Sutter Medical Center Foundation

Business states that they have spoken to consumer, and due to company error, business has offered to pull account from collections as a one time courtesyConsumer agreed to a non-specified payment plan to resolve the pending matterIn regards to credit reporting, the consumer credit will not be negatively affected

To whom it may concern, We do apologize for the inconvenience that the patient has experienced The charges of $(of them) have been adjusted, and patient will be getting a refund As for the facility side, they are currently in review by the hospital compliance department We have taken steps to educate the front desk staff to advise patients to utilize the outpatient imaging suite where applicable Once I heare back from the hosptial compliance departement, I will respond to Revdex.com Thanks, [redacted] Dear [redacted] ***: This message is in regard to a complaint submitted to the Revdex.com about your business on 9/17/5:35:PM by [redacted] This complaint was assigned ID [redacted] Revdex.com received additional information from the consumer involved in the above referenced complaintFor your review, we included the additional information with this letter Please respond within days of receiving this noticeAll responses will be copied to the complainant Sincerely, [redacted] MESSAGE: I am rejecting this response because: The fact that I was being sent into the hospital for the service, and would be billed by the hospital rather than urgent care, was not explained to me by the provider or the office staffDuring the visit, the provider advised I get x-rays of my wrists, and directed me to the radiology facility to have them taken, after which I was to return to her office to discuss the resultsAs this was presented as a part of my outpatient urgent care office visit, I reasonably assumed I would be using an outpatient X-ray facility as wellThe business's response that there is such an outpatient radiology option is especially puzzling, since I was not sent there but rather to the hospital facility Since all Sutter Davis facilities are on the same campus, although I did cross into an adjoining building for the x-rays, the distinction of the separation of facilities was not at all clearHad I known I was being sent in for hospital services, I would certainly have declined this part of the visit, in favor of having x-rays taken a day later at a non-hospital facility, especially given that one of the two x-rays taken was described by the provider as an extra precaution, not medically necessary

Tell us why here..To whom it may concern,This was sent to Sutter Medical Foundation (SMF) by Revdex.com The information provided lacked the required elements to properly address the concern In looking at the billing system for Sutter Medical Foundation, the patient last made a payment on 12/9/13, and there currently is no balance with SMF It is possible that this is a Sutter hospital bill, and Revdex.com would need to send this to the approprriate party.It would be helpful to have the dates of service and charge amounts when forwarding this to the hospital.Thanks,***

I am rejecting this response because: The fact that I was being sent into the hospital for the service, and would be billed by the hospital rather than urgent care, was not explained to me by the provider or the office staffDuring the visit, the provider advised I get x-rays of my wrists, and directed me to the radiology facility to have them taken, after which I was to return to her office to discuss the resultsAs this was presented as a part of my outpatient urgent care office visit, I reasonably assumed I would be using an outpatient X-ray facility as wellThe business's response that there is such an outpatient radiology option is especially puzzling, since I was not sent there but rather to the hospital facility Since all Sutter Davis facilities are on the same campus, although I did cross into an adjoining building for the x-rays, the distinction of the separation of facilities was not at all clearHad I known I was being sent in for hospital services, I would certainly have declined this part of the visit, in favor of having x-rays taken a day later at a non-hospital facility, especially given that one of the two x-rays taken was described by the provider as an extra precaution, not medically necessary

I am rejecting this response because:They wrote: "The funds have been submitted by the business and should post within the next couple of business days to the patient's account."but I do not want the funds posted to a Sutter account. I want the money back, as in a check sent to me.They have my mailing address.

To whom it  may concern,
 
We do apologize for the inconvenience that the patient has experienced.  The charges of $33 (2 of them) have been adjusted, and patient will be getting a refund.  As for the facility side, they are currently in review by the hospital compliance department. 
We have taken steps to educate the front desk staff to advise patients to utilize the outpatient imaging suite where applicable.
 
Once I heare back from the hosptial compliance departement, I will respond to Revdex.com.
 
 
Thanks,
[redacted]
 
 
 
Dear [redacted]:
This message is in regard to a complaint submitted to the Revdex.com about your business on 9/17/2014 5:35:53 PM by [redacted] .  This complaint was assigned ID [redacted].
Revdex.com received additional information from the consumer involved in the above referenced complaint. For your review, we included the additional information with this letter.
Please respond within 10 days of receiving this notice. All responses will be copied to the complainant.
Sincerely,
[redacted] 
MESSAGE:
I am rejecting this response because:
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The fact that I was being sent into the hospital for the service, and would be billed by the hospital rather than urgent care, was not explained to me by the provider or the office staff. During the visit, the provider advised I get x-rays of my wrists, and directed me to the radiology facility to have them taken, after which I was to return to her office to discuss the results. As this was presented as a normal part of my outpatient urgent care office visit, I reasonably assumed I would be using an outpatient X-ray facility as well. The business's response that there is such an outpatient radiology option is especially puzzling, since I was not sent there but rather to the hospital facility.
p { margin-bottom: 0.08in; }
Since all Sutter Davis facilities are on the same campus, although I did cross into an adjoining building for the x-rays, the distinction of the separation of facilities was not at all clear. Had I known I was being sent in for hospital services, I would certainly have declined this part of the visit, in favor of having x-rays taken a day later at a non-hospital facility, especially given that one of the two x-rays taken was described by the provider as an extra precaution, not medically necessary.

Business states that they apologize for the delay and confusion of payment information. The money has been located and the situation will be cleared up promptly. The funds have been submitted by the business and should post within the next couple of business days to the patient's account.

I am rejecting this response because:
p { margin-bottom: 0.08in; }
The fact that I was being sent into the
hospital for the service, and would be billed by the hospital rather
than urgent care, was not explained to me by the provider or the office staff. During the visit, the provider advised
I get x-rays of my wrists, and directed me to the radiology facility
to have them taken, after which I was to return to her office to
discuss the results. As this was presented as a normal part of my outpatient
urgent care office visit, I reasonably assumed I would be using an outpatient X-ray facility as well. The business's response that there is such an outpatient radiology option is especially puzzling, since I was not sent there but rather to the hospital facility.
p { margin-bottom: 0.08in; }
Since all Sutter Davis facilities are on the same
campus, although I did cross into an adjoining building for the
x-rays, the distinction of the separation of facilities was not at all
clear. Had I known I was being sent in for hospital services, I would
certainly have declined this part of the visit, in favor of having
x-rays taken a day later at a non-hospital facility, especially given
that one of the two x-rays taken was described by the provider as an
extra precaution, not medically necessary.

To whom it may concern,
Based on our records, the patient presented to the urgent care facility on May 4th.  There is an outpatient imaging center in the same building as the urgent care center, however the patient entered the hospital and had the services there, which resulted in a...

facility fee in addition to a professional fee.
Thanks,
Sutter Medical Foundation.
 
 
 
 
 
[redacted]
Sutter Medical Center Foundation 
2750 Gateway Oaks Dr Ste 100
Sacramento CA 95833
Dear [redacted]:
 
Revdex.com received a complaint about your business.  The complaint was submitted on 9/17/2014 5:35:53 PM and was assigned an ID of 10225871.  
Your Revdex.com has received a request for assistance from one of your customers. We would like to take this opportunity to help you advance marketplace trust by resolving this dispute. Revdex.com realizes there are two sides to every dispute; and, we want to accurately document your position while assisting both parties with reaching a mutually agreeable resolution. 
Please review the complaint information and respond within the next 10 days.
We encourage you to use our online complaint system to respond to the complaint. If you received this complaint via email, please use the "Respond to this Complaint" link located to the left. If this complaint was received via postal mail, please visit the following URL: [redacted] and respond using the online form. If you are unable to respond online, please reply by letter and send it back via fax or postal mail.
THE TEXT OF YOUR RESPONSE MAY BE PUBLICLY POSTED ON Revdex.com'S WEBSITE.  PLEASE DO NOT INCLUDE ANY PERSONALLY IDENTIFIABLE INFORMATION OR USE INAPPROPRIATE LANGUAGE IN YOUR RESPONSE.  Revdex.com MAY EDIT YOUR RESPONSE TO REMOVE PERSONALLY IDENTIFIABLE INFORMATION AND/OR INAPPROPRIATE LANGUAGE.
Upon receiving your response we will forward it to your customer. If you feel the complainant is not your customer, please send us written clarification to that effect.
Revdex.com thanks you for your prompt reply.
Sincerely,
[redacted]
 
CUSTOMER EXPERIENCE INFORMATION
Customer Information:
[redacted]
[redacted] **  [redacted]
Daytime Phone: ###-###-####
E-mail: [redacted]
The details of this matter are as follows:
Complaint Involves:
Billing or Collection Issues
Customer’s Statement of the Problem:
My complaint concerns the business practices of Sutter Urgent Care: Davis. This urgent care facility, from its advertising, physical signage and location, appears to be a distinct entity from Sutter Davis Hospital. I went to this urgent care facility for diagnostic x-rays precisely because I expected to avoid hospital facility charges. However, Sutter Health does not consider the two facilities as separate, despite advertising them as such, and I was billed a hospital facility charge for my visit. This is despite the fact that, during weekday business hours, physicians such as orthopedist Michael Peterson operate out of the exact physical location as urgent care (same waiting room, exam rooms), without charging facility fees.For each x-ray I received (CPT 73110), I was billed a Hospital Incidentals charge of $521, in addition to the actual X-Ray Services charge of $33. At no time during the office visit was I given any indication that I would be receiving hospital-level charges.
Name of Salesperson:
 
Desired Settlement:
I would like the portion of my bill designated for Hospital Incidentals, which I feel was billed deceptively, to be refunded.

Good afternoon. First off, we apologize for the delay in getting back do you. Sutter Medical Foundation reached out to the Revdex.com and provided the Revdex.com with an updated contact info, as your complaint was sent to the wrong department at Sutter. In looking at your account, you were errorenously billed for...

services, due to the insurance carrier sending the check directly to the providers office instead of our billing office. We have notified the insurance of this error. Also, you are no longer liable for the service in question.

I am rejecting this response because:My last payment to Sutter Health (not the clinic or hospital, but the insurance entity which handles payments and accounts) was made in September of 2014. Their records seem to have missed that  payment.Some of that payment went to pay two Sutter Health accounts in full, while $50.00 of that payment was to pay part of the third account which Sutter Health set up in my name. The Sutter Health representatives have agreed on the phone in calls I have made in recent months to the above facts, which are at odds with this recent claim that the last payment I made was in 2013.They cashed my check, meaning that they have the $50.00 which was supposed to pay part of the hospital bill, but they put that $50.00 somewhere else, and sent that account to a collection agency. They have refused to return the $50.00 to me, saying that they must find out where it went before they can return it. That is not a valid reason to keep my money, that they have not figured out where it was put. The important point is that they took my money, they failed to properly disperse the funds, and now they refuse to return my money.If they cannot find evidence of my payment of last September, they are not competent to run their business.Sincerely,[redacted]

Tell us why here..To whom it may concern,This was sent to Sutter Medical Foundation (SMF) by Revdex.com.  The information provided lacked the required elements to properly address the concern.  In looking at the billing system for Sutter Medical Foundation, the patient last made a payment on...

12/9/13, and there currently is no balance with SMF.  It is possible that this is a Sutter hospital bill, and Revdex.com would need to send this to the approprriate party.It would be helpful to have the dates of service and charge amounts when forwarding this to the hospital.Thanks,[redacted]

Business states that they have spoken to consumer, and due to company error,  business has offered to pull account from collections as a one time courtesy. Consumer agreed to a non-specified payment plan to resolve the pending matter. In regards to credit reporting, the consumer credit will not be negatively affected.

Review: I WISH TO MAKE A COMPLAINT ABOUT THE SUTTER HEALTH BILLING DEPT.

THEY HAVE BILLED ME FOR A PROCEDURE THAT MY INSURANCE COMPANY SAYS I'M NOT RESPOSIBLE FOR.

I HAVE WRITTEN THEM ABOUT THIS & SENT THEM COPIES OF THE DOCUMENT FROM MY INS. CO. WHAT DID THE DO? THEY REBILLED ME!!!Desired Settlement: ID LIKE YOU TO LOOK INTO THIS FOR ME & GET ME AN APOLOGY OR EXPLANATION!

THANK YOU

Business

Response:

Good afternoon. First off, we apologize for the delay in getting back do you. Sutter Medical Foundation reached out to the Revdex.com and provided the Revdex.com with an updated contact info, as your complaint was sent to the wrong department at Sutter. In looking at your account, you were errorenously billed for services, due to the insurance carrier sending the check directly to the providers office instead of our billing office. We have notified the insurance of this error. Also, you are no longer liable for the service in question.

Review: As a patient, participating Sutter Health consumer, I [redacted] have concerns with the multiple errors of billing, tracking, and non readjustments of costs that I have had to absorb.

My concern is that adjustments on dated services made through documented insurance carriers (Medicare, APWU/Cigna) by means of phone contact by me were incorrectly handled, coded, delayed submissions to carriers.

SOME of the services charged and not corrected by SUTTER with collection agency (June 12, 2015 USCB statement as well as phone contact) after adjustments with insurances, Medicare, APWU:

Date of service:

12/18/2013 [redacted] MD ($498.36 $558.99 USCB America interest incurred)

Sutter: 5/21/2014 payment voided… but was not corrected w collection agency

#collection agency med. record [redacted]

2/06/2013 [redacted] ($186.40 $192.55 USCB America)

APWU sent a check on 3/7/2013 for $22.04

Medicare is my primary coverage

12/12/12 [redacted] ($231 APWU…APWU paid Sutter $101 on 1/29/2013 ck number #[redacted] by APWU) Medicare coverage leaving me $18 co pay

USBC collection $108.75 with interest on this service shown on their June 12, 2015

The service costs were still sent to the collection agency, in turn to bill me with the interest costs. The above information is gathered information by myself with multiple calls with Medicare, APWU, Sutter Foundation, and USCB America collection agency.

Sutter Foundations made adjustments within their own system BUT failed to send this information on to USCB (refer to time period to make adjustments). How many other people are experiencing this problem?Desired Settlement: The original billing of $823.40 ballooned to well over $1,339 plus due to accrued interests by USCB collection agency. The given figures were submitted to me, even though corrections and adjustments were made to SUTTER HEALTH. SUTTER HEALTH did not alert the collection agency of these charges spanning over 3 years… leaving me with the cost.

The three listed services among other services I continue to investigate.

Your interest in this matter to be resolves in a timely period as well as resolving the over billing (interest incurred through USCB as well as financial loss, stress that has been placed onto our family). Your response would be appreciated to this matter. These errors have us concerned with the handling of pior billings that we paid for.

Business

Response:

To Revdex.com, I had some serious difficulty in responding to this as I am not able to change

the font. Items in bolded below are the individual responses to the complaint

questions. Date of service: 12/18/2013 [redacted] ($498.36 $558.99 USCB America

interest incurred) Sutter: 5/21/2014 payment voided… but was not corrected w

collection agency #collection agency med. record [redacted]For the above transaction, there were some billing errors made by

the physician for your Welcome to Medicare Physical. During the

correction process, the account was put in collections for a brief time, as the

charge was applied to patient deductible. Currently, this

transaction is no longer in collections and we received payment from Medicare

in June of 2014. ?2/06/2013 [redacted] ($186.40 $192.55 USCB America) [redacted] sent

a check on 3/7/2013 for $22.04 Medicare is my primary coverageFor the above transaction, once payment was received from your

secondary insurer, of $22.04, this was taken out of collections, this

transaction is now a zero balance.12/12/12 [redacted] ($231 PWU…APWU paid Sutter $101 on 1/29/2013

ck number #[redacted] by APWU) Medicare coverage leaving me $18 co pay USBC

collection $108.75 with interest on this service shown on their June 12, 2015

The service costs were still sent to the collection agency, in turn to bill me

with the interest costs. The above information is gathered information by

myself with multiple calls with Medicare, APWU, Sutter Foundation, and USCB

America collection agency.On the above transaction, this was never put in

collections. Your copay of $18, was applied a month later, and that

in addition to the insurance payment brought the account to a zero

balance. We are not aware of any other patients having these issues, we apologize for

the inconvenience.

Consumer

Response:

I am rejecting this response because:Please note that service costs charges that were later addressed were still sent to the collection agency, in turn to billed to me with the interest costs. See enclosed document by UCSB contracted under Sutter Health.The above information is gathered information by myself with multiple calls with Medicare, APWU, Sutter Foundation, and USCB America collection agency.Sutter Foundations made adjustments within their own system BUT failed to send this information on to USCB (refer to time period to make adjustments).The original billing of $823.40 ballooned to well over $1,339 plus due to accrued interests by USCB collection agency. The given figures were submitted to me and paid by me to UCSB before uncovering the errors made by Sutter Health Billing, even though corrections and adjustments were made to SUTTER HEALTH. SUTTER HEALTH did not alert the collection agency of these changes spanning over 3 years…leaving me with the cost. (Please note date of UCSB billing).I am asking for your attention and full repayment of over billing (interest incurred through USCB as well as financial loss, and stress that has been plced onto our family).Your timely response would be appreciated in this matter.These errors have us concerned with the handling of pior billings and billings sent to collections, that were not retracted but leaving the consumer with unwarranted expenses.[redacted]

Review: This pertains to a routine consultation with [redacted] on 1/10/14. The purpose of this initial consultation was to determine possible urologic health issue and discuss treatment options.Based on my insurance policy (UCD student Aetna plan) I have a $25 dollar co-pay for specialist visits. However, my bill from Sutter Health is $322.96. The reason for this "charge" beyond my copay is $406.00 of "surgical charges" that *apparently* took place during the 15 minute examination -- which is not covered by my co-pay.My account of the visit is as follow:After I was greeted by my urologist and explaining my symptoms he essentially told me that I "looked too healthy" to have real concerns, and that my symptoms didn't warrant any treatment except for, possibly, medication. He then asked if I'd like him to examine me anyways - which I did. He then proceeded to conduct a physical exam. After this was completed (and up to this point no charges besides the consultation, which my insurance covered had accrued) I was led out of the examination room.As almost an aside, the doctor noted to a nurse "since we have her here, let's just do this / that." At that point a nurse gave me quick ultrasound ($82) and then had me pee in an "Electro-uroflowmet" ($324). After this took all of five minutes the doctor then quickly showed me a print-out of the results (while standing and walking me out) and stated that it basically confirmed his original opinion.I am upset because of the derogatory treatment I received during the consultation and the additional fact that these expensive tests were *added on* in a seemingly meaningless way. What I feel most violated by is the fact that I believed I was participating in routine examination. It is unethical to bill me for these (classified as surgical!) procedures to which I was unaware there was massive extra charge and to which I did not provide an informed consent. Especially after his initial consultation concluded with "I know there's nothing we can do."Desired Settlement: It seems unethical to provide a diagnoses (of "nothing really wrong) but then as an afterthought (which was literally phrased: "well because she's here let's do this) conduct expensive tests. Had I known that these tests were not a part of my consultation, and especially because I'd already been emphatically told there was nothing wrong, I would have not accepted the procedures. I would like:1) These current charges -- which haven't been paid -- removed or prorated.

Business

Response:

Hello,

The notes from the office visit were reviewed, and the services provided match the services billed. We have communicated your concerns to the provider's office to better disclose addtional fees that may occur during an office visit, going forward. The ordering of the additional test was a clincal decision made by the provider. The charges submitted to the insurance company and processed per plan benefits, in which they were applied to your annual deductible. We are contractually oblgiated by the insurance plan to collect the deductible.

Consumer

Response:

I am rejecting this response because:

Review: Sutter Health is charging me for a bill I have already paid. This bill shows up in my credit report as seriously past due.

I went to Sutter Health in Davis, CA when I was a student at UC Davis. I was charged a bill of $225.00 which was sent to my house. I paid this bill. Then I received another letter in the mail saying it was not paid. I physically went to the hospital and told them I paid the bill. They looked up their records and said I was right, and apologized for the inconvenience. This was in 2010, 3 years ago. Now in 2013, I ran a credit report in order to qualify for the competitive housing market in San Francisco. My credit report shows me owing $225.00 from 11/1/2010. It says this amount is seriously past due. This error in billing by Sutter Health has messed up an otherwise great credit score. I called the Davis Hospital and told them about my situation. They said those records are now in Sacramento. I called Sacramento's billing service and was on hold multiple times for extended periods of time. When prompted to leave a voicemail I was hung up on. I sent an email to their sevrice department over a month ago and have not gotten a response. I know other people who have had similar experiences with Sutter Health trying to bill them multiple times for the same bill. I need to get this resolved so I can fix my credit score and get on with my life.Desired Settlement: I would like Sutter Health to fix their mistake and contact my Financial Services to get this fixed as soon as possible.

Business

Response:

Business' Initial Response

Hello, we have reviwed the records and are not seeing any billed amount of $225.00 on your account. There are numerous Sutter affiliated providers, many of which have a separate billing systems. We also do not impact patient credit scores in this manner. Would you be able to double check the statement? We would be happy to research further if we have the date services were provided, the provider name, your date of birth, and the name of the facility in which you received these services.

Business' Final Response

Hello, I am attaching the update from the patient as a reference since the response form I have only gives me a box, I am not able to review the complaint and respond by using the same webpage.

I don't know the actual date of service but my bill was opened 11/1/2010. The services were from Davis Sutter Health. I'm not sure what your referring to when you ask for the provider name, but my medical insurance provider is Blue Shield of California. My date of birth is [redacted] Please let me know what information you need corrected or in addition to this. Thank you so much for your help!

Updated Response:

Thank you for providing your date of birth. Unfortunately, I am showing you have no oustanding bills for Sutter Medical Foundation. You indicated that the services were from Sutter Davis Health, this could be a service provided in the Davis hospital. Do you happen to have a bill showing you owe $225.00?

Thanks.

Review: My complaint concerns the business practices of Sutter Urgent Care: Davis. This urgent care facility, from its advertising, physical signage and location, appears to be a distinct entity from Sutter Davis Hospital. I went to this urgent care facility for diagnostic x-rays precisely because I expected to avoid hospital facility charges. However, Sutter Health does not consider the two facilities as separate, despite advertising them as such, and I was billed a hospital facility charge for my visit. This is despite the fact that, during weekday business hours, physicians such as orthopedist [redacted] operate out of the exact physical location as urgent care (same waiting room, exam rooms), without charging facility fees.For each x-ray I received (CPT 73110), I was billed a Hospital Incidentals charge of $521, in addition to the actual X-Ray Services charge of $33. At no time during the office visit was I given any indication that I would be receiving hospital-level charges.Desired Settlement: I would like the portion of my bill designated for Hospital Incidentals, which I feel was billed deceptively, to be refunded.

Business

Response:

To whom it may concern,

Based on our records, the patient presented to the urgent care facility on May 4th. There is an outpatient imaging center in the same building as the urgent care center, however the patient entered the hospital and had the services there, which resulted in a facility fee in addition to a professional fee.

Thanks,

Sutter Medical Foundation.

Sutter Medical Center Foundation

2750 Gateway Oaks Dr Ste 100

Sacramento CA 95833

Dear [redacted]:

Revdex.com received a complaint about your business. The complaint was submitted on 9/17/2014 5:35:53 PM and was assigned an ID of 10225871.

Your Revdex.com has received a request for assistance from one of your customers. We would like to take this opportunity to help you advance marketplace trust by resolving this dispute. Revdex.com realizes there are two sides to every dispute; and, we want to accurately document your position while assisting both parties with reaching a mutually agreeable resolution.

Please review the complaint information and respond within the next 10 days.

We encourage you to use our online complaint system to respond to the complaint. If you received this complaint via email, please use the "Respond to this Complaint" link located to the left. If this complaint was received via postal mail, please visit the following URL: [redacted] and respond using the online form. If you are unable to respond online, please reply by letter and send it back via fax or postal mail.

THE TEXT OF YOUR RESPONSE MAY BE PUBLICLY POSTED ON Revdex.com'S WEBSITE. PLEASE DO NOT INCLUDE ANY PERSONALLY IDENTIFIABLE INFORMATION OR USE INAPPROPRIATE LANGUAGE IN YOUR RESPONSE. Revdex.com MAY EDIT YOUR RESPONSE TO REMOVE PERSONALLY IDENTIFIABLE INFORMATION AND/OR INAPPROPRIATE LANGUAGE.

Upon receiving your response we will forward it to your customer. If you feel the complainant is not your customer, please send us written clarification to that effect.

Revdex.com thanks you for your prompt reply.

Sincerely,

Review: Had to have a sleep study done for my apnea. This involved getting an EKG at a sutter facility. I didn't think they took my insurance so I asked multiple times do you actually take my insurance. They said they did, multiple times. Well they lied. I got a bill from them for $386.65. I called my insurance and they let me know they would not pay it, because Sutter does not take our insurance! They just blatantly lied to me and now I am out almost 400 dollars.Desired Settlement: Quit lying to people about what insurances you actually take.

Business

Response:

Business states that they have contacted the consumer directly. There was a miscommunication and for the sake of customer service, business is waving the charges and refunding the consumer payment.

Consumer

Response:

I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me.

Review: When I was with Sutter, my health insurance covered one mammogram per year at no cost to me. In 2012 I had a mammogram and Sutter asked me to come back for a second diagnostic because they were uncertain about something they saw. There was a charge for that, which my mother paid because I couldn't afford it. Sutter asked me to come back in 6 months. I chose to wait until 2013, as I was told by Sutter that I would not be charged if I waited until the next calendar year. When I went in for my mammogram on 3/7/13, I was told that I should go ahead and get both the regular mammogram and an ultrasound on that day, so that they could get a good look at the area they were concerned about, I would avoid the possibility of having to come in a second time and that this way I would also not be charged--it would be covered by my insurance. My test results showed there was no problem, but Sutter billed me. My insurance agent has been with my family for a long time and he has been trying to assist me in many ways. At one point in this long process, he suggested applying for financial assistance, knowing that based on my income, the charges should be dismissed. Sutter wrote back saying I was denied because it was part of my deductible.Desired Settlement: Not only does that not make sense, but I never should have been billed for it in the first place, as they told me I would not be. They then turned it into a collection agency.I have good credit and would like to keep it that way. Please help me end this nightmare.

Business

Response:

The patient exam was performed at [redacted]

Screening on 4/2/12 – recommended the patient return for additional evaluation (Diagnostic mammogram)

4/20/12 Bilateral Diagnostic performed – Recommended 6 month follow up Diagnostic mammogram

3/7/2013 Bilateral Diagnostic performed as recommended by previous exam on 4/20/2012

See conversation with patient below. This is an encounter in her record from her doctor’s office

I cannot speak to what her insurance covers but screenings are a preventative study and a “call back” diagnostic or 6 month follow up diagnostic are no longer preventative studies. It sounds like she believed that if she waited a year to follow up then it would be a screening and therefore covered by her insurance.

We must follow the recommendation of the last exam unless patient refuses and then she may be called back for another diagnostic exam anyway after the screening.

Consumer

Response:

I am rejecting this response because:

I spoke to [redacted] at Sutter (###-###-####). He reviewed my files and also couldn't figure out why my 3/7/13 exam was not covered and said he would get back to me within a week, which he did not do.

Speaking to his statement, "It sounds like she believed that if she waited a year to follow up then it would be a screening and therefore covered by her insurance." Yes I believed that because I was told by an employee at Sutter that if I waited til the next calendar year, it would be covered by my insurance. I was also told by another employee at Sutter that if I got the sonogram as well as the mammogram on 3/7/13 that I would not be called in for a second visit and that it would be covered by my insurance. I believed these things because that was what I was told by the Sutter staff. If these things they told me are not true, they should stand by their word and take responsibility for the bill. There was never even anything wrong in the first place and they got paid for a second visit in 2012, as it is.

Business

Response:

Hello, the services in question were infact covered by the insurance, however the deductible had not been met. The insurance covered $75.52 and the unmet deductible of $214.48 was the patient responsibility.

Consumer

Response:

I am rejecting this response because:

Regarding [redacted] statement, "the services in question were in fact covered by the insurance, however the deductible had not been met. The insurance covered $75.52 and the unmet deductible of $214.48 was the patient responsibility."

When I spoke to [redacted] on the phone, he said because it was a preventative procedure and the insurance should have covered it, my deductible has nothing to do with this - because its a procedure that is covered. I shouldn't have to pay anything.

I believe he is going back on his words because he doesn't want to give back the $214.48 which never should have been paid in the first place.

Also, once again, after our call, he said he would call me in a couple days and he has not followed through.

Since it seems he is someone who can actually get things accomplished at Sutter, I asked him to get back some other payments I had made to Sutter that I was told I would get back. [redacted] was who I was working with on some bills from an accident I was in. While I was waiting for an answer about low income financial assistance, she said if I paid $46.66/month til it was resolved, I would be reimbursed my payments if my financial assistance was approved, which it was.

I made these payments on 1/27/13 (ck [redacted]), 3/3/13 (ck [redacted]), 3/26/13 (ck [redacted]) and 5/30/13 (ck [redacted]) for $46.66 each time.

I have spent much time and gone through a lot of trouble dealing with Sutter on matters that should not be this difficult to resolve. I believe their intention is to tire me out so that I will give up on reclaiming what is mine - a typical tactic of big business. If I am paid back quickly, as I was promised, I will leave this matter alone. However, if Sutter and its staff continue to drag their feet, I will not hesitate to take legal action and add in fees for my time & duress. This is completely unprofessional and I am beyond tired of wasting my time on all this,

Also, I just got a final notice from Sutter on this mammogram bill - if they do in fact turn this in to a collection agency, there will be a price to pay.

Business

Response:

Good morning,

From the Sutter Medical Group portion the billing (This is the physcian's billing) the account is at a zero balance.

The charges in question are currently being re-processed by the insurance company. These charges are for the hospital.

Thanks,

Sutter Medical Foundation.