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Texannie
Member
07-16-2001
| Saturday, August 19, 2006 - 4:30 pm
I received a letter (at my home, addressed to me) from CAREMARK, a pharmacy benefits management company (formerly known as Advance PCS, PCS Health Systems and/or Advance Paradigm) saying that they have a check for me for unreimbursed out of pocket prescription expenses. It gives the date (10/25/2003) the check number, member ID which is MY social security number. You are supposed to check one of the two following choices. 1. The above Payee is not owed this money, please adjust your records accordingly. 2. The above payee has verified that this payment is due. My proof of ownership is: Last 4 digits of Social Security Number or enclose a copy of your photo ID. Then it asks you to fill out your address, phone number and signature. Says to return this notice to Fax: 866-249-6156 or Mail Caremark RX Inc 9501 Shea Blvd MC 090 Scottsdale, AZ 85260 attn Margaret or Michelle Questions call 800-257-6511 Caremark checks out, the formerly known as companies check out. The address in Arizona isn't listed on their website and when I did a reverse lookup nothing came up. But it is my SS# number and address. Is this a scam trying to verify that info? I am weirded out that they have it right.
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Tuzza
Member
08-19-2005
| Saturday, August 19, 2006 - 4:40 pm
I don't have answers for you, but that would weird me out as well. I hope that it checks out fine.
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Max
Moderator
08-12-2000
| Saturday, August 19, 2006 - 4:51 pm
I'd be VERY suspicious of anything that asks for a copy of your photo ID and a verification of your SS#. I'd contact Caremark (whose website indicates they're in Texas) and ask about this. Just as I don't trust emails asking me to verify banking info, I wouldn't trust this, either, without going directly to the supposed source through avenues NOT suggested in the letter. The Caremark website has an email form you can fill out to ask a question. It's worth taking the time to check it out before taking any action. Hope it's legit so you can get some unexpected money, but. . . 
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Juju2bigdog
Member
10-27-2000
| Saturday, August 19, 2006 - 4:51 pm
Call the Phoenix BBB and AZ Attorney General's Office? I suppose you could also call the number on the letter and see what they have to say ... Sounds very strange.
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Herckleperckle
Member
11-20-2003
| Saturday, August 19, 2006 - 5:00 pm
It is not a scam. You WERE covered by PCS at one time, right? I am familiar with CareMark, as Blue Cross Blue Shield of Delaware used PCS to administer its Rx Drug Program--and I know the Caremark name replaced the PCS name. Yes, it is a real entity. It is easily confirmed thru your health carrrier (as they should be aware of it) or the number listed under Caremark. The AZ address is also familiar to me because they used different sites to do certain aspects of the business--mailings, etc. This is probably the result of an audit--or the result of your local Health Insurance Department review--which watches things like an error that affected many consumers--and resulted in incorrect payments. (BCBSD actually went thru something like this with PCS when certain RX drugs were processed improperly.) Any way of you checking your records for that particular drug (e.g., did they supply the name of the drug--and is it something someone in the family did take at that time or do you hold onto all your claims)?
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Texannie
Member
07-16-2001
| Saturday, August 19, 2006 - 5:07 pm
They didn't supply the name of the drug, Herk. They lady I talked with at the 800 number said it was the result of an audit. I asked where their corporate headquarters are and she said AZ. I asked why the headquarters was listed on their website as San Antonio and she said 'yes, we have offices all over'. I asked where she was located and she said she was in a call center in Sacramento. If it's all legit, why do I need to give them a picture ID or verify my social?
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Herckleperckle
Member
11-20-2003
| Saturday, August 19, 2006 - 5:14 pm
If you would feel better about it, wait til Monday and call your health insurance carrier to ask those questions. When we had PCS mail out reimbursement checks, we did not require all that. But I wouldn't balk too much at verifying your soc sec # (just not supplying it) because, for audit purposes, they must confirm the rightful owner was paid. (Ours wasn't the result of an audit; it was something we caught.) Think about it, a bank would do the same thing. Someone is looking over their shoulder on this, and I suspect it is your local health insurance department and your health benefits carrier (because they don't want you cheated, either--believe it or not.) In almost all cases, such an error is the result of something benign on the part of the Rx administrator.
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Karuuna
Board Administrator
08-31-2000
| Saturday, August 19, 2006 - 5:15 pm
What about doing a reverse lookup on the phone number to make sure it checks out? Or checking directory listings for Caremark; or even calling their headquarters in Texas to ask them if it's legit?
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Herckleperckle
Member
11-20-2003
| Saturday, August 19, 2006 - 5:22 pm
If the health insurance carrier is able to confirm this is legit, and that you SHOULD confirm personal information (rather unusual when I think about it) then I would let your carrier know you feel it was bad form for them not to enclose a letter with CareMark's--on your carrier's letterhead, and signed by the appropriate individual at your carrier's, confirming that this is something that they (or the Health Ins Dept) has asked CareMark to do to address inaccuracies in payments for certain prescriptions (which I think they should name; we did!). To get a letter like this asking for personal information does raise questions, so they could have avoided the fallout (which is sure to happen) by simply clarifying this is real and you need to do x,y and z. They have a responsibility to ensure that the administrator they hire for your Rx benefits commmunicates with you properly. (Typically, your carrier will have signoff on all communications before they go out. So they cannot plead ignorance.)
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Herckleperckle
Member
11-20-2003
| Saturday, August 19, 2006 - 5:39 pm
I just remembered something important. We told PCS NOT to name the drug in the letters. The reason we issued that directive was to protect privacy of the patient. For example, in our case some of the Rx medications paid improperly were birth control meds--which a dependent might have gotten without her parent's knowledge--also, we discussed the scenario that it could be a medication a spouse/partner might be taking without the knowledge of the other spouse/partner. We were careful not to step into that mess by not naming any drugs. So that may be exactly why the med wasn't named in this case.
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Whoami
Member
08-03-2001
| Saturday, August 19, 2006 - 6:12 pm
If you don't know to trust the letter, then certainly don't trust the phone number they give you to call. That can be just as fake as anything else. I agree with Karuuna, call the number listed on their website....as long as that's a website you got to on your own, not due a site they told you to go.
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Beachcomber
Member
08-26-2003
| Saturday, August 19, 2006 - 8:14 pm
In my experience, when Blue Cross owed me money they sent me a check with no questions asked. If this was the result of an audit, I would ask the name of the audit firm and confirm directly with them. As an auditor, when we send an audit confirmation they go out on the client's letterhead (in this case the insurance company). If the reimbursement is due to an error noted in an audit, the language customarily will state that "due to an audit we have noted that ....". This is my experience from the world of banking so I will not speak to the world of insurance, but I would be VERY VERY VERY suspicious of anyone asking for a copy of my id. That is a major red flag to me based on the fraud seminars I attend.
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Faerygdds
Member
08-29-2000
| Saturday, August 19, 2006 - 8:24 pm
Just wondering... could they need picture ID for HIPPA??? I know Dr.'s offices copy your ID for insurance purposes... I don't know.. I just woke up from the oddest nap!
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Faerygdds
Member
08-29-2000
| Saturday, August 19, 2006 - 8:34 pm
Beach... the worlds of banking and medicine are apples and oranges... no offense! IDs are taken for any number of reasons. You just don't know... Like I said above... your Dr's office copies your ID for insurance purposes. What you might NOT know is that they usually have to fax it to the ins company for verification. I can envision a scenario where they have had a person using other people's insurace without their knowledge and now they are trying to get the money back to the rightful owners. I can ALSO envision a situation where the pharmacy did a charge back because the meds weren't picked up in time and now they have to verify that you are the rightful owner. No matter what... call the ins company from their company website and ask them. They will tell you the basics (ie. We were audited and they are requiring xyz information before we are allowed to cut the checks., etc...) Don't trust blindly, but if that's what they need to cover their own butts... so be it... if the company says it's legit... don't panick! They ALREADY have a copy of your photo ID... just verify with the ins co that the FAX NUMBER and ADRESS are legit.
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Beachcomber
Member
08-26-2003
| Saturday, August 19, 2006 - 8:38 pm
To clarify, I would be very suspicious of anyone asking for my id via mail. Providing id in person is standard practice at the doctor and in banking. But I have never known of any legitimate purpose behind mailing a copy of your id to someone.
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Texannie
Member
07-16-2001
| Sunday, August 20, 2006 - 4:39 am
I did the reverse lookup before I posted here and it didn't check out. I emailed using the customer service link..couldn't find a phone number on their website. The letter says that this is for payment of unreimbursed out of pocket expenses. We didn't have that if I remember correctly. Herc, I am assuming this is from when we had BCBS but we aren't with them anymore.
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Faerygdds
Member
08-29-2000
| Sunday, August 20, 2006 - 7:08 am
From the Caremark Webstie (googled Caremark Rx)- Contact Us section... Contact Caremark Please call: 1-800-241-2784* for immediate assistance. From the About Caremark - Locations section... Operations Centers: Scottsdale 9501 E. Shea Boulevard Scottsdale, AZ 85260-6719
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Texannie
Member
07-16-2001
| Sunday, August 20, 2006 - 9:40 am
you are a better googler than me. I went to their website and kept getting San Antonio info! addresses match but not phone numbers.
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Ophiliasgrandma
Member
09-04-2001
| Sunday, August 20, 2006 - 12:46 pm
(I can hardly wait for the end of this story.)
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Konamouse
Member
07-16-2001
| Sunday, August 20, 2006 - 1:35 pm
Often phone numbers will be different if they are using a calling service. You are right to question this from all angles. Keep calling and asking for higher ups until you get a satisfactory answer. 'squeek'
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Herckleperckle
Member
11-20-2003
| Sunday, August 20, 2006 - 2:15 pm
You know, you can still call BCBS even if you aren't members anymore. They should be able to look up your old information and talk with you and confirm (or not) the information about CareMark.
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Herckleperckle
Member
11-20-2003
| Sunday, August 20, 2006 - 2:40 pm
Did you have a BCBS Managed Care plan (and pay your copay only) for your covered Rx? Or did you have a Traditional plan (and pay the total up front and then file claims for reimbursement) for covered drugs?
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Texannie
Member
07-16-2001
| Sunday, August 20, 2006 - 3:38 pm
I received a reply from my email with an 800 # to call, at first the lady sounded very skeptical, but then after putting me on hold for a very long time, she said it was legit. The weird thing is that this letter is on xeroxed letterhead not original. Herc, this was over 3 years ago, I haven't a clue! LOL
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Mims
Member
03-31-2006
| Sunday, August 20, 2006 - 8:11 pm
Sorry I'm a little late to jump in here - but thought I would add a few thoughts. I worked for PCS Health Systems for 15 years - prior to them being sold to either Advance or Caremark. I can tell you that the address is legit. That has been the PCS headquarters since the early 80s. Everytime PCS has been sold (and that is quite a few times) the buying company left PCS pretty much intact - to do what PCS has always done. I can also tell you that the letter that you received is pretty common as well. For the id they're only asking for the 4-digits of your soc OR picture id, right? Not both. I think that's just a little coverage of the back-side. You know that your member ID is your soc - but keep in mind, PCS doesn't know that (many carriers assign random numbers for their cardholder's ids). One last thought (I promise) - your insurance carrier (or former carrier) might not know anything about this reimbursement. The reimbursement could actually be the results of a pharmacy audit. PCS audits pharmacies and find problems - then either credits back the carriers or issues checks to the cardholders. Now..the xeroxed letterhead...sounds like either times are tuff and they can't afford letterhead or someone made a mistake and there is this very nice letter on pretty letterhead sitting in file somewhere in Scottsdale.....
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Herckleperckle
Member
11-20-2003
| Monday, August 21, 2006 - 12:15 am
Yay, Mims, for that great info! Annie, I doubt it was xeroxed as you had specific information, personalized for your situation within the letter. It was simply b/w, I imagine. Rarely do you get color letterhead in a mass mailing (large volumes) like this one. For mass mailings where the copy was the same on each letter, I'd send a fresh master (on color letterhead) to our in-house printer at BCBSD. Our printers would produce copies in b/w unless specifically asked to produce in color. Even when there is personalized information within the letter (like the one you received), when large volumes were involved, our company almost always used b/w stationery rather than full color stationery. So I am not surprised you have a b/w version. That is not a biggee.
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