Sutter Health Plus

All posts tagged Sutter Health Plus

Help Make My Voice Heard

Published October 15, 2018 by lynn k scott

I created a petition to alert the state of California to how cancer patients are being treated by Sutter Health.  If you could find it in your heart to sign and then reblog, share on Facebook, Twitter, or any other platform, I’d appreciate it.

It’s time we told insurance companies they can’t let doctors control who they do/don’t treat.  We are all people.  No one facing a life-threatening illness should have the stress of no treatment options because someone deemed a patient not worthy.

You can find the petition HERE.

Thank you for your support in this latest cancer development.

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Kicked out of Sutter Oncology/Hematology

Published October 12, 2018 by lynn k scott

I just learned today, after following up, again, on an oncology referral, that I have been dismissed from Sutter Health Oncology/Hematology. I never received the original dismissal from my first oncologist. Apparently, after I saw my PCP for another referral, because my existing oncologist was bought out by John Muir (which they failed to advise), I was blackballed by Sutter.  I only learned of this today, over the phone that I am not allowed to see any doctor in oncology/hematolgy.

Sutter is refusing to treat a stage 3 colon cancer patient because I couldn’t understand my Russian-born oncologist. They are collecting premiums and denying care.  I went through the steps of seeing a PCP for a referral for an established disease that Sutter knew of for the previous 10-months.  Sutter told me I had to do this to see another oncologist and they knew full well I couldn’t be seen by anyone in Sutter who could treat my cancer.

My only option is to my PCP or go to urgent care; neither of which can treat my disease.  I can go to the Emergency Room but they can’t refer me to an oncologist, whom I’d have to see for follow-up care.  I am only allowed to see someone out of network and they have no one for me to see.

I am allowed to choose my doctor. It is not out of the norm for a female patient to want a female doctor. Based on the medical terminology, it is not out of the norm to insist on a doctor whom I can understand, without the aid of her staff.

Have I been challenging? Yes! Have I been rude and sworn? Yes. Why? Because I, ME, am in charge of my care. I, ALONE, determine my treatment!!!!

Doctors take an oath to treat patients. Yet, they pick and choose who they will care for. The ones who blindly go along with their godlike mentality are their preferred patients. How dare the patient question them? I am the one living and battling cancer – NOT THEM!

Please share this. Let the world know how cancer patients in Northern California are being treated.

 

Still waiting…

Published October 12, 2018 by lynn k scott

Today makes two weeks since the hoop-jumping commenced.  I did as I was required; saw my PCP to get an oncology referral (even though my insurance knows I have cancer).

My PCP claims they called me to say the referral was approved and to call the oncologist.  That was pure fabrication.  I only found out, because I called a week after the appointment since I hadn’t heard anything.

This past Monday, I called the oncologist’s office and was told they hadn’t even reviewed the file yet.  They couldn’t tell me how long it would take for the doctor to review the file to see if she could even treat me.  She only reviewed files in between seeing patients.

Now my PCP was told I was having anemia symptoms, yet she didn’t flag the file with any urgency.  She put it through as a basic referral.  This is the problem with using a PCP for conditions they don’t treat.  If they are to facilitate care, then listening to the patient would be a good place to start.  If the patient deems the situation as an issue, then the doctor has an obligation to process that information accordingly; especially if they are symptomatic.

My energy levels are falling.  Day to day life is becoming more and more challenging (again).  Yet, I sit and wait because the medical profession has no sense of urgency.  I’ve upped my caffeine intake and back to taking naps the second I get home from work.

When will doctors get a clue they are messing with people’s health by their lack of concern.  They aren’t battling a life-threatening disease.  They aren’t waiting in limbo to see if the cancer has spread or new cancer has emerged.  They have all the time in the world (at this point).

Yet, I and so many like me, are dependent on a broken system that doesn’t value life.  This is our reality.  We struggle, we worry, we pray and we just wait.

Sutter Health – 9/25/18

Published September 25, 2018 by lynn k scott

It’s a sad reality when I have to document every phone call and issue because Sutter Health and its providers are fine with denying care to (cancer) patients.  If necessary, this will be a play by play for a lawyer.  I’m also throwing it out there, any lawyer who reads this has my permission to contact me.

  • Current oncologist knew they would not be under contract as of 9/1/18 – failed to notify patient in order to process a referral
    • Now have to see PCP and establish care just to get my referral
  • Try to establish care and the office sends a message and doesn’t make an appointment.
  • Call to follow-up and rude medical assistant claimed she made the call (she didn’t) and then said I swore at her (I didn’t) and disconnected my call.
  • Manage to make an appointment with another doctor in the office.
  • Received call to say appointment was cancelled because “the doctor reviewed your file and won’t see you)
  • Received a call this morning to reschedule with the doctor listed on my medical card.  *Note:  Insurance will let you see any doctor within the practice; this is a point of harassment by the PCP’s office
  • Site Supervisor calls me to tell me I cannot use an “unprofessional tone” with staff.  The tone he is referring to is a frustrated one of being harassed by his staff.
    • Surprisingly….he backed his staff
    • Accused me of being unprofessional with him; oh wait – I was frustrated at this nonsense
  • Threatened my appointment would be cut short if I was not 100% professional with his staff
  • I ended the call telling him my responses would be “yes” and “no”, said, “Good day, Sir” and hung up.

I have no rights.  Sutter Health and its providers should be embarrassed, ashamed and liable for what they are putting me (and no doubt other patients) through.  This is not acceptable and we have no recourse.  They can write anything they want in the chart.  Any complaints to the state, that’s supposed to govern them, only reads the chart and does not contact the patient for details and/or clarification.

I simply ask that people share this.  Silence is their success in being allowed to continue to mistreat, deny care and abuse patients.  Patients are allowed to say “no” and do what is in their best interest; not what’s easiest for the physician’s office.

 

Cancer Update: September

Published September 19, 2018 by lynn k scott

Not a whole lot to report. I am experiencing issues of anemia again.  The same symptoms when I was diagnosed (almost exactly a year ago).

I called the oncologist’s office to find out what’s going on with my CT scan.  Well, it’s on hold because of their inadequate scan coordinator.  The facility, that’s in my city, can do the scan, but refuses to administer lidocaine to numb my arm for the IV.  I have collapsing and rolling veins.  Most IVs take two or three attempts (not to mention hurting like hell on each attempt).  They don’t do that on a “clinical level”.

Seems the scan coordinator is inept at calling the patient to update them or having someone else follow-up.   It would seem, the scan coordinator isn’t able to search other hospitals to see if they might be able to accommodate a very reasonable request.  Nah – let’s not do anything…we’re only talking cancer, right?

The receptionist was gracious enough to let me know that following up wasn’t in her job description.  She agrees someone should have called but couldn’t answer who would do that.  Let’s chalk that up to “no help”, shall we?  Then she told me to feel free to call back to check on the status.  I let her know I have been symptomatic.  Gave her all the symptoms.  Anyone with half a brain, working in a hematology office knows what anemia sounds like and should make sure the patient is called back.  Yea…not this office.

I almost passed out yesterday.  I was able to stay awake for 1.5 hours after work.  I slept after work and was in bed at 9:00 and went to sleep for the evening.  Their inept attitude is robbing me of my quality of life.

Am I demanding?  Yes.  I give them an opportunity to do their job and then I take off the “kid-gloves” and let them have it.  I will not apologize for being my own advocate; esp. when patient advocacy and the online help feature have also failed me.

I submitted a referral request for a doctor, who’s an hour away.  I asked for confirmation they received the fax and confirmation when it was processed.  The fax was sent over five hours ago.  Did the doctor’s office call:  Nope!  Now I have to follow-up with them; again.

There is no excuse I am receiving such horrendous treatment.  If I end up in the emergency room, I will not be paying a bill that could have been prevented by the doctor’s office simply doing their job.

Part of the blog is to show how (cancer) patients are being treated while facing a life-threatening illness as well as documenting issues should a lawsuit be necessary.

Sutter Health Plus, based out of Sacramento, California, should be ashamed at its inability to provide healthcare based on the needs of the patients.  I shouldn’t be forced to go to a subpar facility, even if they deem it ok.

Apparently, I have Schrodinger’s Cancer:  I either have it or I don’t.  Guess we’ll never know because my health isn’t a priority to anyone but myself.

 

ribbon

Not Subjecting Anyone Else

Published July 20, 2018 by lynn k scott

Another failed attempt by Sutter Health Plus to do their job; help patients get treatment.  My journey has taken me to the point that I no longer give a damn what I say or how I say it, because when it comes to dealing with doctors, their staff and the insurance agencies, they have little disregard (in my experience) to actually assisting the patient; in the manner that works best for the patient.

I filed a complaint against my current oncologist’s staff for failing to do their job.  Of course, every complaint is done the same way.  Patient complains, grievance department calls doctor’s practice, “file review” and then issues a form letter that ignores half of what the actual grievance was about, dismisses patient concerns (as if they have been handled) fails to contact patient for clarification on information obtained from doctor’s office and refers patient back to PCP (Primary Care Physician); which patient has never seen.  The PCP is supposed to help with the oncology referral.

The patient is being seen by someone and wants a different doctor.  I didn’t go to medical school, but I’m smart enough to realize that the existing doctor, who already has some knowledge of the patient, should be making (and can make) the referral.  Why should the patient pay more money in copays to see an unfamiliar doctor, have to recount (AGAIN) why they need a referral, to a doctor who has no vested interest in that patient?  I mean, as an HMO, the PCP already gets a monthly stipend for accepting to see that patient; if and when that ever happens.

I’m a ‘bad’ patient, so I have to speak with a “case manager”.  I was already told by Sutter Health Plus, last year, they don’t have those.  The “case manager” is merely a person in the grievance department, who is assigned to deal with me when I call customer service.  Why?  Because I’m not allowed to be upset at their half-assed attempt of treating my disease.  After all, we have to protect the fragile ears of customer service reps, from upset cancer patients, asking…no begging….for support.

The twist in all this, is this person is on the team that reviews my grievances.  They rule the same way, EVERY TIME!  I am not allowed to have someone else review my grievances.  I am only allowed to speak with Carla (my “case manager”) or her supervisor.  I have asked repeatedly to speak to the manager who is above Carla and her manager.

Today, Carla had the nerve to say, “we will not subject anyone else to you and your behavior”.  Hmmm….make me continually deal with people who are part of the problem instead of passing the issue to someone who  1) might have a different perspective on the situation, 2) someone who would be a fresh start and 3) someone who might have the ability to see that my issues are addressed.

I’m such a detriment to the medical community, that I’ve been blackballed by the insurance agency itself.  Could I be nicer?  Perhaps.  Am I going to….NOPE!  Why?  It’s simple, I have had to fight for my basic rights, that I PAY for, just to be treated.  I am holding people responsible and I will not be a doormat because I refuse to let them make any further money off of me because they think they are god in deciding if I live or die.

Sutter Health Plus is in need of major reform (as are most insurance carriers).  Carla in claims needs to be retrained (as does her manager -with whom I will not speak with again).

At this point, I will be utilizing the UC Davis emergency room going forward.  I’ll incur the annual maximum charge and then they can run every test they want, but I’ve hit the maximum.  No patient should ever feel like they are being dismissed or given up on.  Sutter Health Plus (Sacramento, CA) has done just that!

Sutter Health Insurance

Published June 19, 2018 by lynn k scott

I am not an easy patient.  I have little regard for the insurance industry and the doctors it employs.  I have become less than tolerant of the medical world since my cancer diagnosis.

Sutter Health Plus is the health insurance I have.  It’s the least evil of the three options I had to choose from.  That being said, they are far from acceptable.  They care little for their patients.

On Sutter’s website, it boasts how important it is to have a doctor you feel comfortable with.  That is a fallacy.  They don’t care how far you have to travel to see a doctor.  They don’t care if you don’t want to be seen in a certain area.  They don’t care that you can’t understand who they pick for you; even after declining their physician option (multiple times).  They prefer to hire immigrant doctors compared to native-English speaking doctors.  Where medical terminology is a factor, being able to understand your physician is paramount.  Apparently, that only applies if you want to see anyone but an native-English speaking doctor.  They hire for every other language, but English is overrated.  How “PC” of them….I digress.

You can make complaint after complaint about not receiving care, but NO ONE calls you for more information.  Non-doctors simply review your file and regurgitate their initial form letter and continually resend that information to you.

They can get you an appointment in the doctor of their choice, where you don’t want to go and ignore the fact you may have employment obligations to meet.  Did I mention they will give you an appointment out of your area and when you’re not available?

Providers are allowed to drop patients prior to making sure an acceptable referral has been found.  They fail to notify the patients of the change in providers.  Nurses refuse to let you speak to providers.  The online emails are answered by nurses and not doctors.  You get the privilege of playing the adult version of “telephone”.  You never know what their response is going to be, but it rarely is regarding the original issue you are inquiring about.

They claim physicians are required to tell you that they are kicking you out of their practice.  Well, I guess finding out, via another form letter, on a different subject is their view of “notification”.

Do I hang up on them…sure do!  I say what needs saying.  They ignore what I say but mark the notes that “contact was made and patient hung up”.  They fail to mention patient stated their option wasn’t viable.  Patient can’t understand who they assign, but as long as they cover their ass with a half-assed note, I guess they did their job, right?

This is how Sutter Health Plus treats cancer patients.  Western Health Insurance does the same.  They are such a small insurance company, they allow doctors to kick patients out, after ignoring patient concerns.

Keep telling the patient they have an ulcer.  Get irritated with patient because she refuses a G.I. referral.  Blame patient for “refusing care”.  Patient goes to the emergency room, where they have to treat her.  Low and behold, patient was right – it WASN’T an ulcer.  It was a Stage 3 tumor, blocking almost 100% of the colon.  Patient could have died, but hell, as long as the insurance companies continue to make sure they are “PC”, health care of individuals be damned.

I am sure there must be some diligent doctors somewhere, but the insurance carriers, call center staff (because you can no longer call a doctor’s office directly) and their nurses hinder receiving effective and timely treatment.

I will no longer be silent.  The insurance industry needs to change; esp. when it’s an HMO.  Patients are required to jump through hoops to “establish” with providers and to obtain referrals, but the doctors are not required to treat them.

Enough is enough.  Please share.  Silence is compliance!

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