Sutter Medical Center Foundation

Review: My husband [redacted] was admitted to the hospital May 7, 2015. I got a call from Sutter billing asking if I would pay the copay of $287 immediately. The woman stated that the copay would cover all procedures and length of stay. No additional costs would be added. I got a bill for $850. I called them twice about the extra charges and both parties I talked to said the copay was an estimate. At no time did the woman asking for the immediate copay say "estimate". I requested they review the recorded conversations from billing. They agreed all calls are recorded. I never got a call back about the recording of our original conversation, just calls to pay the bill.Desired Settlement: I would like Sutter to review the recorded call stating that the $287 copay would cover all procedures and length of stay with no additional charges

Business

Response:

Thank you so much forwarding this e-mail to me to allow me to respond. We are reviewing the customer’s complaint and working on a resolution. There is some discrepancy between the billing information and the eligibility information posted by the insurance company for the patient’s plan. Once we can resolve the discrepancy, we will contact the customer with a resolution. There is no recording available for the conversation the customer had with our representative as that technology is not in use at the facility. Please let me know if you need any additional information or if this response is not sufficient for your needs. Thank you. [redacted]Patient Access SupervisorSutter Roseville Medical Center

Review: On May 10th 2015 I took my daughter to Sutter Urgent Care. I arrived and paid my $15 co pay. I waited for hours to see the doctor and finally we saw someone.. We were in the room only for a few minutes to handle the issue we had. A few weeks later I received a bill in the mail for $271.90 for this visit- My insurance covers Urgent Care visits at 100%, so I was confused as to why I was receiving this bill, I just pay a co pay of $15 which I did and that should have been all. I called Sutter about this bill NUMEROUS times- no one will help me. They stated that Sutter Urgent care can't bill out as a Urgent Care Facility and that is why my Insurance did not cover it which is not right! Sutter advertises URGENT care through out the entire hospital and this is misleading. I could have taken my daughter to a different Urgent care or to the ER and paid hundreds less. I want Sutter to help me. I don't believe it is fair that because of their false advertising, I should be left with this bill when my insurance said that they will cover it 100% if Sutter resubmits it as Urgent Care as it should have been! I wouldn't even mind paying the $75 more to make it the $100 it would have been to go to the ER, If I would have known Sutter was not going to bill as an Urgent Care facility I would NOT have gone there. I just would like someone to contact me and resolve this issue. I also think Sutter should change their signs so no one else is mislead in thinking this is going to be covered as an Urgent Care visit when its not. I have many pictures to prove the numerous "Urgent Care" signs posted around the hospital. This bill is a hardship and I would please like someone to contact me ASAP. Thank you,[redacted]Desired Settlement: I don't mind paying the $75 more to make it the $100 Co pay I could have paid to take her to the ER instead.. Or I would like Sutter to cover the $271.90 since it would have been 100% covered if they billed it as an Urgent Care visit.

Business

Response:

To whom it may concern,Per our legal counsel, California does not define specifically what an Urgent Care is or who/how it can be billed. The CPT codes are the same regardless of the place of service code being used. We clearly indicate on our claims that these services have been rendered at the Roseville Urgent Care location. It is unfortunate that the patient’s insurance company is unable to process the claim as urgent care even though the claims state thisWe have also taken steps and have appealed this with the insurance. This was done as a telephone appeal, where we spoke to the insurance, explained the situation and advised that they process this as an urgent care visit since that it what appears on the claim form, "Roseville Urgent Care."Please do not hesitate to reach out to us in the future in the event the carrier continues to apply this to your deductible.

Consumer

Response:

I received an email that Sutter had responded and I accepted their response but I contacted my insurance and they have nothing in the system showing they were contact like Sutter stated.Can you please remove that I accepted it so I can send another message/response to them please.Thank you,[redacted]

Business

Response:

To whom it may concern,On 11/09/15, we appealed this claim to your insurance carrier. It is currently in appeals process. Our claim which we submitted to Blue Cross, indicates "Sutter Roseville Urgent Care" and our appeal indicates to make a note of this when reprocessing the claim.Thank you.Sutter Medical Foundation.

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: Sutter Heath cashed my check to pay the co-pay for my hospitalization, but did not credit the proper account, yet they refuse to return my funds, saying they need to find where the money went, before they can do that. It has been months, however, and they still refuse to refund my money.Desired Settlement: I would like the $50.00 back which they have taken from my checking account, but have not credited to my account.

Business

Response:

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]

Consumer

Response:

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]

Business

Response:

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.

Consumer

Response:

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.

Business

Response:

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: On December 31 at 12:01pm I made an over payment of $2070 from my HSA account that was going to cover any overages for 2014 calendar year. Called my insurance provider and they covered all cost for services in said year and Sutter was paid in full on Jan 17th. Called numerous different times over the last the last five months and was told they were still waiting on payment from my provider. Finally got the real answer about the account and they used the over payment to pay back services and should be processing the refund of $1470. I was told that Sutter does not issue refunds as this is not part of their practice and will only take overage payments and apply to future services. I was also informed that they would make special provisions for this account and I would be issued a check that would take two weeks to process. Called today and informed that the $1470 was applied to a new bill dated for payment of 5/17 and they would not be refunding last years over payment. This has now caused a major problem with how my taxes were filed, how this years payment schedule and this years HAS information.Desired Settlement: I would like the $1470 refunded and to me directly and not credited to this years medical billing so I can keep calendar years separate. I have reverted to legal council and was informed to try this first before moving forward as numerous medical issues were violated and HIPPA laws were broken.

Business

Response:

hello, I have reviewed all your accounts. I read the notes on the account that you requested we debit your Health savings Account for $2070.84 on 12/31/14. I have read the account notes that state your account had not been billed so we could not tell you what your out of pocket was at the time of the call. You also stated that you wanted to use your HSA before year end. We complied to your request. When your insurance paid it left a credit of $1470.84. In our financial reconcilation we had discovered you had an out standing patient balance of $2815.15 on another account this left a balance of $1344.31 still owing.Since we process HSA's the same as we do any credit or debit card payment we can refund the overage back you your HSA we will not process this as an out of pocket refund. As an FYI once that tranaction is completed you will owe the $2815.15 for your patient responsibility listed by your your insurance company for services provided on a date of service in 2015. .

Review: I was sent to collections for a medical bill that apparently went past due. I made a payment on 5/29/2014 in the amount of $100. I called on 6/19/2014 to make another $100 payment but that payment was never recorded or taken out of my bank account. Today I received a call that my account has been sent to collections. When I looked online I have no messages about this and it will not allow me to make a payment. I have not received a paper statement or a phone call from Sutter since the beginning of May. I called Sutter billing for information and spoke with [redacted]. She was very rude and told me that the account has defaulted, they are showing they tried calling three times with no answer and now it is in collections and there is nothing else to do. She have me her fax number to show her the payments taken out but would not listen to me explaining when I called and that they were never taken out and I have not received any statements or phone calls. She said there was nothing else I could do and was very rude about it. I went through all of my phone records and I have not received a single phone call from Sutter since May 29, 2014 or a any voicemails. This situation is very upsetting and I am extremely dissatisfied with the service I received. Not only did I never receive a paper statement, but I never received a phone call, a message online or an email about this account now being in default and going to collections. I was more than willing to pay off the entire bill as it is not a substantial amount but I was essentially told too bad and to deal with it on my own with collections agency.Desired Settlement: I would like to have my account removed out of collections and the mark removed and I am more than willing to pay off the entire account. I feel that is only fair considering I was never informed about this account being in a defaulted status, and whomever marked on my account as being contacted and called needs to be investigated.

Business

Response:

To whom it may concern,

Review: I have Insurance with [redacted], and as part of my coverage I get free Health Check-Up (Physical test or Preventive care) every year. I wanted to use this service for the first time. I had no medical condition. I called Sutter Health to reserve an appointment for Preventive Care/Physical test. I got an appointment for My 1, 2014. When I visited the doctor's office on the day of appointment, I did confirm with the reception that I was there for a Physical Test. They took me inside and did the regular (weight/height) check-up and asked me to wait for the doctor to discuss about my health further. The doctor asked me questions related to family history health and my health. I did mention that I sometimes have constipation, but thats not a medical condition that I had visited the doctor for. The doctor advised me to take some flu shot and chicken pox shot. I asked about why would I need a Chicken pox shot. So doctor advised me to take a blood test to find out if I would need a chicken pox test. I agreed to that and had my blood test taken. I did check my test results and everything came out to be normal. I did not go for Chicken pox shot. 2 weeks later Sutter health sent me a bill of $628 for the doctor's visit. I called them more than 3 times to explain them that the service was covered under my Health Insurance with [redacted], but they insist that since I talked about constipation during my visit they are charging me. I communicated with them via online account as well but they deny to remove charges and bill my insurance [redacted]. When I called [redacted] they said they agree with me but there is nothing that they could do about it.Desired Settlement: I would like Sutter Health to remove all charges on my account and as a matter of fact consider my visit as a preventive care (physical test), periodic test that I am eligible per my Health Insurance from [redacted]. And bill [redacted] for all applicable Charges for the visit I had made on 05/01/2014

Business

Response:

To whom it may concern,

A review was done on the notes from the patient visit on May 1, 2014. The notes clearly indicate that the service provided was not prevenative, nor should it be billed as preventive.

This was a visit to establish care where existing conditions or symptoms were addressed and follow up was encouraged. Lab tests were also ordered, for non preventive purposes.

We are unable to remove this charge or make any changes to have the services provided to reflect a physical was done.

Thanks,

Business

Response:

Hello, unfortunately after further review, the visit was not preventive in nature. Lab tests were ordered for non preventive purposes and patient was also given some options on what do do for the symptoms described in the visit.

Sutter Medical Center Foundation 2750 Gateway Oaks Dr Ste 100

Sacramento CA 95833

Dear [redacted]:

This message is in regard to a complaint submitted to the Revdex.com about your business on 6/21/2014 12:21:22 PM by [redacted] . This complaint was assigned ID 10100516.

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,

MESSAGE:

I am rejecting this response because:

My purpose for the visit was only for physical test which I had confirmed twice before meeting with the doctor, and NOT to establish primary care. I have no medical condition and the tests suggested by the doctor were not relevant and I never took those tests. I had no such condition to take those tests. Sutter can check their records if I ever took the test for any medical condition.