Optumrx: Prescription Monitoring For Customer Safety And Care

OptumRx is a pharmacy benefit manager that serves more than 65 million members. They provide safe and cost-effective ways for their customers to access their medications and help them achieve better health outcomes. OptumRx offers home delivery services, allowing customers to receive their routine medications in their mailbox without having to leave home. They also offer an automatic refill program, where customers can automatically receive their next three-month supply of medication. Customers can also use the OptumRx mobile app to view and order prescriptions, check order status, and more. In addition, OptumRx closely monitors the drug supply to its pharmacies to ensure it can fill prescriptions. This includes implementing enhanced protocols for handling opioid prescriptions to reduce their number, dose, and duration.

OptumRx's role as a pharmacy benefit manager

OptumRx is a pharmacy benefit manager (PBM) that serves more than 65 million members. It helps clients and members achieve better health outcomes and lower overall costs through innovative management services. OptumRx provides safe and cost-effective ways for individuals to access their medications.

OptumRx offers a range of services to its members, including home delivery of medications, automatic refills, and 24/7 access to a pharmacist. Members can also track their orders, manage billing information, and request refills through the OptumRx website or mobile app. Additionally, OptumRx provides emotional support through its Emotional Support Help Line, which is available 24 hours a day, 7 days a week, for individuals experiencing anxiety or stress.

As a PBM, OptumRx also works with health plans to review the medications individuals are taking before they are covered. This process, known as prior authorization (PA), ensures safety, effectiveness, and cost control. OptumRx also offers generic medications, which can be more cost-effective than brand-name drugs while providing the same active ingredients and effectiveness.

OptumRx's medication delivery service

OptumRx is a pharmacy benefit manager that serves over 65 million members. They provide safe and cost-effective ways for you to access your medications and help you achieve better health outcomes. OptumRx's medication delivery service, Optum Home Delivery Pharmacy, offers several benefits to its users.

Firstly, it provides convenience by bringing your prescriptions directly to your home, saving you time and avoiding long lines and limited hours at the pharmacy. Eligible members can also use the quick order tracker to check the status of their medication without signing in. The service offers free standard shipping to U.S. addresses, with most medications available in a 3-month supply. After your order is processed, you can expect to receive your medication within 3 to 5 business days.

Secondly, Optum Home Delivery Pharmacy provides 24/7 access to licensed pharmacists who can answer any questions you may have about your medication. This remote consultation service ensures that you receive support and guidance from the comfort of your home.

Thirdly, the service offers cost savings. Optum Home Delivery Pharmacy provides market-competitive pricing and helps you find the lowest available prices for your medications. They also offer various ways to save money on your prescriptions, such as switching to generic alternatives or a 3-month supply. Additionally, they offer low-cost insulin for $35 per month for those without insurance.

To enroll in Optum Home Delivery Pharmacy, you can ask your doctor to send an electronic prescription or transfer your current medication. You will also need to set up an account on their website or through their mobile app, where you can manage your prescriptions and track your orders.

OptumRx's mobile app

OptumRx is a pharmacy benefit manager that serves over 65 million members. The OptumRx mobile app is available for download on the Apple App Store and Google Play. The app allows users to manage their pharmacy benefits without having to go to a physical pharmacy.

The OptumRx app has several features that enable users to manage their medications on the go. Users can compare drug prices, view all their medications, and transfer eligible medications to home delivery. They can also refill their home delivery prescriptions, check order status, and set up automatic refills. Additionally, users can view their member ID card, resolve home delivery order holds, and manage their account information.

The app also includes tools to help users find the right drug and pricing options. Users can search, compare, and save medication information. They can also set up text message medication reminders within the app.

The OptumRx app is designed to provide affordability, accessibility, and advocacy for its users. It helps users find medications at the lowest prices available to them and ensures they receive their medications when and where they need them. The app also provides compassionate care and a simple experience for its users.

Overall, the OptumRx mobile app offers a convenient and comprehensive way for users to manage their pharmacy benefits and medications from the comfort of their homes.

OptumRx's safety protocols

• Medication Monitoring: OptumRx monitors prescription usage to identify potential drug abuse or diversion. This includes identifying red flags associated with certain combinations of medications, such as opioids, benzodiazepines, and muscle relaxants, which could indicate illegitimate medical use. By monitoring prescriptions, OptumRx can help prevent potential harm to patients and contribute to addressing the opioid crisis.
• Enhanced Protocols for Opioid Prescriptions: OptumRx has implemented stricter protocols for handling opioid prescriptions to reduce the number, dosage, and duration of opioids dispensed. They actively work to identify and not fill prescriptions for dangerous opioid combinations and excessive dosing.
• Electronic Prescription System: OptumRx encourages the use of a safe and secure electronic system for sending and receiving prescriptions. This system improves prescription accuracy and security, reducing the risk of errors and misuse.
• Medication Disposal: OptumRx educates patients about the proper disposal of leftover or expired medications, in accordance with state laws and federal guidelines. This helps prevent medication misuse and protects the environment.
• Home Delivery Pharmacy: OptumRx offers home delivery services, providing patients with a convenient and safe way to receive their medications without leaving home. This service includes automatic refills and free standard shipping.
• Quality Assurance: OptumRx pharmacies review prescriptions at multiple points to ensure quality, accuracy, and safety. They have a 99.99% dispensing accuracy rate, demonstrating their commitment to providing patients with the correct medications.
• COVID-19 Precautions: During the COVID-19 pandemic, OptumRx follows CDC-recommended precautions in their pharmacy locations, including the use of gloves, hand-washing, and enhanced cleaning protocols, to protect the health and safety of their patients and staff.
• Communication and Caregiver Access: OptumRx allows patients to manage their prescriptions and communicate with their care team through a secure online account and mobile app. Patients can also grant caregivers access to their accounts to assist in managing their medications and care.

These safety protocols demonstrate OptumRx's commitment to providing safe, effective, and secure medication management services to their patients, while also playing a proactive role in addressing public health concerns, such as the opioid crisis and the COVID-19 pandemic.

OptumRx's history of legal issues

OptumRx has been involved in several legal issues in recent years, facing lawsuits and settlements over its prescription practices and pricing procedures.

In 2024, OptumRx agreed to pay $20 million to resolve allegations that it improperly filled certain opioid prescriptions in violation of the Controlled Substances Act. The settlement resolved an investigation by the Drug Enforcement Administration (DEA) into whether, between April 2013 and April 2015, OptumRx filled certain opioid prescriptions in combination with other drugs, such as benzodiazepines and muscle relaxants, commonly known as "trinity" prescriptions. The United States alleged that these combinations raised red flags, indicating that the prescriptions may not have been intended for legitimate medical use and could have led to abuse or diversion of highly addictive opioids. OptumRx denied any wrongdoing but agreed to the settlement and implemented enhanced protocols for handling opioid prescriptions.

In the same year, OptumRx faced legal action from the state of Ohio, which accused the company of overcharging the state's worker's compensation agency for prescription drugs. The state claimed that OptumRx failed to provide agreed-upon discounts for generic drugs purchased by injured workers, resulting in overcharges of nearly $16 million. OptumRx agreed to settle the claims for $15 million without admitting wrongdoing.

Additionally, OptumRx was included as a defendant in a lawsuit filed by the city of Boston, targeting pharmacy benefit managers' role in the opioid epidemic. The lawsuit alleged that OptumRx and other companies collaborated with drug makers to promote the use of prescription opioids and fuel the creation of an illegal market for these drugs. OptumRx denied the charges, stating that it has taken a comprehensive approach to address opioid abuse and that it did not cause or worsen the opioid crisis.

Furthermore, Optum Rx faced legal action from the Attorney General's Office in Massachusetts, where it agreed to pay $5.8 million for allegedly failing to follow workers' compensation prescription pricing procedures. This settlement resolves allegations that Optum Rx, in some circumstances, failed to apply regulatory benchmarks, resulting in increased costs for small business owners and the workers' compensation insurance system.

Frequently asked questions