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Sharp HealthCare

Additional Locations

Phone: (800) 827-4277 Fax: (858) 636-2145 View Additional Phone Numbers 8695 Spectrum Ctr Blvd, San Diego, CA 92123 http://www.sharp.com View Additional Web Addresses


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Description

This company offers healthcare services.


BBB Accreditation

A BBB Accredited Business since

BBB has determined that Sharp HealthCare meets BBB accreditation standards, which include a commitment to make a good faith effort to resolve any consumer complaints. BBB Accredited Businesses pay a fee for accreditation review/monitoring and for support of BBB services to the public.

BBB accreditation does not mean that the business' products or services have been evaluated or endorsed by BBB, or that BBB has made a determination as to the business' product quality or competency in performing services.


Reason for Rating

BBB rating is based on 13 factors. Get the details about the factors considered.

Factors that affect the rating for Sharp HealthCare include:

  • Length of time business has been operating
  • Complaint volume filed with BBB for business of this size
  • Response to 11 complaint(s) filed against business
  • Resolution of complaint(s) filed against business


Customer Complaints Summary Read complaint details

11 complaints closed with BBB in last 3 years | 4 closed in last 12 months
Complaint Type Total Closed Complaints
Advertising/Sales Issues 1
Billing/Collection Issues 9
Delivery Issues 0
Guarantee/Warranty Issues 0
Problems with Product/Service 1
Total Closed Complaints 11

Customer Reviews Summary Read customer reviews

5 Customer Reviews on Sharp HealthCare
Customer Experience Total Customer Reviews
Positive Experience 0
Neutral Experience 0
Negative Experience 5
Total Customer Reviews 5

Additional Information

BBB file opened: July 01, 1994 Business started: 12/04/1946 in CA Business incorporated 12/04/1946 in CA
Licensing, Bonding or Registration

This business is in an industry that may require professional licensing, bonding or registration. BBB encourages you to check with the appropriate agency to be certain any requirements are currently being met.

These agencies may include:

Medical Board of California
1434 Howe Avenue #92, Sacramento CA 95825-3236
http://www.mbc.ca.gov
Phone Number: (800) 633-2322
Fax Number: (916) 263-2387
The number is 24476.

Type of Entity

Corporation

Business Management
Ms. Jenna Haynes, Legal Secretary
Contact Information
Customer Contact: Ms. Jenna Haynes, Legal Secretary
Number of Employees

14,000

Business Category

Hospitals Rehabilitation Services Senior Citizens Service Organization Physicians - Specialists Health & Medical - General Insurance Companies

Alternate Business Names
Sharp Chula Vista Medical Center Sharp Community Medical Group Sharp Coronado Hospital & Health Care Center Sharp Grossmont Hospital Sharp Home Care Sharp Hospice Care Sharp Mary Birch Hospital for Women Sharp Memorial Hospital Sharp Memorial Outpatient Pavilion Sharp Mesa Vista Hospital Sharp Rees-Stealy Medical Centers Sharp Rees-Stealy Medical Group Sharp Villa Coronado Snf Sharp Vista Pacifica Hospital
Industry Tips
Cancer Treatment Scams

Additional Locations

  • 233 Prospect Pl

    Coronado, CA 92118

  • 3405 Kenyon St # 101

    San Diego, CA 92110

  • 8080 Dagget St #210

    San Diego, CA 92124

  • 8695 Spectrum Ctr Blvd

    San Diego, CA 92123 (800) 827-4277 (858) 499-4000 (858) 499-2410 (619) 221-9560

  • 8933 Activity Rd

    San Diego, CA 92126

  • 9765 Clairemont Mesa Blvd

    San Diego, CA 92124

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BBB Customer Review Rating plus BBB Rating Overview


BBB Customer Reviews Rating represents the customers opinions of the business. The Customer Review Rating is based on the number of positive, neutral and negative customer reviews posted that are calculated to produce a score.

Customer Review Experience Value
Positive Review 5 points per review
Neutral Review 3 points per review
Negative Review 1 point per review

BBB letter grades represent the BBB's opinion of the business. The BBB grade is based on BBB file information about the business. In some cases, a business' grade may be lowered if the BBB does not have sufficient information about the business despite BBB requests for that information from the business.
Details

BBB Letter Grade Scale

BBB Rating Value
A+ 5
A 4.66
A- 4.33
B+ 4
B 3.66
B- 3.33
C+ 3
C 2.66
C- 2.33
D+ 2
D 1.66
D- 1.33
F 1
NR -----
Star Rating scale

  Average Score
5 stars 5.00
4.5 stars 4.50-4.99
4 stars 4.00-4.49
3.5 stars 3.50-3.99
3 stars 3.00-3.49
2.5 stars 2.50-2.99
2 stars 2.00-2.49
1.5 stars 1.50-1.99
1 star 0-1.49

BBB Customer Review Rating plus BBB Rating is not a guarantee of a business' reliability or performance, and BBB recommends that consumers consider a business' BBB Rating and Customer Review Rating in addition to all other available information about the business. If the BBB Rating is NR then only Customer Reviews are used for the Star Rating.

Complaint Detail(s)

8/5/2016 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: Complaint: I received an Authorization for Surgery from Sharp Rees-Stealy Medical Group acting for/as Health Net. The Authorization indicated “You may have a co-payment at the time services are rendered.” I paid my $250.00 co-pay on the day services were performed (02/29/2016) at Sharp Memorial Hospital. At no time was I informed of any potential additional cost, or presented with an itemized explanation of items not covered. I was not made aware of any contracted pricing between Sharp Memorial and Sharp Rees-Stealy Medical Group. With this knowledge I consented to the Surgical Procedures recommended by and performed by my ETN Specialist.

Desired Settlement: Desired Settlement: Have the balance of $2,524.54 removed from my Sharp Billing Statement. An Updated Statement showing the balance amount has been resolved by Sharp Memorial and Sharp Rees-Stealy and Health Net

Business Response:

Thank you for contacting the Better Business Bureau regarding your healthcare experience. We are very sorry to hear that our services did not meet your expectations. Your concern was received in the Quality Management Department for review.

SRS has an extensive Quality Management Program, which includes the evaluation of all issues of concern brought to our attention. We are dedicated to providing high quality medical care and patient satisfaction.

An evaluation of your concern has been conducted by the SRS Quality Management Department. A thorough evaluation helps to determine if the care you were provided met the community standard of care. Furthermore, it helps SRS to review the current Standards of Practice to identify any potential opportunities for growth and betterment. Please be aware that we take your concern very seriously.

Information generated from the Quality Management Department review is confidential, as expressed in the California Evidence Code, the Health and Safety Code and the California Business and Professionals Code. For this reason, SRS is unable to discuss the outcome of Quality Management reviews or the disciplinary steps that may be taken within SRS.

All patient concerns are cumulatively tracked regardless of the outcome. This is a component of the overall Quality Assurance monitoring program which evaluates medical care provided to our patients. Communication is an essential component of medical care, and through communication, we can improve the services provided to our patients.

On 2/25/16, you were contacted via phone by the PFS Dept. to inform you that you would be responsible for a copay of $250.00 due at the time of service, 2/29/16.

In addition to the phone notification from the PFS Dept., a copy of the approval for surgical referral authorization was mailed to you on 1/18/16 stating, “Please note that payment for services is dependent upon your eligibility with Sharp Rees-Stealy Medical Group and Health Net at the time services are rendered. You may have a co-payment at the time services are rendered. For questions regarding benefits or co-payment information, please call Health Net, Customer Service Department at 1-800-522-0088”.

You made the copayment of $250.00 on admission, but you were also responsible for a 20% co-insurance on the out-patient procedure, for which you are being billed in the amount of $2,524.54.

The PFS Dept. has spoken with you on several occasions and you have been offered the following payment options:
Discount 20%: $2,019.63
Monthly payment plan 12 months $210.38
Loan 24 months $112.34
Loan Pt Pref. 24 months$114.00

Upon review of the concern with Patient Financial Services (PFS) Department, it has been determined that you are responsible for the 20% co-insurance for services performed on 2/29/16.To discuss this matter directly with the PFS Dept. or for any questions, please call ************.

You also have the right to initiate an independent review with your health plan by contacting them in writing. If so, please address your concerns to your health plan, Appeals/Grievance Department.

Sincerely,

***** **** 
Care Coordinator 
Quality Management 
Sharp Rees-Stealy


4/21/2016 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: February 2015 and March 2015 my wife was admitted to Sharp Memorial Hospital 7901 Frost Street San Diego to undergo heart surgery. As result of her admittance, teams of physicians were assigned to her medical care. Most of these physicians my wife and myself never met and did not know they were assigned to my wife's medical care. Now months later, our Health insurance company (**** ***** *** **** ******* has informed use some of the physicians working on my wife's medical care were non-participating providers. As a result, I have to pay thousands of dollars out of pocket for physicians who did not disclose they were non-participating providers. One example of a non-participating provider is Dr ***** **********. I consider this non-disclosure of non-participating physicians as a deceptive business practice and possibly medical insurance fraud. I am requesting all of the non-participating physicians assigned to my wife's medical care at Sharp Memorial Hospital 2015 refund my out of pocket cost for their services due to their deception. My medical insurance company is aware of this non-disclosure of non-participating providers,so this has happened to many patients in the past. I am also asking Sharp Memorial Hospital to stop this deceptive business practice. ** ******* ** *******

Desired Settlement: Refund my out of pocket cost and stop this deceptive business practice.

Business Response:

Sharp HealthCare has communicated directly with our patient in writing. The letter provided a signed copy of the patient's Conditions of Admission (COA) agreement, directing the patient to item number two where the legal relationship is explained between a Hospital and Physicians.

Should you have any questions regarding this matter, please contact me at ***** ********. I would be happy to speak with you.
Sincerely,

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

Sharp HealthCare

Manager, Patient Financial Services


Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Regards,

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


Sharp Memorial is admitting the doctors who practice at their facility are guilty of deceptive practices regarding non disclosure of their non-participating status with Blue Cross Blue Shield.  They are accepting no guilt based on the Doctor's are contract and they have no control over their billing practices.  These Doctors wear Sharp Smocks, they hand out Sharp business cards, and they have Sharp business addresses.  So they think it's OK for these Doctors to financially destroy patients and their families because the Doctors are contract.  Is this the type of businesses BBB has as members? 

The same goes for Alvardo Hospital.
******* ** *******

Business Response:

I am in receipt of your second letter to Ms. ***** ******, Legal Secretary for Sharp HealthCare (SHC). Ms. ****** has requested I respond on her behalf to your correspondence.

Sharp HealthCare has again communicated directly with our patient in writing. We have once more directed our patient to review the Conditions of Admission (COA) agreement previously provided, directing the patient to item number two, where the legal relationship is explained between a Hospital and Physicians.

Should you have any questions regarding this matter, please contact me at ***** ********. I would be happy to speak with you.

Sincerely,

******* ***** 
Sharp HealthCare 
Manager, Patient Financial Services



1/15/2016 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: Following a visit to the emergency department, I received a number of bills, including one for the ED. I requested itemized bill since the amount seemed high. I discovered that there were charges for medications and services that I did not received during my visit (my wife, who is a Nurse Practitioner and holds a PhD in Nursing was with me the entire time). I repeatedly tried to explain this by phone to the billing department, but was simply told that a nurse had looked at my file and verified that all the charges were correct. I then requested to have an in-person meeting with a representative of the billing department so that we could go over the issue line by line, and was told that was not possible. I finally gave up. I will not pay a bill if it is not correct. I am able and willing to pay the bill, but not until it is correct. I recently discovered that the full amount plus interest is now reporting on my credit reports and delinquent and in collections (even though I have not heard from any collections agencies).

Desired Settlement: I would like: 1) That this stop being reported to my credit reports until I am able to sit down and review the billing, line by line, and come to an agreement. 2) The medications and services to be removed from the billing so that I can pay the correct amount.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. 

I was able to speak directly with a representative of the hospital, who listened to my issues, adjusted what was being billed accordingly, and accepted my payment.  I am also in receipt of documentation from Sharp Hospital and the collection agency that the matter has been resolved and had been removed from my credit reports.

Regards,

***** ******

12/8/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: I came to Sharp OP physical therapy for 4 visits. Each had a $20 copay which I paid each time I went in (you are required to pay at the time of service). I was getting a bill for $16. I called them and they said there was one copay amount of $16. I advised them since I paid $20 each time they owe me $4. She stated she saw all four payments of $20 and they agreed. No refund came. Only a bill for $20 now. I called and they stated I had two accounts, one for cervical spine therapy and one for thoracic spine therapy. She (the manager now) said one account had a credit and one account had a balance. She said the account that had a balance had not been processed by insurance. If this is the case they should be following up with the insurance not harassing my. I am now getting phone calls and bills threatening to send me to collections. The type of insurance I have is has a capitated contract with this physical therapy department. The insurance doesnt really pay them, but patients DO NOT GET BILLED FOR THIS. ( I used to work in medical billing ). Patients only have to pay their copays which I have.

Desired Settlement: They need to adjust the outstanding balance on the one account and refund me the overpayment on the other. They also need to stop calling me, and sending me bills saying that they are sending me to collections.

Consumer Response:

To Whom it May Concern,
I just wanted to let you know that I received a response from sharp healthcare indicating that they researched my account and determined that I do not owe them anything and that they in fact owe me $20 and I will be refunded.
Thank you very much for your assistance.

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

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

6/29/2015 Problems with Product/Service
5/1/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: My son's pediatrician sent a request to the Sharp speech therapist for speech therapy. I was contacted by them to set up an appointment and was told that I was only going to be responsible for a $15 copay and that they had talked to my insurance and that the service was covered. I agreed to the appointment telling them that the only reason I would go is because there was only a $15 copay and nothing else I cannot afford more than that. After countless calls and no answer I am being billed for $388. I have been talking to the billing department since September 2014 and have not been able to resolve this issue. The customer service is terrible because I am told I will get a call back with and answer on my situation and never do.

Desired Settlement: I am not able to pay the $388 being billed so I would like that charge to be removed.

Business Response:

Per your request I have reviewed the complaint that was referred to you, the Better
Business Bureau. I have researched to see where we could improve in our process of
following up with our patients.

I have listened to every call that the patient's mother made to Customer Service, as
well as those calls we made to her and the insurance company ..

Please see below for a list of calls.

06.20.2014 site Representative CAY JO called **** ****s 800.67 6.2583 spoke with Til a
Reference#************ ** speech therapy was quoted at $50.00 COPA Y, No deductible and
service covered at 100%. Visits are based on Medical Necessity and Pre Certification is not
required. **** ****s representatives do not check on OX codes however procedure code
92521, 92522,92523 and 92507 are all valid and billable.

09. 11 .2014 patient mother called spoke to * **** to inform that onsite advised her only a $ 15.00
copay would apply to the visit. However she is getting a bill for $388.00, CSR explained that per
the insurance Explanation Of Benefits the service was not a covered benefit and directed
patient mother to the site that first assisted her.

09.22.2014 Site Rep called PFS Customer Service and asked that we call patient mother for claim
review
09.23.2014 CSR ***** ** called Insurance **** ****s and was directed to a different number,
CSR called mother and left message that she is working on account and to please allow time for
her to contac t insurance.

09.23.2014 Patient mother returned call to Customer Service Representative (*******) LUNJE5
took the call and advised patient mother ***** ** is working on the account

09.23.2014 ***** ** placed call to patient mother to advise she is working on account and will
call insurance on 09.24.2014

10.03.2014 Patient mother called, ROBTE2 took call and call dropped

10.03.2014 Patient mother called again ***** took call and advised patient mother she would
let ***** ** know to call her back with an update.

10.03.2014 ******* called **** ****s 800.444.2726 spoke with ***** and explained per call on
06.24.2014 REF#***** ******* ** benefits for Speech Therapy were verified and no
precertification was required, ***** advised she would send the claim back for reconsideration,
she explained to ***** ** to allow 14 days for response and provided REF#*** **** ********

10.06.2014 Patient mother called spoke with ****** advised CSR that her insurance denied the
claim and explained to CSR that she is waiting on a call from ***** **, CSR explained to
patient mother to a llow more time for insurance to reprocess the c laim

10.07.2014 ******* called patient mother to advise that she spoke with insurance and they
are reprocessing the c laim to allow time.

10.10.2014 Patient mother called advising she is waiting on a call back from ***** ** CSR
HILMO explained time frame and advise to allow time

11.06.2014 Patient mother called to inquire on status of c laim ***** explained to mother that as
of 10.28.2014 SRS received a letter from **** ****s advising the claim was received and
reviewed. CSR advised she would delay dunning level and asked to check status of claim with
insurance in two weeks.

12.18.2014 Patient mother called to follow up on claim *** *** took information and advised
patient mother he would relay message to *****

01 .07.2015 Patient mother called to make credit card payment on the balance of $388.00

01 .1 2.2015 ** ***** called patient mother to review account and see how she can assist her.
Pt mother advised of everything that has happened during her calls ***** advised patient
mother that she will research account and get back to her in two business days. *****
reviewed account and submitted coding request to make sure that DX code used was
appropriate and also submitted refund request in the amount of $164.93.

01.14.2015 TL ***** called **** ****s at 800.444.2726 spoke with ******* who advised claim
was sent to home plan on 10.03.2014 for reprocessing, 10.06.2014 home plan advised claim was
sent to technical team for review, 10.09.2014 final decision was made advising claim was
processed correctly as developmental delay is not a covered benefit.

At this time, we have decided to refund *** ****** ******* $388.00. Though the denial for
services was appropriate per the insurance, we do not feel we provided the very best customer
service we could have.

If you have any questions please feel free to contact me.

 

********************* Team Lead CCD

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********* and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

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

12/8/2014 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: I have been under treatment for cancer and other health problems with this group, insured thrugh my job, back in July 2014, I had a horrible rush and itching, I needed to make an appointment, they send me an e-mail saying that I was assigned to another doctor, I went there, it was no good, she did not do anything for me, instead I was informed that they belong to another group, and needed to change all my doctors, I call Sharp Rees-Stealy, and was told that they have seen the e-mail, and it was a mistake, I had no intentions of changing my doctors, I ended up in the ER, having to pay $100 co-payment and nothing was done again, then I demanded they return me to my original medical group and doctors, so they send me a bill for $539.00, that I do not have to pay because the mistake was theirs, apparently they have two different medical groups, and I keep calling them, but all I hear is that the group is not the insurance, that it is a different entity, they know it was there mistake, but refused to fix it. I still do not understand their group insurance setup, but they do not explained to anyone how they conduct business, I do not have to pay them, I only pay the c0-payments when I see my doctors.

Desired Settlement: That they cancelled this debt, fix their mistake, and tell all insure people, how their group and insurance business work.

Business Response:

Dear Mr. *******,

Thank you for your letter to the Better Business Bureau (BBB) regarding your concern at Sharp Rees-Stealy (SRS). The
concern was forwarded to the Quality Department for review and investigation. We are very sorry to hear that our services
did not meet your expectations.

SRS has an extensive Quality Management Program, which includes the evaluation of all issues of concern brought to our
attention and a thorough evaluation of your grievance was conducted by the SRS Quality Management Department based on
your dissatisfaction with SRS billing issues.

Your concern was reviewed with Sharp Health Plan. In the Summary of Benefits, which I have enclosed, you are responsible
for a $100.00 Emergency Services copay. If you are admitted to the hospital then the copay is waived.

In addition, I reviewed your concern indicating you received a bill that did not have to be paid. In speaking with your
insurance company, Sharp Health Plan, and the SRS Patient Financial Services Dept., you do not have any current charges.
The document you received is called an Explanation of Benefits and provides you with billing information. The charges have
been paid by your insurance plan.

In your statement to the Better Business Bureau, you indicated changing physicians. Within SRS, you have the right to
change your Primary Care Physician if you are dissatisfied.

If any further assistance is needed, please contact Sharp Health Plan, Customer Services Dept. at 800 359-2002.

Sincerely,

***** ****, L VN
Care Coordinator
Quality Management
Sharp Rees-Stealy

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

***** *******

10/30/2014 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: My wife(***** ***) and I for annual checkup and they sent it to sharp lab. The lab service is a new service at the hospital. The lab at sharp hospital billed us the wrong code, and we kept receiving bills. We took initiative by contacting the sharp lab, the doctor office, and our insurance regarding these matter. We called our insurances 4 times and they said the lab billed the wrong code. We called the lab again, and the doctor office but nobody are doing anything. At the end we called the doctor office, we received the contact of the person in charge of our case. We talked to her on the phone and email regarding this issue but she refused to respond back and we are stuck with the bills. After months going back and forth with them, our bills got sent to the collector agents. The doctor at the office we visited for the annual checkup told us we are not the only people who are having the same issue. We have bill reports saved up as evidences, and also recorded the conversations between the doctor, the person in charge of the lab billings, and our insurance as well.

Desired Settlement: remove the incorrect billings and charges on my wife and I. Make sure it doesn't affect my wife credit score and my credit score.

Consumer Response: The consumer indicated to the BBB that this complaint has been resolved.

10/27/2014 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: On August 10/2014 I admitted to Sharp hospital for a bump above my eyelid. Doctor diagnosis was Sty. After injecting powerful antibiotic, I was released with Patient education paper regarding Sty. My eye situation not only didn't get better but it got worse. After so many unnecessary doctors visits,finally I was able to see an Ophthalmologist on August 13th. There he told me none of other treatments would have helped my eye and since it was getting worse with infections, eye redness and extreme pressure he end up doing a surgery to open up and drain eyelid. I was misdiagnost by sharp hospital. I thought by going to hospital , I will get treated but send home. When my sister brought my concern regarding misdiagnose by sharp hospital to Patient Relations specialist (Ms.Jodi Gross) after waiting a month for answer , Ms Jodi wrote me an email to explain according to review by medical committee, care was given to me was correct. REALLY...........

Business Response: We have conducted an internal investigation of the complaints brought to your attention by Consumer ID #********.  I have reviewed the records related to her visit to the Sharp Memorial Hospital Emergency Department and the following is a summary of our investigation.
 
We understand that times of medical care are stressful and it is important that the medical team takes the time to communicate with the patient and family and ensure they understand the plan of care. The patient’s chart was reviewed and her concerns were discussed with the Hospital Grievance Committee.  Physicians on staff at Sharp Memorial Hospital are private practitioners, not agents of the hospital, and are a self-governing body; therefore, the patient’s concerns regarding the medical care were also forwarded to the medical staff committee that addresses grievances against physicians.   We are not able to provide specific details of the committee’s review as those records and proceedings are confidential under California law; however, please be assured that her concerns are taken seriously. 

After thorough consideration, the hospital care was determined to be appropriate; therefore the patient’s request for reimbursement and waiver of the bill for this visit has been denied.  We understand that this is not the outcome that she was hoping for and we are sorry that her experience was anything short of excellent.
 
Patient satisfaction is a high priority at Sharp Memorial Hospital and we appreciate the opportunity to evaluate and improve our systems and processes.  Please do not hesitate to contact me should you have any additional questions or concerns. 

Regards, 

**** *****, MPH, MSW                               
Patient Relations Specialist

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID********, and have determined that this proposed action would not resolve my complaint.  

 In very simple words , I believe Sharp hospital has commited fraud by misdiagnosing and mistreating me while at their care and charging me and my insurance for their profit not honest medical care , I am extremely disappointed and dissatisfied by them. 

Regards,

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

Business Response: Dear Ms.*****,
 
This letter is in response to the appeal brought to your attention by Consumer ID #********.  The complaint has been carefully reviewed by the Sharp Memorial Hospital Executive team and our Patient Grievance Subcommittee.  After thorough investigation, the care was deemed to be appropriate.  Therefore, Sharp Memorial Hospital’s position remains the same.

10/8/2014 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: This is in regards to account #********** for my wife, ******* ******, and a charge for time spent in a Sharp Memorial observation room on November 1, 2013 during a blood transfusion. My wife was provided a blood transfusion at Sharp Memorial Hospital in the South Tower - the observation rooms over two days - October 31th and November 1st, 2013. Arrangements for the blood transfusion had been made between my wife's doctor at the Sarcoma Oncology Center in Santa Monica, and Dr. ***** ******** at Sharp Rees-Stealy. We were told by the Sarcoma Oncology Center doctor that the blood transfusion would be for 3 units of blood due to my wife's very low hemoglobin count - 6.0. When we arrived at Sharp Memorial on October 31th, the nurse said the order was for 2 units of blood. I told the nurse that we were told 3 units of blood, but she refused to follow up with Dr. ******** since it was "too late" (about 7 pm). The following morning my wife again asked the nurse if she could check the order to see if it should be 3 units, but the nurse did not check. At about 2:00 pm, my wife asked the nurse again, and this time she did follow up with Dr. ********, who confirmed that 3 units should be provided. My wife had just finished the second unit around this time too. The third unit did not start until 8 pm. The nurse told us part of the delay was due to a mistake upon the part of the tech who ordered the blood. She said the order neglected to specify that the blood needed to be irradiated. Therefore, the 5 1/2 hour delay between completion of the second unit and start of the third is due to two Sharp mistakes: failure to act upon our initial request on October 31st to consult with the prescribing doctor regarding the order, and an error in the order for the third unit (failure to specify irradiation). We should not be responsible for the charges related to use of the observation room since these are due to Sharp errors. On Sharp's invoice this is charge #********* for November 1th, which is currently 23 hours. This should be reduced to 17 1/2 hours. My wife has provided authorization for my access to her medical and billing records at Sharp. I can provide a copy of the authorization form. I previously filed this complaint with Sharp on January 12th, 2014, but have not received a written response.

Desired Settlement: Time reduced for observation room charge from 23.0 hours to 17.5 hours. I wish to have a written response to this complaint from Sharp. Note that this charge was paid by my health insurer, Aetna, so I wish the refund to be paid to Aetna at Aetna's rate of compensation, which is lower than the amounts given. These amounts are from Sharp's invoice.

Business Response:

Dear *** *****,

Thank you for forwarding the concerns brought to your attention by *** ******* ****** on February 15, 2014.  A follow-up letter was sent to *** ****** on April 28, 2014, and his concerns will be reviewed with our Hospital Grievance Committee for a determination of his request.  Should you have additional questions, please do not hesitate to contact me at 858.939.3388.

Thank you,

**** *****

 

 

**** *****, MPH, MSW

Patient Relations Specialist

Sharp Metropolitan Medical Campus

7901 Frost Street

San Diego, California 92123

Phone – 858.939.3388

Fax – 858.939.4485

Consumer Response: This is a follow-up to a prior complaint I made against Sharp Healthcare - complaint ID *******. As part of the resolution of that complaint Sharp said it would make an adjustment to the bill for observation room time. Sharp said: "Our billing department has been informed and they will work with Aetna to reimburse and/or rebill as appropriate." It has been over two months and Sharp has failed to make any adjustments to their claim. About a week and half ago I tried contact the Sharp representative who made this statement, but have received no response.
 
I wish for Sharp to make the billing adjustment as promised.

Business Response: I am writing in follow-up to Complaint #*******.  This morning I was able to connect with the Manager of Patient Access Services.  The patients bill will be modified today and sent to Aetna for reprocessing.  We apologize for the delay in the process.  Please let me know if you have any questions or need any additional information.
Thank you,
**** *****
 
**** *****, MPH, MSW
Patient Relations Specialist
Sharp Metropolitan Medical Campus
7901 Frost Street
San Diego, California 92123

7/19/2014 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: On 04/14/2014 I went to Sharp Urgent Care on 3rd Ave in Chula Vista, CA. I was experiencing pain on my left adomin and my blood pressure was high. This is a chonic problem due to previous surgeries that I have had. I was previously treated at Kaiser and Sharp for these issues. After my last surgery in September 2013, I was told by Kaiser that I had a lot of adhesions in that left area that is causing the pain but surgery in that area would be too dangerous so I will have to learn to deal with it with medications and pain management. My insurance with Kaiser ended in February and on 4/14/2014 I woke to pain and found that my blood pressure was real high. I went to Sharp Urgent care to be seen. I brought my Kaiser medical paper work to show what medications that I am currently taking. At this time I was out of multiple medications which included pain pills and blood pressure pills. I was told that I would have to leave a 175.00 deposit and pay the difference after treatment from urgent care physician. The MD told me that it was better for me to go to the Emergency Room because it will be less expensive. I first agreed. The MD left the office to let the front office know that he will not be treating me and he was also going to contact the emergency room to let them know I was coming. When the MD came back in the room I told him that I would rather just been seen by him and I will pay the 600-800 fee that I was quoted by the front office. He again told me that he just wants to save me money and I could save money by going to the ER. He even told me that legally they cannot charge me to be seen unlike urgent care. He told that the ER will bill me at a later time. I took his advice and went to the ER. I explain my issues with the ER doctor and he told me that he could do a CT scan to see what is going on in my abdimon area but those scans can cause cancer and also you cannot see scar tissue in the scan. He told me that I know my own body and if I feel like I just need my medications refilled that he will just do that and refer me to my primary care doctor. I told him that I do not want to be exposed to cancer because I already have enough health issues. He gave me a prescription for pain pills and blood pressure pills. They said I had to pay a 200.00 deposit and released me. On 4/28/2014. I received a bill from the ER for 2340.25. They did apply the 200.00 that I had already paid but I was shocked to see that the bill was over 800.00 because I was told by the Urgent care doctor that I was going to save money by ER. I spoke a patient advocate that told me that there was nothing that she could do because she only represents the Sharps Hospital not Sharp Urgent care. I spoke to ********* ***** who is a patient advocate for Sharps urgent care. I told her that I was misled into thinking I was saving money by going to the ER. She told me the reason that he sent me to the ER was because he felt like I may have had a cyst in my ovary. I let her know that that could not have been the reason because I had told him that my ovary had already been removed. I explained to her again what was told to me. She told me that there was nothing that she could do for me but she definatly was not going to help me with the bill. I asked about the deposit of 175.00 that they took from me without rendering any services. She told me that I did have a 175.00 credit but if I wanted my money back I would have to request it. At this time I realized that I was just ripped off by Sharp and they have no intention of trying to resolve the issue

Desired Settlement: I will like to pay the amount that I would have to pay if the MD would have just seen me at urgent care which is between 600-800.00. I will also like my 175.00 either refunded to me or applied to my balance.

Business Response:  Dear Ms. *****,

This letter is in response to your complaint filed with the Better Business Bureau on May 12, 2014. Sharp Rees Stealy has reviewed your medical record with the doctor, and the physician you spoke with at Sharp Rees Stealy about your medical condition. The doctors’ specialty is emergency medicine and is very aware of the costs of care in the emergency room.

The doctor explained to you that you would be better served going to the ER because the urgent care could not provide the full work up you required to safely treat the symptoms you presented at the urgent care and therefore, directed you to the emergency room. A credit of $175.00 that you initially paid to Sharp Rees Stealy will be credited back to your credit card.

In addition, the hospital billing was reviewed and the total charges for services at the emergency room were $3,387.00. You were given a self- pay discount of 25% which brought the balance to $2,340.25. It is noted in your account that you are currently not employed and that the hospital sent you a financial packet to complete as you may be eligible for further discounts. To date, the financial packet has not been returned.

At this time the balance of $2,340.25 is outstanding and should be paid to Sharp Chula Vista Hospital unless additional financial information is received. Please contact me if you have additional questions regarding your account.

We thank you for choosing Sharp HealthCare to provide your health care needs.

Sincerely,

Vice President, Managed Care Operations

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

As, like the other representatives I talked to, no one seems to listen and the Dr is not telling the truth.  First of all I own a business and make over 400,000.00 a year.  I don't qualify for any assistance.  I already told the reps at Sharps this information.  Secondly instead of you just taking the word of the Dr. it would have been nice if you would have contacted me and asked for my side.  The Dr. not only referred me to the ER, he also referred me to a clinic on 3rd ave that he said would save me money.  I told him that I was only confortable with Sharp or Kaiser.  I still don't believe that I should be responsible for this entire bill because I was mislead.  I was told that he said that he sent me to the ER because he thought that maybe my ovary had ruptured.  If he would have listened to me, he would have known that I had them removed in September.  This is not about the money, it is about the principle.  I don't think I should have to pay for the scam that your doctor and your organization did to me.


Regards,

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

Business Response:

July 1, 2014

******* *****
1304 Santa Ynez Ave.  Apt 249
Chula Vista, CA 91913-1492

Dear Ms. *****, 

Thank you for your letter to the Better Business Bureau (BBB) regarding your concern at Sharp Rees-Stealy (SRS). The concern was forwarded to the Quality Department for review and investigation. We are very sorry to hear that our services did not meet your expectations.
   
SRS has an extensive Quality Management Program, which includes the evaluation of all issues of concern brought to our attention and a thorough evaluation of your grievance was conducted by the SRS Quality Management Department based on your dissatisfaction with SRS billing issues. 

Your statement of the problem as noted in the BBB concern: 1.) you don’t qualify for any assistance, 2.) someone from SRS did not speak to you, and  you do not believe you are responsible for the entire bill because you were misled and that your ovary was removed in September so it could not have been a ruptured ovary. 

In reviewing your complaint, first we are sorry that you do not quality for any assistance. Our billing department was able to obtain a 25% discount for you and any other discount would need to be discussed with the hospital. Secondly, several of the SRS employees have spoken to you about your compliance. 

The medical record documentation from your visit to Urgent Care (UC) states you complained of intermittent left lower quadrant pain that you had for 2 years and worsened over the past several days.  It also states you reported that you had already undergone a GYN surgery but it was unsuccessful due to adhesions. In addition, you requested medication for pain relief. 

Given the diagnoses possibilities, the UC physician was concerned due to your stated surgical history, that a work up in UC would not properly assess your complaints. The physician also took into consideration that you did not have insurance and gave you an option and recommendation of further care at the Emergency Dept. (ED).  He stated you agreed to go to the ED. Ibuprofen was prescribed for pain relief.  The UC physician further stated he would not tell a patient that going to an ED would be less expensive.

At the ED, you requested only pain medication and refused imaging that could have been used to assist in a diagnosis. You were prescribed narcotic and non-narcotic prescriptions and advised by the ED physician to follow up with your Primary Care Provider and to return the ED for worsening symptoms. 

Your credit card was refunded the $175.00 UC deposit and a 25% discount was applied to the bill.  Your request to assist further with the ED bill is being denied. 

If any further assistance is needed, I can be reached at 619.446.1886, for any questions.
Sincerely,


***** ****, LVN
Care Coordinator
Quality Management
Sharp Rees-Stealy  

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

[I am still not satisfied with your responds so this time I have attached proof that your Sharp personal has their facts wrong.  I have had multiple surgeries that have removed my uterus and ovaries and I do have a lot of scar tissue.  I did say that I believe that the scar tissue is the problem and I had been being treated for that and blood pressure issues due to the pain.   As the doctor at urgent care should have known is that you cannot see scar tissue with any type of scan.  I was told this from the ER doctor. The ER doctor told me that it would be a waste of my money to do that scan because it would not show the internal scar tissue. The ER doctor told me that the scan would not show the scar tissue  and asked me what would I like to do.  I told him that although I do take multiple medications that I would only need the medication for the pain and my blood pressure because my blood pressure goes up when I am in pain. I told him I will follow up with my primary when I get insurance what was going to be with Sharp but I decided to back to Kaiser. I wan not only given Ibruprofen and pain pills, I was also given blood pressure pills.  The doctor at urgent care could have did the same thing without charging as much.  I would have been fine with just the blood pressure pills and Iburprofen until I seen my regular doctor.  They gave me percet that is a pain pill that is terrible.  But I know he was just trying to stop the pain .  Attached you will find my prescription for blood pressure pills that will prove to you that they either don't remember what happed or they are lying.

Regards,

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


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