Rant here! Back in 2024, my co-pay went from $28.25 to $78.12 and I was wondering if anyone else has had this issue… US Meds started billing $520.80 every month instead of the $188.35 per month to CareCentrix (the middle man)! This, of course, raised their payment and my co-pay for every month. I called when the payment went up to ask why and was told this was their 90 day billing and would have to pay quarterly. US Meds billed the significantly higher amount every month, except one, from Feb. ‘24 through to Oct. ‘24. Then US Meds started billing it correctly in Nov. ‘24. Both US Meds & CareCentrix have escalated the issue for months and has yet to resolve this issue. I called the NJ Insurance Fraud Hotline and reported both companies and now am in collections for 9/24 & 10/24 non-payment. My answer is that CareCentrix (and US Meds) over-billed me throughout the year and want resolution to the fraudulent billing.
Anyone else have problems with this provider over billing last year? If so, have you pursued it?
Sharon @ShashInEHT, what does your policy state your co-pay should be, what assistance have you received from BC/BS of Rep? Does your BC/BS plan offer mail-order?
IM know nothing about US Meds or CareCentrix, but I suppose they are third-party profit centers that you’re using - why? Does BC/BS require these parties?
Some suggestions; visit a local drug store with your BC/BS ID card and ask this facility to “price” your insulin needs and see if you will be in a better position. My insurer has this pricing feature on its web page and tells me my co-pay for all available options.
Hi Dennis. I forgot to mention in the post that the whole issue last year was for my freestyle Libre sensors. (CGM under DME) My insulin & supplies go thru CVS Caremark and they’re 99.9% great. My local pharmacy will ONLY give 30 days at a time (I think).
US Med billed a 90 day supply each month, as I said, and CareCentrix is the middle man with services such as assuring the prior authorization and prescriptions are in place for US Meds to ship the 90 day supplies. Been using the freestyle Libre sensor since 2018 or so and never had the pricing issues.
My plan is FEP Blue (Federal Employees Program) and the plan hasn’t changed much at all.
US Meds messed up and they don’t call back even with multiple requests to SPEAK to the billing department. CareCentrix takes my calls but won’t follow up as US Meds is like talking to a wall. I was just ranting n wanted to see if there was anyone else that had this kinds of problem. I’ve spent hours on the phone trying to get an answer from them to understand the mistakes.
I was told I have up to 6 months to file a complaint in writing to BCBS… well, their delays in responding caused my time to expire and that made me even more aggravated. Think insurance does the delay tactic to mess things up and then tell you to wait 30 days for an agent to address the problem…they’ve put me off for over 6 months although I called weekly in April 
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Like I said , just ranting and wondering if anyone has had problems with US Meds and the overwhelming price jump last year. 
You might want to look into finding a medical ombudsman. I think they are generally referenced in association with hospitals and/or Medicare, but where I live the ombudsman is described as follows:
An individual who investigates complaints by District consumers regarding health care issues against their health plan or provider.
A neutral mediator in dispute resolution, with the ability to investigate and make recommendations – without authority to make or reverse a decision.
It appears they may work with individuals as well, maybe depending on the area you live in.