Sutter Gould Medical Foundation

Review: I was advised that this appointment will not be billed. the reason for this appointment is to transfer medical record from Kaiser, due to my company is not longer carry Kaiser. in order to transfer record, I was advised I need to make a regular check up appointment. and on the phone and at the receicetion desk, both advised that we will not be charge it. and we get a bill both me and my wife stated that our insurance will not be cover it. If we know we will not be covered by insurance why will we make the appointment, and the insurance will be end 20 days later, I was already notified I will be laid off. I will lost all the insurance. that is reason, when we make the appointment, keep ask them if there is going to be charge to us. they said it on the phone and in front of us. "no, you will not be charge!" we have try to contact sutter billing, they refuse to do anything. my billing account number is [redacted], $197. [redacted]My wife billing account number is [redacted] $287. [redacted], We both have the same doctor, both only take 15 mins, the the amount is also unreasonable.no charge should be billed to us. it is their fall to told us it is no charge. it just like a scam.Desired Settlement: no charge should be billed to us. it is their fall to told us it is no charge. it just like a scam.

Business

Response:

Complaint for [redacted] and [redacted] Cheng has been reviewed by Sutter Gould Medical Foundation. The patients were not advised there would not be a charge for their office visit.

The patients have been made aware that their balance is applied to their deductible with their insurance and they are responsible for the remaining balance.

[redacted] was offered the opportunity to set up a payment plan. Patient declined and advised the representative he would call back next month to set up payment for the balance.

[redacted] was contacted by a representative who advised her that the remaining balance was her responsibility.

No changes, the patient's are responsible for the remaining balances of $197.00 and $287.00 for both office visits.

Thank you

Consumer

Response:

I am rejecting this response because: the advise of the charge was not up front, it is after we got the bill, they just said that is what it is, the point we try to make is we ask them at the appointment making and check in desk, "are we going to be billed!" the answer was "no!" now they said you have to pay for it. it is scam. if we were advised up front that we will need to pay for those appointment. we will cancel the appointment!

Business

Response:

Sutter Gould Medical Foundation did not bill the patient initially, they billed the patient's insurance. Sutter Gould cannot decifer whether the patient will be responsible or not for billed services as it is dependent on their insurance coverage. Unfortunately the patient has a deductible with the insurance which has made them ultimately responsible for the balance on their account.

Thank you

Review: Improper and negligent medical billing practices has lead to medical bill collection a year after the services were rendered.

Saw a provider in October 2012, and gave them updated insurance policy information and new policy number. Provider as an agent of Sutter Gould Medical Foundation (SG), processed the claim under an old policy number (even though I had given them updated information) and it was subsequently denied by my insurance company.

I started to receive medical bills for the amount of the service rendered, $190.00. I did not understand why and contacted my health insurance company and they informed me that SG had improperly ran the claim under an old policy number and that was the reason for the denial. I contacted SG and notified them of their error and again, gave them my updated information.

Recently, I have received a bill from SG regarding the same bill and the same amount, $190.00. I contacted SG confused about why I was still receiving a bill a year later and informed me that they were unable to re-review the amount and that the bill was already handed over to their collection agency since it has been a year from the date of service and they had not received any payment.

After contacting the collection agency immediately, they reiterated the same information and denied any review of the amount owed and their reason for the denial was that it has been a year since the service was rendered. I informed them of SG's contributory negligence conduct in the billing procedure that resulted to the year delay. And still review of the amount owed was denied and any effort to reconcile the amount allegedly owed was rejected.

SG's negligent billing practices have added to the delay in getting this issue and amount resolved. Had they initially, properly filed the claim with my health insurance company with the correct information I provided them, any subsequent time between my discovering their error and correction would have been voided. Therefore, due to their negligence and their unfair billing/credit reporting practices have resulted to an injury to my credit report.

As a result, I have received a negative mark on my credit score. In addition, the subsequent time-consuming procedures to seek relief have increased my burdens on such relief sought. The added headache and trouble I am having to go through to address this issue is a further result of their negligent billing practices. Desired Settlement: (1) A discharge of the amount owed to Sutter Gould Medical Foundation (SG) and (2) a reversal of any negative reporting to my credit report from SG and it's collection agencies.

Business

Response:

Initial Business Response

1)A discharge of the amount owed to SGMF

a. Insuarance was billed correctly by us after verifying coverage details and plan address.

b. Claim approved by correct insurance but applied to patients deductible.

c. Balance billed to patient as instructed by insurance.

d. No discharge of balance due.

2. A reversal of any negative reporting to my the pt's credit report from SGMF and its collection agencies.

The pt was sent to collections for $190.00. This amount has not been reported to the credit bureau, nor has the pt been reported to the credit bureau for any other collection balances.

Please feel free to contact me with any additional questions. Thank you!