Complaint Review: PharmaCare Direct

As an employee of this company, I would like to make a few clarifications.

First of all, an explanation of how pharmacy pricing and pharmaceutical insurance works. No pharmacy sets the pricing on any medication unless you do not have insurance. On ALL paid claims, even those that have reached their benefit maximum, the cost is determined by the insurance carrier. That price is a discounted rate below the actual retail cost of the medication, and is determined by the contract set by your insurance carrier.

Secondly, as PharmaCare Direct is a pharmacy, not the insurance carrier, they cannot tell you what your claim will cost under the insurance. They can tell you what your previous costs for the medication were, and they can submit a 'Trial Claim' to your insurance provider to see what the provider states it will cost. However, the ultimate cost is still not going to be determined until the date and time the insurance company processes the electronic claim. The length of time it takes the insurance provider to respond is determined by the insurance provider.

Additionally, if the incorrect price was quoted over the telephone, there is a verbal record of this. PharmaCare Direct records ANY and ALL calls made to or by them. Any and all claims, including trial claims, remain in their PharmaCare Direct's computer systems for seven years. These records include the identification of who performed them, the date and time the claims were submitted, and the results of the claim. It even stores the rejected claims and pricing information. Any agent at PharmaCare Direct, in either the Customer Service or Supervisory Teams, can access the computer information at any time. Access to the recorded call can only be performed by the Supervisory Team after all other research tools have been exhausted.

Another item is that PharmaCare Direct generally doesn't work without insurance. They contract directly with insurance companies to provide mail order benefits. For PharmaCare Direct to send anything out at retail price, a special profile has to be created. A limitation in the system will not allow a claim to go out unless the permanent profile has either an insurance tag, or a cash tag. You cannot change the 'tags' in the profile on the system that they use. If it was sent out at a retail cost, this profile would still exist in your system, as they must be maintained for seven years by Federal law.

Next, the cost of the medication. If your existing balance plus the cost of the medication exceeds $199.99, the order should not ship. The system stops it automatically. Before the order can be shipped a payment must be applied to bring the total (existing balance + order cost) to $199.99 or below.

The only exception to this is if you have a credit card on file and have previously given authorization to charge all shipments to said credit card. This, however, would result in you having a $0.00 balance and would NOT restrict the shipping of any further medications. It is possible that the balance is high enough that the copay of your next order would take it above $199.99. If this is the case, a payment accompanying the next order, of the copay of that medication only, should allow it to ship.

Now the manufacturing cost of the medication is spot on, for one of the manufacturers. However, this is NOT what the manufacturer sold the medication for. The medication was distributed nationwide with an Average Wholesale Price of $2.77 per tablet, for the 10Mg tablet, for the primary manufacturer. This information is publically available via the FDA and the manufacturer's website.

Now, to the gentleman who had questions about the website. The website is, in fact, pharmacare.com. It has been for a number of years. On the lower right hand side of the home page is a link that says 'Mail Service Pharmacy'. This goes directly to PharmaCare Direct.

As far as the address, that's actually a simple one. The address that was reported is the physical location of ONE three different pharmacies. That is one of the locations where the physical prescriptions are processed, where the pill bottles are filled, and where the medications ship from. However, it is NOT where the Customer Service functions are performed. Those functions are performed at a number of facilities nationwide, including Texas, Florida, Pittsburgh, and Rhode Island.

A quick review of the website shows that the main corporate address is:

PharmaCare Management Services, Inc.
695 George Washington Highway
Lincoln, RI 02865

I will warn you however that, unless this has been reviewed by the Customer Service Department, any correspondance will simply be forwarded back to the Customer Service department. In all likelihood it will be forwarded back down to our Texas office.

Finally, regarding the post on the Better Business Bureau reports. A quick review of the Better Business Bureau search page (search.bbb.org) forwards one to the Cincinnati, OH, Better Business Bureau. This page does not provide any form of 'rating' system for PharmaCare Direct. I would like to know where you found the information on an 'Unsatisfactory' rating was found, just out of personal curiosity.

The Cincinnati BBB indicates that there have been seven complaints filed within the last 36 months. As this particular facility fills a minimum of 3,000 prescriptions per day, that means that there have been seven complaints filed out of approximately 3,285,000 prescriptions. Of these seven, six have been resolved. This means that within the last 36 months approximately .0000003% of all claims have resulted in complaints.

Here's what I can do. Give me an e-mail address that I can communicate with you at. I'll review your information and give you a straight up answer as to what has happened.

I found a real address for the company that scammed you. Direct from the Better Business Bureau.
513-881-6800
Fax# 513-881-6841
6820 Fairfield Business C
Fairfield,OH 45014
The BBB gave this company an 'Unsatisfactory' record.

Website is not pharmacare.com Everything else is correct. Sorry!

In the future, never ever order from a company off of the internet that does not list a street address. No P.O.Boxes. Good luck.

In the future, never ever order from a company off of the internet that does not list a street address. No P.O.Boxes. Good luck.

In the future, never ever order from a company off of the internet that does not list a street address. No P.O.Boxes. Good luck.

In the future, never ever order from a company off of the internet that does not list a street address. No P.O.Boxes. Good luck.