I was a PJP Health Agency policy holder residing in NYC. I am writing to express my extreme frustration and dissatisfaction with PJP Health Agency. I've suffered a series of health mishaps in the last year and the process of trying to get them to pay for my medical and prescription claims is an exercise in futility. Wait times on the phone are insufferably long, paperwork is lost, calls are not returned.
Once a claim is finally received, the process of documentation is so mangled and inconsistent as to drive a sane person crazy. I began a generic blood pressure medication in September and they have yet to pay for it. The claim is not denied, but just sits in limbo. Then, every time I call there is a different reason why the claim isn't paid. The customer service rep promises to check the inconsistencies and call me back. I receive a call-back roughly 25% of the time. I have received ZERO
communication on my prescription being covered. Theclaims are not even processed yet, nearly a month and a half after submission. This is fraud.
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