On 4/20/20 my Neurologist's office submitted a request for home infusions through Optum Specialty Pharmacy in Albany, NY at my request due to COVID-19 and trying to minimize my exposure. I felt it would be better to have the infusions in my home and only coming into contact with only one nurse over a 5 days period for my infusions. I normally have my infusions in the apheresis unit at a hospital. My infusions were due to be infused from 5/11/20-5/15/20 and today is 5/8/20 -15 days after my first communication with them - and I was told they had not even submitted a prior authorization request to my insurer. When I initially spoke with Latoya Adams on 4/23/20 I explained to her that I had spoken with a pharmacist at my insurance company who told me since I already had infusions approved all they would need to do is submit a prior authorization so they can change the system to pay them and not the hospital. I told her what medication I have infused and what my 3 premeds I take are and that I needed the special formulation due to stage 3 chronic kidney disease. She told that formulation is in limited supply and their clinical team would decide if they would infuse it. I was very clear I would not have another medication infused or a different type of the same infusion because my Neurologist and Nephrologist decided that was the best choice for my complex medical needs. She was not listening to me and kept cutting me off telling me no ma'am. I know most patients are not as versed in their care as I am, but I felt dismissed by her every time we had a conversation. She called me about 3 times in 15 days and it was always someone else's fault of why nothing was done. The next call they needed a medical necessity letter from my Neurologist, this was more than a week after our first conversation. I contacted my Neurologist's office via a member portal and it was submitted within an hour. I do not believe Optum had ever contacted my Neurologist's office. She tells me their clinical team needs to review the letter of medical necessity and approve or deny the only infusion I have been taking since May 2018. I don't like the fact that Optum thinks their clinical staff who knows nothing about my complex medical history should have authority to override my Neurologist and Nephrologist orders. Today all 3 premeds appeared in their system as she acted surprised to see them, the same premeds I had named days before. So today Optum tells me they would not have an answer for at least 72 hours on top of the 15 days they already had to obtain prior authorization from my insurer. This morning I also called the Optum Specialty Pharmacy on Albany, NY and asked for a supervisor. She tried to connect me to Latoya Adams and I told her I had just left her a voicemail. I was placed on hold so she can find out who her supervisor was. She took my number and said a supervisor would call me back. No supervisor called me, but Latoya called me a minute after I completed my call asking for a supervisor. That would delay my treatment and there was still no guarantee that I would receive the infusion and premeds prescribed. So, after a lot of aggravation for myself and my doctor's office I will be having my infusions in the apheresis department at the hospital I have been having them for 2 years. My recommendation to Optum Specialty Pharmacy that a nurse make contact with the patients being referred to you for services not a rude, unknowledgeable, dismissive, non-clinical person who obviously needs to be retrained in customer service specifically on how to listen to and treat a customer. If there were negative stars or no stars that would be my rating. I do not recommend Optum Specialty Pharmacy to anyone. read more
