Public Mediation

T.M. vs. Optum Specialty Pharmacy

  • 10% of recovery offered for best resolution


T. M. vs. Optumrx
11000 Optum Circle, Eden Prairie, Minnesota, 55344, United States
    • Status: In Negotiation
      This claim has posted for public comment and negotiation. It will remain posted until resolved to the claimant's satisfaction. Suggest a resolution to help these parties reach a settlement.
      (seeking public comment)
    • Claimant Seeks: View.
    • Claim #: 1312793
    • Amount Involved: 50,000.00
    • Filed On: Feb 11, 2022
    • Posted On: Feb 22, 2022
    • Complaint(s):
      • Rude or Unprofessional Behavior
      • Incompetence
      • Negligence
  • Review this case.
  • Propose your solution.
  • Win the reward (1,000)
Statement of Claim
Claimant says:
"I am a 40-year-old woman who has been living with MS for 20 years. The cost of my medication after insurance is 681.93 for a 1 month supply. Last me after a lengthy back-and-forth process I was awarded a co-pay assistance program. I spoke with a very helpful woman Chaquita Taylor for an extended time plus emailed back and forth to finally get it added to my account.

The very next time I had to call for a refill, no one saw any notes of the previous conversation, no one saw that I had a co-pay assistance on my account. I had to be on hold and be transferred just to finally come back and they saw it after they dug.

My question and concern is why does your system not populate when a person has co-pay assistance? Does Optum RX not understand that stress is horrible for a person with multiple sclerosis? Every time I call for a refill, which is every month, the agents do not see any other previous conversation and I am on hold back-and-forth getting upset.

I am very fortunate that I am still able to talk and I have no issues I have all of my working faculties; however not all MS patients can do this. I end up in tears every time I get off the phone because it's so much stress and worry. I need this medication for my life sustenance.

I called on 2/5/22 To start my refill because I received a call to do so. When I called them that agent was actually very rude, she did not seem to have a care in the world for my situation. She also did not see any notes about my co-pay assistance and she was asking for me to give her the 681.93 to schedule my delivery.

Yet again I explained to her the whole situation and explained to her how I did not understand why I have to keep going through this each time. She put me on hold and came back to say the department that handles my account because of my co-assistance was closed on the weekend and I wouldn’t need to call back. Horrible horrible customer service. Why would this not be notated on my account?

Getting my prescription filled should not be a source of extreme stress and anxiety for me every month. I always feel bad for other people with MS who cannot communicate as well or make these calls or keep being a detective with a company that has an inadequate, insufficient, or non-existent note-taking process.

I spoke to someone on 2/7/22 - again they saw NO NOTES, no pop up, I had to explain all over again, be on hold, ridiculous! Thought it was set for delivery by 2/9. Nope! I just called today and spoke to Raina. Very nice lady but same story - different person. I actually started to cry.

I can’t take this. Optum Specialty Pharmacy is going to cause me to have a nervous breakdown going through this every month. Stress is horrible for people with MS and unfortunately for me, the pharmacy I have to get my refills though is a source of stress and anxiety for me. Regularly!

I am going to inform the National MS society about this. This has to be changed and updated with your systems. It’s 2022. This is unacceptable and I will take this to the media if I have to. I don’t want other MS patients to deal with this.

I did tell Raina that although she seemed nice and claimed she would note my account, as did countless others, I have zero faith in Optum Specialty, so I let her know that the same way I know their calls are monitored, I was also monitoring the call and I recorded it.
Reply Have a similar problem?
What Claimant Wants Hide
1. Compensation: pain, suffering, stress and anxiety Feb 26, 2022 $50,000.00
2. Other – Pay for claim posting cost Feb 26, 2022 $14.99
Cash total : $50,014.99
  • 0
Do you agree with the claimant’s demands?  (If you are a party to this claim, click here.)

Respondent's Counteroffer

There has been no response to this claim from OptumRx. This claim will remain posted until resolved
Get fast access to our Resolver community, for...
  • help with a PeopleClaim or any other complaint
  • assistance with a purchase or contract
  • expert advice
Other PeopleClaim resolvers
Get Free alerts when claims post in your area.
Get Alert

Need help resolving a dispute? Learn more.

Public Mediation

The shortest path from your problem to its resolution.
Peer to Peer

Engage the other party and use powerful tools to negotiate the best resolution.

If Unresolved
Community Resolution

Post your case online and get help from legal professionals, industry experts, consumers & advocates competing to find the best resolution to your claim.

$14.99 + optional reward for best resolution
Full refund if not resolved to your satisfaction
If Unresolved
Private Mediation

Lets you mediate your case privately with the help of our professional mediators and industry experts.

Free to claimant. Mediator fees negotiable.
If Unresolved
Engage a Professional

Find the best community-reviewed professionals near you to resolve your issue in private online mediation or traditional court/mediation.


A wonderful serenity has taken possession of my entire soul, like these sweet mornings of spring which I enjoy with my whole heart.

I am (not) alone, and I feel the charm of existence in this spot, which was created for the bliss of souls like mine...~ Goethe

Get a public verdict — create an online trial $50 public trial / $50 reward for successful resolution
Important: All information contained herein is the opinion of the posting parties, who are solely responsible for its content. PeopleClaim offers both free and paid services to help consumers, patients, employee, tenants, and others resolve disputes without lawyers or courts, through negotiated online settlement and public disclosure of wrongdoing or unfair treatment.
Claims against parties operating under bankruptcy protection, by law must be processed solely through the appropriate US bankruptcy court. Any claims against this party currently posted on PeopleClaim are available for purposes of public business review only and are not an attempt to collect money or recover assets subject to protections under the United States Bankruptcy Code.
*IMPORTANT: PeopleClaim is a public dispute resolution system, independent of the BBB, small claims court, or other dispute resolution services. PeopleClaim is not a law firm and does not provide legal services, opinions, or advice. PeopleClaim facilitates peer-to-peer negotiation and resolution and crowdsourced input on issues of fairness to help resolve complaints. Users should contact professional legal counsel on any matters of law or regulation regarding their claims. PeopleClaim does not review or evaluate the merits of claims submitted through its site, and users are solely responsible for all content filed in their claims.
© reserved by PeopleClaim