ComplaintsforD & J Medical Center
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Complaint Details
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Initial Complaint
09/13/2022
- Complaint Type:
- Delivery Issues
- Status:
- Answered
8/26/22-Current I have been receiving compression garments from (D and J Medical) since approximately 2009. Most recently I was seen by doctor and given a new Rx for new compression garments. As usual, I scheduled the appointment with D and J for a fitting and they told me they would verify my insurance and have my garments ordered as I told them I made them aware that I desperately need them as I know swelling could lead to MUCH worse health complications that could land me in the hospital. The people are voiced their understanding an told me I would have them. 9/2/2022 I received correspondence that they needed more information from my doctor to submit the claim. I alerted my doctors that they need this information ASAP, to submit the claim. My doctors sent the information. The staff members told me what was sent is "not enough" as they "know" my insurance company will want more. I asked if they could submit the claim and allow the insurance company to make a determination and so that i could receive my medical supplies by the needed date. They said they would send what I have to their compliance team for review but not to insurance. As of today, I contacted my Insurance3x, today w/ a representative from their company on the phone. She was informed by my insurance company that the documentation they have, should be enough to get an approval. They have a letter of medical necessity from doctor and told me that they needed medical documentation that states I have the disease, they have that as well, my doctor faxed this information. This company is refusing to submit my claim to my insurance for approval because they feel they don't have enough info, despite being told by my insurance that what they have is enough. Therefore, preventing me from receiving my medical supplies that I have been using for the past 13 years of my life. The company has made determined that they want more info, despite insurance stating this is enough, leaving me without my medical needsBusiness response
10/31/2022
Business Response /* (1000, 8, 2022/09/27) */ D&J Medical provides quality custom prosthetic and orthotic care, as well as compression and custom lymphedema garments. The care we provide is unique as it is the result of an entire team of highly competent people who continually raise the bar and except nothing less than quality patient outcomes. We offer several options to ensure patients receive quality products and services. D&J Medical strives to adhere to the ever-changing requirements of our payers to ensure successful insurance claims. To learn more about our services, please visit our website at: www.dandjmedical.com Consumer Response /* (3000, 15, 2022/10/13) */ This business was medically neglectful and because of them not issuing my garments, I am now on antibiotics due to a skin infection that could've been avoided had I had the proper compressions garments, this was a concern that I voiced to the disgusting staff who refused to bill my insurance company. I found another company who used all the information I sent D and J medical and submitted a claim to my insurance and is in the process of getting me the proper garments. The insurance claim has been approved with the same information D and J medical refused to send out for review which now has left me more medically fragile and unable to walk. Business Response /* (4000, 17, 2022/10/17) */ We understand Ms. Mill's frustration. However, we tried on multiple occasions to obtain supporting documentation to submit a claim to her insurance company. Ms. Mills was also given two other alternatives to obtain her custom compression garments. She was advised to make an appointment at GBMC Lymphedema Clinic and then we could submit the office notes to insurance, or to be a self-pay. Neither of those options were pursued by Ms. Mills. A letter was then emailed to her on 9/13/22 advising her we were unable to provide the garments due to not having supporting documentation. We do wish Ms. Mills well and hope she feels better soon.
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Contact Information
Customer Complaints Summary
1 total complaints in the last 3 years.
0 complaints closed in the last 12 months.