I was an established patient there in the midst of a cardiology work up with the doctor who Dr. Brion referred me to. Suddenly, (2025) I was told they no longer accepted my insurance. Today, while trying to locate a rheumatologist through my health insurance app, Dr. Paul Brion's name was listed as a contracted provider.
I called United Healthcare (UHC), and Gabby confirmed that I am indeed listed as an active member with the policy and that Dr. Brion is contracted. We then called Sharp Medical Group (SMG) on three-way, and we spoke w Jonathan. He also told me that I am active w both UHC and SMG, and so is Dr. Brion. Jonathan confirmed that there was an auth on file. I was given the auth number and the dates that the auth was good for (5/1 - 10/28). When Jonathan called on four-way for us, Dr. Brion's answering srvc picked up, so Jonathan left a msg for them to call me to sch the appt.
I called Dr. Brion's ofc a bit later to get sch'd. I just barely missed their call. The person didn't leave their name, but they did leave me a vm, asking me to call back to schedule. So I attempted to do so. (if I am able, I'll attach the transcribed message left by their ofc).
When I called (solo), Brenda answered. She told me my info wasnt listed online in the Sharp portal, and there was no auth on file. She said there was NO record of me in the Sharp database. When I asked her if we could plz call them on three-way to clear up the misunderstanding, she literally said to me, "No; I have other calls." She acted as if I was inconveniencing her by calling. She left me on hold for an extended period of time before telling me she would not do anything to assist. I asked who the manager was and if I could speak with that person. She told me her name was Tiffany, and "she only works remotely." she says she's left Tiffany a msg to call me.
So, I hv to call Sharp back to try to get assistance with sch'ing w Dr.Brion's ofc. Everyone was on the same page except the Dr. B's ofc. I spk w Amanda with SMG. She confirmed all the info I had gotten from the previous call w Jonathan and Gabby.
Amanda calls Dr. B's ofc again, on three-way. Rosio picked up. Amanda again asked to speak with Brenda, who we were told "was tied up." After a couple of minutes, Rosio found my info online, and she noted I had been an est'd patient there since 2024. After Amanda offered her an auth and a ref number, Rosio said she DID see an active referral and authorization on file for me... They just needed my PCP to change one of my procedure codes from a "99215 to a 99214" (A procedure code ofcs use for billing purposes. If Im able, I'll attach a pic of the comparison between the two billing codes.
After establishing it was a procedure code holding things up, Amanda directly asked Rosio why Brenda turned me away. She said was bc Brenda told me I needed to have those codes updated. That was absolutely not the case. Brenda gaslit me, and she stonewalled the appointment process. She never mentioned a procedure code. I would've been happy to contact my PCP's office to request the update on the auth. Brenda told me I wa in the system at all. There's no authorization. Open and shut. "Leave me alone."
My professional and personal lives hv been consumed with medicine and Public Health. other pts would give up. I'm not trying to rob a bank. I'm trying to sch a follow up appt w my doctor.
Ultimately, I wasn't able to sch the appt I've been working on all day. Fortunately, I felt very seen and heard by Amanda w SMG. She also noted the way in which we were brushed off, and Rosio was covering for Brenda in that call. Amanda commented to me that Brenda's behavior was completely unacceptable (she actually used the word "embarrassing") , and she'll be reporting his ofc and staff to management within SMG. She apologized to me for the way I was treated, though she doesn't work for his ofc.
It's challenging to hv many different specialists and continually be given pushback as if I am (you are) doing something wrong by trying to sch an appt. Pts shouldn't end up in tears after calling your ofc. If you treat me that way, you treat other patients the same. We all know the expression, "one bad seed..."
This is unfortunate. Dr. Brion is an excellent doctor.
As a patient, you have options. If the staff is abusive, try to find another doctor. read more
