Complaints

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

close

Find a Location

Sutter Health has 63 locations, listed below.

*This company may be headquartered in or have additional locations in another country. Please click on the country abbreviation in the search box below to change to a different country location.

BBB accredited

Near

Country

USUnited States

Please enter a valid location.

Filter

• 

  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:04/06/2023

  Type:Service or Repair 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 3/11/23, I went to Sutter Medical lab to have **** bloodwork drawn. Before making the appointment, during check-in, and during the blood draw, I was assured that the results would be ****. My physician required the results by 2 pm PST that day. The results never arrived by 2 pm PST. I called the lab and they were closed. The after-hours line could not assist me. My IVF treatment (which is why I required Sutter services) is time sensitive. The doctor who requested these results never got the results the following day on Sunday, since the office was closed. By the time he got them on Monday, 3/13/23, it was too late. *************** had missed critical information and my IVF cycle was ruined due to Sutters negligence. I had a failed IVF cycle due to the negligence of Sutter Health lab not providing the **** results I was assured my physician would receive by 2 pm on 3/11/23. I have been unable to locate the proper **** at Sutter to file a complaint. Now as of 4/6/23, Sutter Health has the gall to bill me for $164.60 for the blood draw and **** fee! I am filing a formal grievance and disputing the claim billed to my insurance. I should not have to pay or have my insurance cover this blood draw as it was not drawn **** and Im out literally thousands of dollars (the cost of my IVF cycle) due to late test results and negligence from Sutter Health lab.

  Business Response

  Date: 04/13/2023

  A Sutter Representative reviewed the account. They confirmed that this lab was not completed as STAT as it was sent to a reference lab not a STAT lab. Due to this error, the ************ has adjusted the patient responsibility for these charges. Her account reflects a zero balance. The patients concern about negligence of Sutter Health Lab is being forwarded to the ******************** for follow up.

  Customer Answer

  Date: 04/14/2023

   
  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. My one request is that Sutter provides a timeframe for when I will hear from the *************** dept. 
  

  Customer Answer

  Date: 05/09/2023

  I am rejecting this response because:

  Unfortunately this is a new complaint extending from my 4/6/23 complaint. Ive filed several complaints about care I received in March 2023 through Sutter, BBB, and my insurance provider, Cigna. I spoke with a ************************* at Sutter a few weeks ago regarding a bill dispute. ***** reached out to me assuring me that the charges were reversed. She even sent me confirmation. Please see attached. Today ***** reached out to me and stated the claims have already been processed by *****. It seems that Sutter never reached out to my insurance so the claims can be denied. Please see attached. Im quite furious if this is the case and will reopen my complaints. I was assured this matter was handled. Im also upset as I had received a call from Sutter Patient Resource **** *********************** on 4/14/23. As per the BBB complaint and *************************, ******* and I would discuss the problematic care I received. On several occasions since 4/14/23, I have called ******* and left her messages. She has never returned my call. This is simply unacceptable. Now, I will have to refile the necessary complaints as the lack of care I received at Sutter caused my physician to not have my lab results in time. As a result, my IVF cycle failed and Im out of thousands of dollars. What Sutter has done to me is atrocious and I need individuals at Sutter on this case to be consistent and follow through with what was said and agreed upon. Instead of provide care, youre extending my agony.
  

  Business Response

  Date: 05/09/2023

  Based on patients statement regarding the lack of care I received at Sutter As a result, my IVF cycle failed and Im out of thousands of dollars, this concern has been forwarded to our 3rd party claims administrator. It has been assigned a claims administrator who will be reaching out to the patient to discuss the case.  

  Customer Answer

  Date: 05/10/2023

  I am rejecting this response because: this matter was not accurately handled by billing, the claims representative and Patient ************* to whim with. ***** still states the claim was not denied and this matter shouldve been resolved over a month ago. Additionally, after a month of reaching out to *********************** (Patient *************), she has been negligent and neglectful as she has not contacted me to discuss these matters. This resolution will continued to be rejected until ALL matters hace been resolved to my satisfaction. 
  

  Business Response

  Date: 05/23/2023

  As stated in the prior response, this concern has been forwarded to our 3rd party claims administrator. It has been assigned a claims administrator who will be reaching out to the patient to discuss the case. From a billing perspective, this concern has been closed. 

  Customer Answer

  Date: 05/24/2023

  I am rejecting this response because Sutter Health does not state when this claim administrator will reach out. I filed the initial complaint OVER TWO MONTHS AGO. No one from claims or the Patient Resource Center has responded to my calls or emails to discuss this matter since March 2023. I am now going to file complaints with ***************** **** of ******* Healthcare and CDPH Licensing and Certification. I dont appreciate getting the runaround and clearly Sutter is not taking my complaint seriously. Its completely unacceptable to continually fail to respond to a patient with a complaint that cost them thousands of dollars in their medical care! Your response is careless and reckless, exactly how your medical institution was with my health. Do better Sutter!
  

• Initial Complaint

  Date:03/25/2023

  Type:Service or Repair 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 08/29/2002, I tested COVID+ve using a home test and reached out to my ******* Care Physician ************************* at PAMF/Sutter Health using their online portal asking for help on what I should be doing to take care of myself. In response a ************ scheduled a video visit with *****************. The video visit was about 10 minutes. A few days later, when I received the bill from PAMF, I noticed a higher charge then expected. On looking at explanation of benefits, I noticed they had charged me for a Office or outpatient visit with a new patient which is higher than for an existing patient. I had been a patient of PAMF/Sutter Health and ********************** for more than ~7 years at that point and believed I was incorrectly billed. I reached out to PAMF to resolve the issue on 09/06 via their online portal and I was told the bill provided was for the date of service 08/29/2022 as a new patient office visit in the Family Visit specialty. When a patient has not been seen by a provider in a specific specialty within a three year period, the visit will then be considered a new patient visit rather than an established patient visit. After reviewing your account, I show that services were rendered by a physician in the Family Medicine specialty. Upon further research, I was able to confirm that you have not been seen with a physician in Family Medicine As mentioned, I am not a new patient to PAMF. The doctor has access to all the same records that my PCP has. It was not my choice to see a new doctor.I called PAMF/Sutter Health again on 02/23/2023 and explained they had assigned the doctor to me without my consent and explaining the charges, but they have not changed the bill and have now sent it for debt collection to USCB America who is calling me multiple times a week to collect this incorrect bill. Looking at BBB reports, this does not seem to be an isolated case and I see a similar issue reported on BBB on 02/24/2023. Please help with this situation.

  Business Response

  Date: 04/05/2023

  A Sutter Representative reviewed the account.  The coding was reviewed and changed to reflect an established patient visit.  The patient's bill was adjusted.  Patient was unhappy that it took so long to resolve.  Representative explained that it needed to go through several levels of review.  The Representative apologized for his frustration and explained that processes were followed for appropriate reviews.  Payment options were discussed, and it was explained that it was reversed from collections. 

• Initial Complaint

  Date:03/23/2023

  Type:Billing 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.

  - I visited urgent care on 6/23/22, briefly spoke to a doctor who told me they were about to close and wouldn't have time to provide care, but took my vitals, offered a ride in an ambulance to the nearby ER (I declined and went on my own), and then ended the visit. - In September I got a bill for $461, and called to ask for details since this was higher than expected. On 9/15/22 when I made the call, I was told I owed $0 by the billing representative -- this is included in Sutter Health's records.- I then got a bill for $75, and since I expected it to be $0, called to ask for clarification on 10/3/22. I was told a review would be submitted. No follow-up was made.- I then got a updated bill for $538. On a call on 12/12/22, billing relations told me I could open a review if I wished, but otherwise had to pay the money if I wanted to close out the case. On the call, they confirmed that in their records, they say the note about $0 owed. However, they refused to honor it.- Giving up on receiving proper resolution through the billing department, I contacted Sutter Health patient relations. In mid-January (around 1/17), they responded to me saying that the case was updated, and that outstanding bill would be $0. The breakdown was $75 that I owed, which they were waiving as a courtesy, with the rest being billed to insurance. I assumed the case was closed.- On 3/7/23, I received a letter in the mail that my bill would be sent to collections if not paid by 3/1. They letter was dated 2/15, though I received it after the deadline. When I called, I was told my bill hadn't gone to collections, that it was a mistake, and it would be sent to another department for review -- I owed nothing.- On 3/22/23, I called to follow up, and found the case unresolved. I requested it be closed and handled as an internal issue, rather than leaving me with a balance of (now) $461 in their system. They submitted a new review, but refused to close the case. I'm requesting it be closed.

  Business Response

  Date: 03/28/2023

  A Sutter Representative reviewed this concern and determined that the patient was billed in error. The balance was submitted back to the insurance.The corrections have been made on the account and the patient shouldnt be billed in error again. It was determined that the insurance paid twice on a corrected claim. A refund is being issued to the insurance which should clear up the problem of charges showing as the patient being billed. The Sutter Representative spoke to the patient and provided the patient her direct contact info. She will monitor the account for the next few weeks to make sure the patient is not billed in error again.

  Customer Answer

  Date: 03/28/2023

   
  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:03/17/2023

  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.

  Dear Better Business Bureau,I am writing to express my disappointment and frustration with the Sutter Health ********* Medical Foundation. I recently had an annual physical at their facility and was charged an outrageous amount of $227.37. I want to register a complaint about their unethical billing practices.I specifically emphasized that I only wanted to do an annual physical, which is 100% covered by my insurance, when I scheduled the appointment. I reiterated the same to the staff and the doctor during my visit. Despite my clear instructions, I was still charged an exorbitant fee.When I contacted their billing department, I was met with rude and unhelpful responses. They simply said that I should contact my insurance company. However, my insurance company informed me that the procedure code used by Sutter Health ********* Medical Foundation was incorrect, which caused the physical to not be covered by insurance.I have been using the same insurance for the last five years and have undergone many annual physicals at different providers, and have never been charged at all. I believe that Sutter Health ********* Medical Foundation is taking advantage of patients who do not possess medical knowledge and wrongly charging them to make a profit.I am extremely dissatisfied with their lack of transparency in billing and want BBB's assistance in resolving this issue. I hope that this complaint will lead to Sutter Health ********* Medical Foundation's awareness of the inappropriateness of its practices, fostering a healthier environment for consumers.Account #: ******** Thank you for your time and efforts.Sincerely,****

  Business Response

  Date: 03/23/2023

  A Sutter Representative reviewed the account specific to the billing for the labs and *** ordered during his preventive exam. The lab coding was updated, and his insurance reprocessed but due to posting error on our part the balance was not removed. This has been corrected.
  
  The coding for the *** was changed to reflect preventive dx codes and submitted for processing to his insurance. However, this is not a preventive test. Most insurances categorize this as diagnostic. Therefore, this does not guarantee payment under his preventive benefit.
  
  The Sutter Representative has attempted several times to contact the patient to provide an explanation of the review and account status but has been unsuccessful in reaching the patient. A letter has been sent.

• Initial Complaint

  Date:03/14/2023

  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.

  I had Health Insurance from Blue Shield through my work (Intuitive Surgical). Over a year ago, my husband put me and our son on his Blue Shield policy and my previous policy was terminated. My husband moved to another job and again put me and our son on his health insurance. While on the new policies, I was seen at Sutter Health Palo Alto Medical Foundation. I repeatedly gave them my new health card when I was seen at the medical facility, I repeatedly called the billing office to give them the new health card information, and even had a Blue Shield rep (representing the new policy) on the phone with me with the Sutter Health rep to clarify the new policy information. Yet, every time I called, they had the old policy information and not the new information and they repeatedly billed my old policy. Not surprisingly, Blue shield did not pay because I no longer had the old policy. I was repeatedly told by the Sutter Health reps that they would fix this issue, but I keep on getting bills in the mail, phone calls, and complete disregard to fix this issue via the MyHealth Online messages from the billing office. It is clear they are billing under the old policy (even the Sutter Health bill has a code "A"- Expenses incurred after coverage terminated" obviously referring to the old policy. See attachment. I don't know what else to do. Please help me to get through to these billing reps who will end up ruining my credit score with this nonsense. Best, *******************

  Business Response

  Date: 03/23/2023

  A Sutter Representative reviewed this concern. They confirm that initially the incorrect coverage was billed. This error was corrected, and the patients current coverage was billed on each account. The claim was processed,and balances applied to the patients deductible.  The Sutter Representative attempted several times to contact the patient, without success. A letter has been sent.

  Customer Answer

  Date: 03/23/2023

   
  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.
  
  Thank you for your assistance. Only after you sent your inquiry to SutterHealth, did I actually get some attention from the patient advocate at Sutter health. There are other issues I need to discuss with them, like billing on a billing code for a 40 minute appointment when only about ***** minutes we spent with me by a doctor, or SutterHealth not referring me out to any other place or procedure that would be beneficial to me just because Sutter health does not perform that procedure. This happened with my thyroid nodule where Sutter health insisted that I needed a thyroidectomy and that I was not a candidate for anything else and then it turned out that I was a candidate for a much much less invasive procedure, but that Sutter health does not perform. I ended up having that procedure outside of SutterHealth and Im much better off than if I had had the surgery that Sutter health recommended.  

• Initial Complaint

  Date:03/12/2023

  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.

  I went for annual physical check at ********* Medical foundation at ************* and I made it very clear that Im only here for annual physical which was documented for my appointment. I asked doctor to take a quick look at my throat as good will. The Doctor **************** took a quick look and didnt diagnose anything, no medication, no advice. Just referred me to specialist. And then I proceeded to do my blood work for annual physical. To my surprise, the nurse took 5-6 tubes of blood and I was very confused. Shortly after I received a bill of $2000 for my annual physical visit, of which only a small amount was paid by insurance. I looked into details to find that Doctor **************** ordered a lot of blood tests I did not agree to, nor I was notified of the absurd costs. In addition, Sutter charged me TWO separate charges for the office visit, one for annual physical which insurance paid but another charge for checking my throat. This is unacceptable. The doctor barely did anything and I was not aware of any additional cost for taking a minute of her time in the SAME visit would result in double the charge. This is clearly a terrible practice to abuse insurance and patients. Of course my insurance refused to pay double on the same visit and I do not blame them. If I were to get charged extra in excess of the annual physical which I ordered for the appointment, I should have been warned before the service was provided. I contacted the billing department many times and just received the same answer stating thats their policy and thats how they operate. If every patient and insurance company is getting abused by Sutter Healths business practice, I feel my experiences should be known to others to avoid this business and I should get my bill removed/adjusted. Please escalate to management, I have talked to so many billing employees already.

  Business Response

  Date: 03/16/2023

  A Sutter Representative spoke with the patient and provided an explanation that it is the patients responsibility to verify coverage with insurance prior to service being rendered and the physician documented that he advised the patient to check with insurance regarding coverage before proceeding with labs. The patient was provided education on how we bill for appointments. The patient was advised that the physician will make a determination and treat the patient according to the symptoms or problem the patient presents at the time of the visit in order to provide the best care possible. Our physicians are there to make sure your healthcare needs are met and are not always aware of how your insurance will pay for services.  Therefore, it is the patients responsibility to know and understand their benefits.  If you are not sure at the time of service, you have the right to refuse treatment until you can clarify if the service is something that will be covered by your insurance carrier. The patient was advised that the physician documented that he advised the patient to check with insurance regarding coverage before proceeding with lab test.
  
  A one-time adjustment for the additional office visit charged was made. The lab charges will remain the patients responsibility and the next step he will need to take if he wishes to dispute them is to file a grievance with his insurance. A follow-up letter was sent.

  Customer Answer

  Date: 03/17/2023

  I am rejecting this response because:

  I was never told what test was even ordered for me. Physician and nurse never provided me the after visit ******* at the end of the visit. Immediately after the doctors office, I was asked to get my blood drawn just next door from the doctors office. I went and no one told me what tests were even being drawn for. The lab tech simply withdrawn all the tests ordered by doctor. In addition, my lab tech was an intern. Maybe she forgot the standard procedure to check with me. Put yourself in my shoe, I came for annual physical which supposed to not cost me. I get home to find thousands dollar bill for service I didnt even need. This is a terrible experience.

  Furthermore, the representative on the phone told me she was going to apply 30% off on the lab costs, which was not applied. 

  Business Response

  Date: 03/23/2023

  A Sutter Representative confirmed that the 30% discount was applied to the patients labs. The after-visit summary was sent to the patient immediately after his visit that showed the labs ordered as well. It is the patients responsibility to verify coverage and any out-of-pocket costs (deductible,co-pay, cost share or coinsurance) with insurance prior to service being rendered.

• Initial Complaint

  Date:03/02/2023

  Type:Service or Repair 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.

  Claim ID: ********* Claim ID: ERWZ3N7NJ This appeal is regarding the claims above. For my physical checkup, Sutter Health insists that that the services are for preventative purposes, they have filed the claim as such, and that the problem lies in the insurance providers definition of preventative services. As a result, now I owe $100.40 worth of charges that should have been covered by annual physical checkup coverage.During the physical exam, I have also repeatedly told the doctor to make sure all the tests are only done for physical checkup as I did not have any medical issue nor did I raise any concern about any medical issue at that point. So I do not know why theres any gap at all in the way the physical checkup was billed.This is getting no where and neither Sutter Health nor ***** is willing to recognize the problem in the billing or the claim process.Please help review this. Thanks.

  Business Response

  Date: 03/13/2023

  A Sutter Representative reviewed the account. The lab in questioned was ordered in February 2022. Since ********** never responded to the *** messages,  the ordering providers office mailed ********** a letter regarding this lab. ********** never completed this lab, but the order was still in his account.Therefore, when ********** had his labs completed as part of his annual physical this lab was run as well. The Sutter Representative contacted ********** to explain.He did recall this order when a review of this account and lab order history was explained. It was also explained that for any service it is the patients responsibility to know his benefits and covered services including which may be subject to his out-of-pocket responsibility.  The labs were ordered and billed appropriately, and the balance remains as patient responsibility.

• Initial Complaint

  Date:03/02/2023

  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.

  Date of 5/23/2022 I had an appointment with Ent at ***** health in ************** for ear cleaning. The Ent choose to use Endoscopy to review my sinuses. I had no problem with my sinuses. Therefore I was charged fraudulent amount of $895.00 for endoscopy procedure. My out of pocket is $401.30.Tried to resolve this with grievance center **************. Wasnt successful. Also tried to resolve it with patient relations and wasnt successful.I shouldnt be responsible for a fee which I didnt have any health concern for it.I should be responsible only for ear cleaning. Sutter charged my insurance $1338.50 for this visit. And billed me for $401.30 and refered it to collections. This is truly a fraudulent charge. Nationally ear cleaning doesnt cost more than $100.00.My 2nd complain is for my husband ***************************, Sutter charged him $230.00 for an appointment that I personally had cancelled for him as he was Ill to attend. Sutter neglected to cancel it and sending us a bill for it.The insurance declined payment for it also.

  Business Response

  Date: 03/15/2023

  A Sutter Representative spoke with the patient and spouse explaining the following.
  Regarding date of service 5/23/22, a review of the account and charges as well as the chart documentation was reviewed with her. The medical record indicates the patient consented to the procedure and gave specific instruction in regard to the anesthetic. She indicated that she did not consent to this service and stated that she will pursue dispute and will request medical records.
  
  Regarding date of service (***)  7/26/2022 for ***************, the account was discussed in detail. A coding review was completed, and the *** was corrected for this charge. A corrected claim has been sent to the insurance for processing.  Tests were performed as well as a Physician Certification for continued visits. For now, the balance is on hold waiting for insurance to process. The Sutter Representative discussed benefits and difference between copays and coinsurances and referred him to his insurance for specific benefits questions.

  Customer Answer

  Date: 03/15/2023

  I am rejecting this response because:

  I told the Doctor do not spray anti inflammatory in my nose due to rebound effect. He can look it visually as is.

  I didnt provided permission to perform endoscopy and charge me the enormous fee while I didnt have any sinus infection and no pain.

  that is why he didnt provide any prescription to resolve any problems for my sinuses. Documentation supports

  that I went only for ear cleaning as he cleaned my ear only.

  I believe the charges are fraudulent and unethical.

  
  regarding ***************************, I would like to keep our file active untill we hear finall resolution for the unethical charges.

  kind regards

  ***********************

  Business Response

  Date: 03/21/2023

  Specific to the complaint regarding ****************
  The documentation in **. ******* medical record reflects she was asking for a medication refill and the ENT physician needed to perform the endoscopy examination prior to prescribing requested medication. The documentation also indicates that the doctors office contacted her a few days after the appointment to let her know the prescription had been called in. 
  This concern has been referred to PAMF Patient Relations. **************** can reach out to them to further discuss her concerns about the documentation in her record. The phone # is ************

  Customer Answer

  Date: 03/23/2023

  I am rejecting this response because: I didnt ask for prescription to treat any infection in sinuses. Therefore there was no need for endoscopy.

  the prescription given was mucipron ointment for the rinse purposes.

  Had no problem with sinuses. It wasnt required the excessive charges of endoscopy. The Doctor should have discussed the cost with me before performing this procedure. Was charged exuberant charge of $1338.50 to my insurance for simple ear cleaning and endoscopy. My insurance paid

  $937.47 for a simple ear cleaning procedure. My insurance had already paid great portion of Endoscopy fee too! Sutter billing is requesting additional payment of $401.30 from me.

  This is unethical billing from Sutter Health billing organization. Now I have been sent to collections.

• Initial Complaint

  Date:02/24/2023

  Type:Customer Service 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 insurance allows me one free physical exam per year. I went for my 2022 exam on December 2. Then I received a bill from ********* Medical Foundation (PAMF) for $323.26. My insurance said this $323.26 was billed under a different code than the physical exam and it was a code that the insurance does not cover. After many calls to PAMF, I determined that the reason for this extra charge was because my primary doctor had left PAMF and I therefore saw a new doctor for my physical. **** basically told me this was a fee for establishing new patient care. However, I am not a new patient to PAMF. The new doctor has access to all the same records (in their EPIC system) that the previous doctor did. It was not my choice to see a new doctor, and I've been using PAMF exclusively for all of my healthcare needs for more than 20 years. I believe the $323.26 is unfair and unwarranted.Furthermore, this type of charge has implications that are harmful to consumers. Using this method, PAMF can generate additional revenue whenever it wants just by telling patients that their original doctor is not available and the patient must see a new doctor. Per my understanding, this would then automatically trigger this billing, which provides benefit to PAMF in the form of revenue, but absolutely no benefit to the patient. My physical exam was no better than the one I would have received from the prior doctor, and, in fact, was probably not as good because the new doctor didn't know me as well as the old one. Effectively I am being charged $323.26 more for an inferior product through no fault of my own.I have tried to appeal this to PAMF, but all they will say is that their billing was proper. I have tried to appeal this to my insurance company, but all they will tell me is that the decision on which codes to use is owned by PAMF. BBB is now the only hope I can see to bring some sanity to this situation.

  Business Response

  Date: 03/06/2023

  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 protentional billing of the office visit in this case; therefore, his account has been adjusted. A letter has sent been which explains the adjustment as well as the reason we must bill this way for future reference.

• Initial Complaint

  Date:01/30/2023

  Type:Billing 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.

  Hello-I called the scheduling department to schedule a wellness exam (free of charge with my insurance) for a Feb 18 2022 doctor visit. I spoke to the representative and confirmed there was no charge, and I was only going in for a wellness exam. I also emailed customer service to confirm my appointment was a wellness visit with no charge and I did not want anything else. I went to see my doctor and she asked me about my overall health which I told her. Then I get charged for two doctor visits incurring a $221.37 charge for the second visit during that same visit. I specifically requested and instructed the staff I was only there for a wellness exam. I was never asked if I wanted to have an additional medical visit charge. They never even mentioned there was going to be an additional medical visit charge until they send me a bill. They are fraudulently billing me twice for one doctor visit where I only spoke about my overall health which the doctor asked me about. I have contacted Sutter patient services and spoke to several representatives throughout the spring and summer 2022 and they understood the concern I had and it made sense that I should not be charged for two visits. They let me know they are looking into resolving this with a billing adjustment because this is a fraudulent and unethical billing practice. I have not heard from them since they said they were looking into resolving this for me. I am escalating here so you can help me remove this fraudulent additional bill. Thank you.

  Business Response

  Date: 02/01/2023

  A Sutter Representative reviewed concern. A coding review was complete, and charges were determined to be accurate. The Representative spoke with the patient, explained the chart documentation regarding 3 additional concerns addressed by provider and advised charges can be billed separately even if new or existing conditions. Patient now understands no fraudulent billing practices occurred,  however still she believes was not adequately informed.
  Action taken: The balance of $221.37 has been recalled from collections with adjustment made to the charges. A response letter was sent to the patient.  

  Customer Answer

  Date: 02/01/2023

   
  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.