct 2022 for a prescription I paid for because I didnt want to wait 3-4 days of having pain. (according to the pharmacist) that needed pre authorization, which they approved after dozens of phone calls and really giving up Medimpact sent me a letter saying that they had paid me $100 and the copy was $75.55. Tots to prescription was $$175.55. Of wich I Never received any $ amount. So I called. Now theyre saying it could take 5 months to pay. What a pos company. Ive get better service from the local garbage men.
Business response
02/10/2023
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information.

MedImpact respectfully requests the consumer to please provide the information below related to the covered member:

1. Health insurer information for the consumer -MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Date of birth or health plan identification number
3. Claim or prescription number

Sincerely,
MedImpact Healthcare Systems, Inc.
Customer response
02/11/2023

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

*****************
well they already have all that info but Ill provide again
Bright Health Care
id *********
effective Date of membership 01/01/2022
subscription # *******
date of subscription 09/24/2022
name of subscription trifluridine ophthalmic solution
cost $ 175.55
pharmacy name Wal mart pharmacy ************************************************************************* 73162
**************
like I said Medimpact has this info. The complaint is Medimpact wants 5 months to reimburse
Initial Complaint
09/07/2022
Complaint Type:
Service or Repair Issues
Status:
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.
I purchased 8 at home Covid tests at a local ********* pharmacy in June at a cost of $105 and promptly submitted to MedImpact for reimbursement. Today I was informed that ********* is not in the preferred network of pharmacies for this benefit and my claim was denied. Per federal mandate, this cost must be reimbursed regardless of place of purchase at a minimum of $12 per test. https://www.cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free If your plan has set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers if you buy them outside of that network. Your plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Save your receipt(s) to submit to your plan for reimbursement at a rate of at least $12 per individual test (or the cost of the test, if less than $12).https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/aca-part-51.pdf Therefore, the Departments will not take enforcement action related to coverage of OTC COVID-19 tests against any plan or issuer that provides coverage of OTC COVID-19 tests purchased by participants, beneficiaries, and enrollees during the public health emergency by arranging for direct coverage of OTC COVID-19 tests that meet the statutory criteria under section 6001(a)(1) of the ***** through both its pharmacy network and a direct-to-consumer shipping program, and otherwise limits reimbursement for OTC COVID-19 tests from non- preferred pharmacies or other retailers to no less than the actual price, or $12 per test (whichever is lower).15
Business response
09/12/2022
Medlmpact is in receipt of this complaint and is unable to process the inquiry without the following additional
information. Medlmpact respectfully requests the consumer to please provide the information below related to the covered member:

1. Health insurer information for the consumer - Medlmpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Date of birth or health plan identification number
3. Claim or prescription number

Sincerely,
Medlmpact Healthcare Systems, Inc.
Customer response
09/12/2022
My name is ************************* and member ID is *******. The claim number has not been provided to me.
Business response
09/19/2022
In order for the member to be reimbursed in accordance with the plans benefit, the clients benefit information regarding Covid tests must be coded into the system at the clients request.

This is in process and when completed will be retroactive to January 15, 2022.

The member will receive notice of the reprocessing of the claim and any payment due to member.
Sincerely,
Medlmpact Healthcare Systems, Inc.

Customer response
10/01/2022
I do not consider the matter closed until I see the results of the reprocessing and they are consistent with the law.

Thank you.
Initial Complaint
08/11/2022
Complaint Type:
Service or Repair Issues
Status:
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.
My healthcare insurance uses MedImpact as their prescription provider. Over the last three months, they have removed two medications from their formulary that I take and also one that my husband takes several months ago. I find this unacceptable. They make us jump through some hoops to continue to take medications that we have been taking for years, like asking my doctor to request a formulary exception. This process takes awhile and I really dont understand why it keeps happening. The most recent letter states after 9/30/22, we will stop covering this Rx. Please contact your doctor about changing your medication. Its very frustrating because for the first one they dropped, it took me years to finally find one that works for me and then they pulled it. It took me a couple of months going back and forth with them and my doctors office to finally get it put back onto my Rx list. And then when I did receive it, the price was higher! Also, I have had in recent past, two incidents where they say they mailed my Rx and I did not receive it. When I called to inquire about it, they said that they will re-send but I have to pay for it again. I live in a place where I have never had issue with mail being stolen so I find this highly suspicious also. It happened twice, the first time the Rx was only $15 to refill so it wasn't a terrible problem but the most recent time (which I haven't requested a re-send yet) was with a Rx that was removed from their formulary so it will cost me over $50 to replace.
Business response
08/12/2022
MedImpact is in receipt of this complaint and is unable to process the inquiry without the following additional information. MedImpact respectfully requests the consumer to please provide the information below related to the covered member:
1. Health insurer information for the consumer - MedImpact is a pharmacy benefit manager that administers prescription benefits on behalf of health insurers
2. Member Name(s) applicable to the specific complaint
3. Date of birth or health plan identification number
4. Claim or prescription number.

Sincerely,
MedImpact Healthcare Systems, Inc.

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. ↩

BBB Business Profiles may not be reproduced for sales or promotional purposes.

BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.

When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.

BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.

As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation.

Cookies on BBB.org

ComplaintsforMedImpact Healthcare Systems Inc

Need to file a complaint?

Complaint Details

Showing all complaints

Business response

Business response

Customer response

Business response

Business response

Customer response

Business response

Business response

Customer response

Business response

Customer response

Business response

Business response

Business response

Customer response

Business response

Customer response

Business response

Customer response

Business response

BBB Rating & Accreditation

Contact Information

Customer Complaints Summary