When recently faced with the possibility of having to lose a trip due unprocessed medical, I contacted AVMED and explained my situation and how my employer required a few extra days on top of the trip dates due upline change possibility, they were on to it and I had my renewal slip within a few hours.
No complaints from me for the office staff.
As for the dope who came up with this new system and insufficient support staff to make it work, a pox on them.