Complaints

This profile includes complaints for Sutter Health's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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• 

  Sutter Health

  2200 River Plaza Dr Sacramento, CA 95833-4134

• 

  Sutter Health

  1201 Alhambra Blvd Ste 410 Sacramento, CA 95816-5243

• 

  Sutter Medical Foundation

  45 Castro Street San Francisco, CA 94114-1022

• 

  Eden Medical Center

  20103 Lake Chabot Rd Castro Valley, CA 94546-5305

• 

  Sutter Pacific Medical Offices

  3883 Airway Drive Santa Rosa, CA 95403

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:12/08/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In June 2023, my mother was transferred to Sutter Medical Center in Sacramento, where she ultimately died. I am the executor of her estate. Since her death, her insurance company has paid Sutter Health the ******** allowable amount for this hospitalization, and I have paid them the copay owed by my mother's estate according to her EOB and health insurance representatives. Sutter continues to attempt to bill the patient for the amount disallowed by ********. I have called the billing department myself, called again with a representative from the insurance company on the phone to explain the issue to them, and the insurance company has made additional attempts (at least one other call and letter) to solve the problem for me with Sutter, to no avail. They are billing more than $103,000 and pretending it's due to the way the charges appear on the **** which the insurance company says is nonsense. Dealing with the administrative side of Sutter is impossible. I am now resorting to filing complaints with any agency that might be able to help, because Sutter has already been paid everything they're entitled to for their services by my mother's supplemental ******** plan and by her estate. I received a Final Notice and threatening letter from them in the mail yesterday.

  Business Response

  Date: 12/18/2023

  A Sutter Representative reviewed this concern. The Representative spoke to the patients daughter and advised her that the account has been adjusted and reflects a zero balance.  She was satisfied with the outcome.

• Initial Complaint

  Date:11/18/2023

  Type:Product Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was billed $40 for a co payment on October 5 for a simple visit to the *************** and received my EOB a few days later. My insurance said I only needed to pay $10.00. I have waited almost 4 weeks for a refund check. I called the ******** office at ************, address *************************************************************. I was told they dont handle refunds, yet they were able to take my $40 co pay instantly. I called the customer service number and was promised a refund within 7 days. This office also overbilled my insurance of $554.00. I was there 15 minutes. The most I have ever been billed by any specialist was $200.00. This is highly irregular and have called my insurance to call this business. I want my $10 refunded asap and I am filing additional complaints with medical board and my insurance.

• Initial Complaint

  Date:11/06/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 2/25/23 Lab work was done at Sutter testing my levels of 2 medications I was taking. They outsourced the testing to Quest Diagnostics but provided them with an incorrect billing code (well ness visit for a child. I am not a child!) My insurance denied the claim because of the incorrect billing code.I received the bill from Quest of 3/15/23. I received multiple bills and they were threatening to take me to collections, so I paid $211.69, the total amount of the bill.On 6/13/23, I spoke with ******* in customer service. She said I needed to send an email explaining the problem to the outside lab dispute team, which I did immediately. She stated it would take ***** days to resolve the claim.On 8/21, 23 I spoke with ******* in customer service. She said she would escalate the matter to the outside lab dispute team. I heard nothing further.On 11/6/23, I once again called customer service and spoke with ****. She said she would put in another escalation. I asked her why she thought that would resolve things when the first escalation had resulted in no action. I asked to speak to a supervisor, who basically said there was nothing they could do and that the disputes were taking ***** days. Mind you, it has been almost 5 months and still nothing has happened. She said she would see if someone from the team could call **** have made 3 good faith efforts to resolve this and nothing has been done.

  Business Response

  Date: 11/09/2023

  A Sutter Representative reviewed this concern and confirmed the claim has been resubmitted removing the previous Dx codes.  The Representative spoke to the patient and explained this is not a guarantee of payment but that the claim was submitted for review.  If the claim is paid she will be refunded accordingly and if denied she could reach out to the representative directly with questions.  The patient was satisfied with the outcome.

• Initial Complaint

  Date:11/04/2023

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Earlier this year I scheduled a Health Maintenance Exam (i.e. annual wellness exam, i.e. preventative visit) with my ******* Care Provider (PCP) for August 17, 2023 at **************** Family Medicine (part of Palo Alto Medical Foundation, a division of Sutter Health). This was the only appointment requested and scheduled. I confirmed in the My Health Online (MHO) online portal that the appointment showed as Health Maintenance Exam. On August 17th, I presented myself at the office for this appointment and confirmed that it was only supposed to be a Health Maintenance Exam. However, when I received my bill for this one (1) visit I was instead billed for two visits, a Health Maintenance Exam (which is fully covered by my insurance) and an office visit (for an additional $154 that was not covered by my insurance). There was only the one (1) visit for a Health Maintenance Exam, and I did not request for, consent to, or was consulted about any other services being provided. This secondary charge of $154 for a separate office visit should be reversed. I have filed appeals of this issue with PAMF twice with no satisfactory resolution.

  Business Response

  Date: 11/09/2023

  A Sutter Representative reviewed this concern.  Upon review of the account the office visit, in addition to the annual exam, was billed appropriately.  However, ******************** was not informed of the potential billing of the office visit in this case; therefore, his account has been adjusted.  A letter has been sent which explains the adjustment as well as the reason we must bill this way for future reference. 

  Customer Answer

  Date: 11/16/2023

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

• Initial Complaint

  Date:10/21/2023

  Type:Service or Repair Issues
  Status:

  UnresolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 05/14/23 I dropped a knife on my right foot and cut it on the base of the big toe. I sent photos and talked with a friend who is a Carewound doctor specialist and she asked me to perform a few movement tests and advised me to go to the *********** for stitches. I thought about gluing at home but she advised against it. I went to the Sutter *********** in Alhambra and the first thing that happened was that they did not accept my Insurance (it was active but they said not in their system). I paid out of pocket. I was the last one seen by ******************************** who said he could not give me stitches because I had a "complete laceration of extensor tendon". He sent me to the ** across the street. I was there for almost 4 hours and in the end, PA ************************* assessed that I only needed stitches. At the ** my Insurance was not accepted as well and I ended up getting a big bill for the ** visit and services. After updating the information and contacting Sutter they accepted the insurance but I was still being charged for the ** visit. I exchanged several messages, chatted with them, and even called. My situation is clearly one of a misdiagnosis and I've been pleading with Sutter to investigate and do what is right. It is not I could dismiss ********************** diagnosis and force him to give me stitches or go back home and glue the cut. I did not have a reasonable option besides heading to the ** where I received what I needed - and I paid for it - but did not receive it at the *** Now I was forced to create a payment plan to pay for the bill because I received a letter threatening to send my info to collection agencies. Sutter is being very dismissive and careless with my case and only one time in a call I made to the billing **** I got an agent that was caring and understood my situation and how unfair it is what is happening. I messaged Sutter first on May 24 (reference 5/25/2023 10:09 AM S238873]

  Business Response

  Date: 11/03/2023

  The concern was reviewed by Sutter Medical Foundation Patient Resource Center. The care provided by the ****** Care clinician followed protocol for the type of injury.

  Customer Answer

  Date: 11/03/2023

  I am rejecting this response because:
  
  This is the answer I received from Sutter: "The concern was reviewed by Sutter Medical Foundation Patient Resource Center. The care provided by the ****** Care clinician followed protocol for the type of injury." 
  
  This is not true. The Type of injury I had required only stitches. As you can read on the clinician's notes he wrote I had a "complete laceration of extensor tendon" and he said I needed foot surgery thus refusing to provide the care I needed. I ONLY NEEDED THE STITCHES. 
  
  How could I know that I only needed a suture, since I am not a doctor, and how I could refuse to go the *** and demand from ********************, that he would close the cut? I only came to know I needed only stitches and not surgery for my extensor tendon after I was seen by the P.A. doctor at the *************** So he, the ****** Care clinician DID NOT PROVIDE ME WITH CARE but provided me with a diagnosis and sent me away to receive care in the ER. 
  
  It is the diagnosis I received from the clinician at the ****** Care facility that I am complaining that was wrong.
  
  The clinician at the ****** Care was capable, if he wished to do so, of providing the stitches and closing my cut, without sending me to the *************** One more time, to be clear - I am not contesting the bill I paid for the ****** Care. I am contesting the bill I am paying for the *************** since ultimately I did not need to go there but I was left without options. 
  
  What I see is a dismissive and disinteresting attitude from Sutter, when it looks like they are not even reading what I am writing or checking the documents I attached where everyone considering the situation, can see the mistake. 
  

• Initial Complaint

  Date:10/06/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On November 23, 2022, I received medical services at a Sutter facility which was in network for my health insurance. My insurance paid the negotiated rate in early 2023. In August, however, a Sutter systems errors resulted in multiple requests sent to me demanding payment for the full amount (which was already paid by my insurer). After six to seven calls to Sutter and my insurer, I was told Sutter would be reversing the $3,485.35 balance and refund a previous patient difference of $54.65 that was erroneously billed and paid. As of today, October 6, 2023, the refund of $54.65 remains unresolved.According to both the 2022 federal and 2017 California surprise medical bill regulations , Sutter never should have tried to bill a patient for difference between their rate and my insurance reimbursement rate for in network service. Unfortunately, I believed a June 5th email from Sutter telling me that I was responsible for the difference. Having spent countless hours and calls with my insurer and Sutter on multiple ******** issues over the years, I am no longer willing to let this slide. I request the full refund of $54.65 billed as patient billing difference for in network services, as I was legally only responsible for the $20 copay.

  Business Response

  Date: 10/13/2023

  A Sutter Representative spoke with ************. In summary, her insurance voided the claim out in error and only processed a portion of it resulting in recoupment of their payment and miscommunication of copay to the patent. The insurance will need to reprocess the entire claim. The patient has been refunded her payment with the explanation and understanding that if her insurance reprocesses the claim with additional patient responsibility, she will receive a bill. Patient verbalized understanding.  

• Initial Complaint

  Date:10/01/2023

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  *********** work outsourced to out-of-network provider (Diagnostic Pathology Med Grp Inc).Date of Service - 6/7/23.Amount Originally Billed by Out-of-Network Provider - $206.30.New Amount (Adjusted by Out-of-Network Provider) - $96.15 (unpaid as of 10/1/23).Sutter Billing Acct # - ****************** 6/**/** - call to ********************** billing department after receipt of EOB stating that lab work is not covered as it was sent to out-of-network provider; service rep. stated that when I receive the bill, I should fax a copy of it in, call customer service back, and they will start the review process.(2) 8/18/23 - online chat with Sutter to commence review process (Ticket #*******); emailed copy of bill to ******************************************* per online chat agent. Agent stated that claim should be reviewed and resolved within 30 days.(3) 9/30/23 - No response from Sutter yet; follow-up call to Sutter billing ***** Entire call took approx. 35 min. Agent first stated they didn't have a copy of the bill (note to reach out to patient, yet nobody reached out to me) and put me on hold several times needing to speak with her supervisor. Couldn't clearly state whether my claim was actually denied. Stated I should confirm a provider is in network before I go to see them. I let her know I was unaware that lab work was outsourced at the time of my appt, but I know my doctor is in-network. She then stated I should try to get my insurance to pay; this is not an option, they already paid for a similar circumstance which was under review at the time of the 6/7/23 appt. Could not resolve my issue, told me to call pathology *** and see if they could work with me on the bill.When the main provider accepts you as a patient, they always confirm insurance coverage, yet they feel they have no obligation to confirm network coverage before outsourcing lab work. This is wrong. There are several references online (provider referrals) that describe how doctors can check up-to-date lists of in-network labs.

  Business Response

  Date: 10/09/2023

  A Sutter Representative confirmed with Blue Shield that the claim for 6/7/23 with Diagnostic ******************* was processed as out of network INCORRECTLY by Blue Shield.  We confirmed with Diagnostic ******************* that they are in network with Blue Shield.  It has been confirmed that Diagnostic ******************* submitted an appeal to Blue Shield for this claim and placed the balance on hold pending the outcome of appeal.  Sutter Medical Foundation has tried reaching the patient but has been unsuccessful therefore a letter has been sent advising of this information. Diagnostic ******************* will be following up to provide this information to the patient as well.  

  Customer Answer

  Date: 10/10/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me. It appears as if this issue, and the bulk of the responsibility, lies with Blue Shield for inaccurately denying claims; however I am incredibly thankful for the Better Business Bureau's involvement which ensured a speedy resolution. Sutter Medical Foundation should have been able to assist with this, over a month a half's time span and several calls and claims, what BBB resolved in a couple of days. Thank you for your help and advocacy.
  
  

• Initial Complaint

  Date:09/27/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My kids had optometrists visits on 2/15/2022 ($463 for each kid that we paid out of pocket, "2022 visits") and then in 5/2023 and 6/2023 ($429 for each kid, "2023 visits") that should have been covered under our *** insurance. Never once did anyone ask us to provide or verify insurance. It was only when I challenged the bills for the 2023 visits that I found out that our *** insurance was never used. It took many hours of being on hold and getting through various reps to open and verify the *** accounts. When I tried to have the 2/15/2022 visits for my kids reviewed and resubmitted for ***, I got the most ridiculous and harassing treatment from Sutter's billing department. During a phone call on 9/27/2023 between 11AM-11:45AM, "******" from Sutter Billing started shaming me: "You waited 18 months to contact us and there's nothing we can do." I explained that I discovered the billing mistakes recently through our 2023 optometrist visits and was trying to right a wrong. Then when I asked to speak with someone else, "******" started lying gleefully: "There's no one to speak to and everyone is busy." Sutter claimed that they couldn't do anything with the 2022 visits because they were outside of 1-year window. However *** told me that Sutter Billing should have asked for coordination of benefits since the original claims were timely submitted with our medical insurance, and *** should be secondary insurance. In addition, *** had NO RECORD of claims for the 2/15/2022 visits, and Sutter Billing lied about these claims being denied by *** (How can a claim be denied without being submitted?). Ironically, Sutter was not barred by this so-called time limitation and now I have $62 balance for 1 kid and the $463 was never resolved for the other kid. Not only were "******" and others at Sutter Billing unwilling to assist me, they provided wrong, misleading, conflicted information and exhibited intentionally predatory, harassing behaviors that inflicted me with emotional distress.

  Business Response

  Date: 10/06/2023

  A Sutter Representative review this concern. The accounts were ****ed correctly.
  Her 2 children had appointments in 2022 and medical insurance was ****ed and processed correctly according to the patients benefits. As guarantor, ************ signed a waiver that stated medical insurance does not cover refractions.
  
  On 9/26/2023 there was a refund issued in error when ****ing incorrectly adjusted a claim. That refund will be honored as it has it already been refunded.
  
  The remaining charges have been ****ed correctly and per the Ms. ***** request the charges have been ****ed to VSP and are pending with VSP.
  
  The Sutter Representative spoke with ************ advising her that VSP will most likely deny as the provider is not contracted and then her medical insurance will be ****ed. The Representative went over the refractions charges and reminded ************ that a waiver was signed agreeing to pay. Everything was reviewed with ************, and she understands better now what happened and why it happened. The Sutter Representative informed ************ that she can contact her directly should she have further questions. Education was provided that the current Eye Doctor her children are seeing is not contracted to **** **************** and she understands. 

• Initial Complaint

  Date:09/21/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My doctor ordered a *** in December 2022. In early January, the doctor contacted me indicated that she should have ordered the *** with contrast instead of without contrast; thus the original *** on 12/5/22 was not clear. The radiologist suggested that I have another follow up ***. I originally disagreed since I did not want to pay for another $325 copay for the second ***. After several calls and emails with my doctor, she said I do not need a full ***, just a subset of the *** (5 minutes scan) which I did on 1/25/23.When I got the bill for the service on 1/25/23 in the amount of $2,535, I thought that make sense since the original *** was billed for $1,935, so the updated bill of $2,535 should have covered for not only the original *** on 12/5, but also included the additional cost for the subset *** on 1/25/23. I agreed and paid for the $325 copayment in March. Apparently Sutter Health went back to Anthem and dispute the bill on 12/5/22 in the amount of $1,935 which had already billed and included in the bill submitted to Anthem on 1/25/23. Sutter Health now claims that I owe another $325 copay for he duplicated bill. I dont mind paying for service rendered, but disagreed with billing errors that cause me to pay for the copayment twice. I would appreciate if the billing staff can follow up and check the medical procedures that were done and properly correct the billing issues.

  Business Response

  Date: 09/26/2023

  A Sutter Representative has reviewed these concerns and determined that the care and billing for the care was appropriate.  A representative has reached out to Ms. ** and explained the findings and that the balance remains her responsibility.  

  Customer Answer

  Date: 09/26/2023

  I am rejecting this response because: as I have stated in my original complaint, the duplicated charged on 12/5 has already included in the bill Sutter sent to my ********** on 1/25/23. I have filed an appeal with ********** as well as ****************** Health *********** and requested that they review the Sutter billing practice. Thanks!
  

  Business Response

  Date: 10/09/2023

  Sutter ************ changed the 12/5/22 MRI to a ***************** and refunded the patients insurance. They spoke with the patient and she was satisfied with this resolution.  

• Initial Complaint

  Date:08/07/2023

  Type:Customer Service Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Sutter has billed and continues to bill be for a copay. I do not owe this copay. I was seen as part of a VA referral. Sutter billed my insurance anyways. I have gone though an enormous amount of effort to clear this up. I would like them to stop billing me.

  Business Response

  Date: 08/18/2023

  A Sutter Representative has confirmed that there is a zero balance on ********************* account.  A letter will be sent to confirm if they are unable to contact him by phone. 

  Customer Answer

  Date: 08/19/2023

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