April 2022 by Lou M.
Dr. Leandra Michelle Lyon located at Sutter Lake of the Pines Family Medicine in Auburn, CA. I had an annual wellness/check-up appointment in early March. I called my insurance prior to scheduling to confirm my requested service was covered, and to get an in-network referral, which is how I found this doctor. When scheduling the appointment, I was also extremely clear what the appointment was for. Of note within this appointment, without any indication of interest or need for, I was offered two pharmaceuticals and two vaccinations. When mentioning all the preventive healthy lifestyle habits I employ, it was barely acknowledged. After the appointment, I decided I was not going to see this doctor again, I did not feel like she really listened to me, heard me or was genuinely interested in my health, rather just in prescribing me pharmaceuticals. I also felt like she was - for lack of a better word- up-selling me the entire time by trying to bring all services to her, i.e., I mentioned going to a dermatologist and she said it could be handled in-house, I mentioned an appt I have later this year with an OBGYN and she said I could schedule that with her...it just didn't feel right. Shortly after the appointment I received a statement for $334! LONG story short - after calling my insurance and Sutter many times, my visit was coded to include a 'diagnosis' (for what?! no has yet to answer that) and another code that I was "very sick" (which was not true)- and due to these codings, I was billed and it was not covered as a basic wellness appointment that my insurance DOES cover. I have spent endless hours on the phone with both my insurance and Sutter and Sutter will not change the coding. It is unacceptable that this is allowed and that a doctor can do this. I was not notified at any time during our appointment that I was receiving a service outside my covered appt (at which point I would have stopped the appt because there as NO service outside what should have been covered). I was told on my last call with Sutter that I was charged a new patient fee. No one had mentioned that after many calls and no one mentioned that at booking the appointment or during OR as explanation when I first began calling. There was no notice of an additional fee and in my 47 years I have never paid a 'new patient' fee to see a doctor for a basic annual wellness appointment. I'm highly discouraged and disappointed in Sutter for not addressing what I would consider a breach of patient trust for requested and intended service, for a miscoded visit to financially benefit Sutter for a service that IS covered by insurance and for not reprimanding a doctor that is clearly out of line. I am changed by this experience and an already degrading trust in our healthcare professionals has been cemented. I will be very cautious in future situations to validate, confirm and reconfirm the services requested and provided. Shame on Sutter and this doctor.
