CONTACTS
SUBJECTS
UCSF Billing Irregularities Requests Kaiser Assistance Force Patient
6203 -
6203 - ..
6204 - Summary/Objective
6205 -
620501 - Follow up ref SDS 10 0000.
620502 -
620503 -
620504 -
620505 -
620506 -
620508 - ..
6206 -
6207 -
6208 - Progress
6209 -
620901 - UCSF Asks Kaiser to Tell Patient Send Questions on UCSF Billings to Kaiser
620902 -
620903 - Follow up ref SDS 12 X58I, ref SDS 11 0001.
620904 -
620905 - Millie received rex DRT 1 0001, a letter dated today from Bob at UCSF
620906 - responding to a copy of the letter on 071007, ref SDS 12 X58I,
620907 - confirming that Kaiser is working on paying UCSF for medical services
620908 - to treat Millie in a clinical trial in accordance with Kaiser's
620909 - referral on 061230. ref SDS 2 3X6K
620911 - ..
620912 - UCSF letter says...
620913 -
620914 - 1. I just spoke with Kitty C at Kaiser (phone number 1 800 464
620915 - 4000) who said she would call you today to reconfirm that any
620916 - billing issues for ******* need to be directed to Kaiser, not
620917 - UCSF Medical Center. ref DRT 1 0001
620919 - ..
620920 - Bob's letter from UCSF continues below... ref SDS 0 N88P
620922 - ..
620923 - Seems unclear why UCSF would respond to good news on 071007 that
620924 - Kaiser is working to pay UCSF billings, ref SDS 12 X58I, by telling
620925 - the patient to contact Kaiser about terms and conditions of payment
620926 - which were arranged on 061230 entirely between UCSF and Kaiser,
620927 - ref SDS 2 3X6K, and in which the patient had no involvement.
620928 -
620929 - [...below, Kitty invokes HIPAA to tell Millie UCSF does not
620930 - want communications on solving billing problems.
620931 - ref SDS 0 KP5H
620933 - ..
620934 - [On 071026 billing irreglarities make health care major
620935 - challenge for everyone. ref SDS 14 X18J
620937 - ..
620938 - [On 071128 Kaiser Appeals Committee approved payment for
620939 - Millie's care on referral to UCSF. ref SDS 15 JZ5R
620940 -
620941 -
620942 -
620943 -
620944 -
6210 -
SUBJECTS
Kaiser Calls Emotional Stressed Stage IV Cancer Patient Misrepresent
A103 -
A10401 - ..
A10402 - Emotional Stress Payment Dispute Driven Threaten Stave IV Cancer Patient
A10403 - Kaiser Helps UCSF Collect Payment from Patient Owed by Kaiser
A10404 - HIPAA Misrepresented Bill Collection Sensitive Medical Information
A10405 - Kaiser Calls Bill Collection for UCSF Sensitive Medical Information
A10406 -
A10407 - Millie received a call this morning from Kitty at Kaiser. Kitty was
A10408 - emotional and would not give her name, Kaiser ID, department, phone
A10409 - number, nor email address to confirm what she said. Kitty hung up
A10410 - when asked for identification, per below. ref SDS 0 KP61
A10412 - ..
A10413 - Difficulty coping with emotional trauma presented by complex problems
A10414 - was addressed by Millie's doctor during the meeting at Kaiser on
A10415 - 070921. ref SDS 8 QY9V Complexity of Millie's patient history is
A10416 - shown in case study reported on 061020. ref SDS 1 T25H
A10418 - ..
A10419 - At the time of the call, Millie was resting in bed.
A10421 - ..
A10422 - Kitty was adament insisting she could only talk to Millie. She said
A10423 - that HIPAA regulations require conveying sensitive medical information
A10424 - only directly to the patient. She asked that Millie be awakened and
A10425 - called to the telephone to personally take Kitty's call.
A10426 -
A10427 - [On 090219 1315 HIPPA cited for preventing submission of
A10428 - patient medical records to the patient. ref SDS 16 9O6L
A10430 - ..
A10431 - [On 100701 0915 Carol, representing herself as Chief of
A10432 - Hospice, asked to wake Millie up to talk directly about
A10433 - Carol having been told that Millie wants to dis-enroll from
A10434 - Hospice; Carol insisted that HIPAA entitles her to evaluate
A10435 - Millie's intent on the telephone, without having ever met
A10436 - Millie nor read the record of patient history; Millie
A10437 - explained she wants to continue in Hospice for pain relief
A10438 - from chemotherapy until Kaiesr responds to her claim for
A10439 - standard of care to recover from UCSF medical mistakes;
A10440 - Millie will consider dis-enrolling from Hospice when Kaiser
A10441 - explains choices for recovery. ref SDS 22 036C
A10442 -
A10443 -
A10444 -
A10445 -
A105 -
SUBJECTS
HIPAA Health Information Portability and Accountability Act Entitles
A903 -
A90401 - ..
A90402 - HIPAA Entitles Patient to Medical Records and to Submit Corrections
A90403 -
A90404 - Research shows HIPAA requirements to protect privacy of personal
A90405 - health information are listed on the Internet...
A90406 -
A90407 - United States Department of Health & Human Services
A90408 - Office for Civil Rights
A90409 - Medical Privacy
A90410 - National Standards to Protect the Privacy of Personal Health Information
A90412 - ..
A90413 - HIPAA - Health Information Portability and Accountability Act
A90415 - ..
A90416 - Beginning 030413.
A90417 -
A90418 - US Department of Health and Human Services (HHS)
A90420 - ..
A90421 - Office of Civil Rights
A90423 - ..
A90424 - Health Information Privacy
A90426 - ..
A90427 - Health Insurance Portability and Accountability Act
A90428 - (HIPAA) 1996
A90429 -
A90430 -
A90431 - http://www.hhs.gov/ocr/privacy/index.html
A90433 - ..
A90434 - The Office for Civil Rights enforces the HIPAA Privacy Rule,
A90435 - which protects the privacy of individually identifiable health
A90436 - information, and the confidentiality provisions of the Patient
A90437 - Safety Act, which protects identifiable information being used
A90438 - to analyze patient safety events and improve patient safety.
A90440 - ..
A90441 - Access. Except in certain circumstances, individuals have the
A90442 - right to review and obtain a copy of their protected health
A90443 - information in a covered entity's designated record set.55 The
A90444 - "designated record set" is that group of records maintained by
A90445 - or for a covered entity that is used, in whole or part, to
A90446 - make decisions about individuals, or that is a provider's
A90447 - medical and billing records about individuals or a health
A90448 - plan's enrollment, payment, claims adjudication, and case or
A90449 - medical management record systems.56 The Rule excepts from the
A90450 - right of access the following protected health information:
A90451 - psychotherapy notes, information compiled for legal
A90452 - proceedings, laboratory results to which the Clinical
A90453 - Laboratory Improvement Act (CLIA) prohibits access, or
A90454 - information held by certain research laboratories. For
A90455 - information included within the right of access, covered
A90456 - entities may deny an individual access in certain specified
A90457 - situations, such as when a health care professional believes
A90458 - access could cause harm to the individual or another. In such
A90459 - situations, the individual must be given the right to have
A90460 - such denials reviewed by a licensed health care professional
A90461 - for a second opinion.57 Covered entities may impose
A90462 - reasonable, cost-based fees for the cost of copying and
A90463 - postage.
A90464 -
A90465 - [On 091112 0930 Doctor Johnson reports that Millie's health
A90466 - care benefits from getting communications among the medical
A90467 - team at UCSF and Kaiser by providing transparency that
A90468 - encourages timely, accurate work to avoid mistakes, and
A90469 - providing analysis showing alignment with the record on
A90470 - objectives, requirements, and commitments that makes case
A90471 - management effective for Millie's survival. ref SDS 17 4W8K
A90473 - ..
A90474 - [On 091112 0930 Millie asked Doctor Johnson for all
A90475 - communications between UCSF and Kaiser on her care; Doctor
A90476 - Johnson could not find any such communications, and cited
A90477 - guidance at Kaiser that HIPAA deny's patients access to
A90478 - communications on their care. ref SDS 17 LQ5N
A90480 - ..
A90481 - [On 091210 0950 Millie asks Doctor Johnson for Kaiser's
A90482 - medical records communicating with UCSF on the UCSF work
A90483 - plan for Millie to recover from medical mistakes.
A90484 - ref SDS 18 OJ9F
A90486 - ..
A90487 - [On 100502 0140 Millie notifies Kaiser and UCSF she waives
A90488 - right to confidential health records in order exercise her
A90489 - right to health using efficient public domain email because
A90490 - patient history using securemail encrypted to protect
A90491 - confidential health records shows this causes chronic
A90492 - failure to communicate in time to be effective. ref SDS 19
A90493 - CO3W
A90495 - ..
A90496 - [On 100504 1609 Sara, Practice Manager for UCSF Oncology
A90497 - Breast Care Clinic, called and notified Millie that lawyers
A90498 - in the UCSF Risk Management Department want Millie to use
A90499 - secure email to comply with Federal regulations; Sara does
A90500 - not know what Federal regulations apply in this case, nor
A90501 - what the regulations say that justify denying the patient
A90502 - the right to choose the level of confidentiality suited to
A90503 - the patients need for communicating effectively with her
A90504 - medical team, and with transparency that encourages
A90505 - accuracy and timeliness. ref SDS 20 ZV6M
A90507 - ..
A90508 - [On 100601 0830 Doctor Johnson reported he received
A90509 - securemail from Doctor Rugo at UCSF encrypted to protect
A90510 - confidentiality of Millie's health records, but he could
A90511 - not open the letter; he sent Doctor a securemail advising
A90512 - he could not open her securemail, and he received back a
A90513 - public domain email from Doctor Rugo that she could not
A90514 - open Doctor Johnson's letter from Kaiesr; as a result of
A90515 - failed communcation with email and telephone for over a
A90516 - month, Doctor Johnson was unable to prescribe treatment for
A90517 - Millie to recover from medical mistakes getting radiation
A90518 - treatments at UCSF on referral from Kaiser; resulting in
A90519 - Millie being forced into Hospice to die. ref SDS 21 D658
A90521 - ..
A90522 - Another HHS source summarizes HIPAA requirements...
A90523 -
A90524 - Your Health Information Privacy Righs
A90525 -
A90526 - http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/consumer_rights.pdf
A90527 -
A90528 - You can ask to see and get a copy of your medical record and
A90529 - other health information. You may not be able to get all of
A90530 - your information in a few special cases. For example, if your
A90531 - doctor decides something in your file might endanger you or
A90532 - someone else, the doctor may not have to give this information
A90533 - to you.
A90535 - ..
A90536 - HIPAA requires service providers to add information to the medical
A90537 - chart showing corrections submitted by the patient...
A90539 - ..
A90540 - Have corrections added to your health information.
A90542 - ..
A90543 - You can ask to change any wrong information in your file or add
A90544 - information to your file if it is incomplete. For example, if
A90545 - you and your hospital agree that your file has the wrong result
A90546 - for a test, the hospital must change it. Even if the hospital
A90547 - believes the test result is correct, you still have the right
A90548 - to have your disagreement noted in your file.
A90549 -
A90550 - In most cases the file should be changed within 60 days,
A90551 - but the hospital can take an extra 30 days if you are given
A90552 - a reason.
A90553 -
A90554 -
A90555 -
A906 -
SUBJECTS
Kaiser Calls Emotional Stressed Stage IV Cancer Patient Misrepresent
BG03 -
BG0401 - ..
BG0402 - Health Care Professional Stress Cannot Help Emotionally Stressed Patient
BG0403 -
BG0404 - Explained that Millie has been upset by erroneous, complex, confusing
BG0405 - UCSF billings reported recently when Kaiser called on 071006 and
BG0406 - Millie was unable to take the call. ref SDS 11 ZE9H Millie's doctor
BG0407 - prescribed medication to treat for stress arising from billing
BG0408 - problems, reported on 070921. ref SDS 8 QY9V Patient assistance helps
BG0409 - Millie focus on recovery by avoiding worry that compounds stress
BG0410 - suffering from 45 medical issues, listed on 070524, ref SDS 3 LU3J,
BG0411 - illustrated by the call from Kaiser a few days ago on 071006.
BG0412 - ref SDS 11 Q998
BG0414 - ..
BG0415 - Kitty explained her job is very stressful communicating with difficult
BG0416 - patients on taking medical action Kaiser determines is needed.
BG0418 - ..
BG0419 - Kitty was aware that Millie has assistance. She was adament that her
BG0420 - call today involved sensitive, critical medical information which
BG0421 - HIPAA regulations required being conveyed only to Millie. Kitty was
BG0422 - asked if Kaiser could send a letter addressed to Millie, since Kitty
BG0423 - has never met Millie and would not know her from anyone else in a
BG0424 - first time telephone call?
BG0426 - ..
BG0427 - Kitty advised that her information is urgent, and asked to talk to
BG0428 - Millie immediately. She seemed willing to talk to anyone with an
BG0429 - evident female voice, and mentioned having been warned not to talk to
BG0430 - the patient assistant.
BG0432 - ..
BG0433 - Millie talked to Kitty.
BG0435 - ..
BG0436 - Kitty said in a loud, abusive tone and language toward Millie that she
BG0437 - received a call from Bob Schwartz with UCSF Accounting Department
BG0438 - complaining to Kaiser about receiving improper, repetitive,
BG0439 - unnecessary correspondence through email from Millie and her
BG0440 - representative asking for explanations of UCSF billings, and reporting
BG0441 - efforts to resolve payment dispute between UCSF and Kaiser.
BG0442 -
BG0443 - [On 071128 Kaiser Appeals Committee approved payment for
BG0444 - Millie's care on referral to UCSF. ref SDS 15 JZ5R
BG0446 - ..
BG0447 - [On 100723 1810 Millie received another call from someone
BG0448 - claiming to represent Kaiser, and insisting on talking only
BG0449 - to Millie about sensitive medical information, and was told
BG0450 - to submit questions in writing. ref SDS 23 036C
BG0452 - ..
BG0453 - Millie asked if correspondence on UCSF billings should be sent to
BG0454 - Kitty? Has she been assigned to work this issue at Kaiser?
BG0456 - ..
BG0457 - Kitty said she knows nothing about it. She is only doing a favor for
BG0458 - Bob, because he called and asked her to tell the "deadbeat" patient
BG0459 - that UCSF does not want correspondence and calls from the patient on
BG0460 - efforts to solve billing problems; an example is the copy sent to Bob
BG0461 - of a recent letter on 071007 relating good news that Kaiser is working
BG0462 - on resolving billing dispute with UCSF in Millie's case. ref SDS 12
BG0463 - X58I Kitty's explanation that UCSF refuses to participate in resolving
BG0464 - billing problems with Kaiser seems to align with the letter from UCSF,
BG0465 - which Millie received from Bob this morning, per above. ref SDS 0 X65I
BG0467 - ..
BG0468 - UCSF refusal to discuss billings conflicts with Bob's letter to Millie
BG0469 - on 070924 offering close communication on billing issues. ref SDS 9
BG0470 - N45S
BG0471 -
BG0472 - [On 071026 billing irreglarities make health care major
BG0473 - challenge for everyone. ref SDS 14 X18J
BG0475 - ..
BG0476 - Millie asked if Kitty knows who at Kaiser can address this, since she
BG0477 - has asked her doctor, and he could not help, reported on 070907.
BG0478 - ref SDS 6 XH5H
BG0480 - ..
BG0481 - Kitty said she doesn't know what should be done.
BG0482 -
BG0483 - [On 071128 Kaiser Appeals Committee approved payment for
BG0484 - Millie's care on referral to UCSF. ref SDS 15 JZ5R
BG0486 - ..
BG0487 - Millie asked Kitty for her department and phone number.
BG0489 - ..
BG0490 - Kitty hung up.
BG0492 - ..
BG0493 - Called Kaiser using the number for Kitty C in the letter from from Bob
BG0494 - Schwartz at UCSF, 1 800 464 4000, per above, ref SDS 0 N87V,
BG0496 - ..
BG0497 - Got a message saying...
BG0498 -
BG0499 - If you are a member press 1.
BG0500 -
BG0501 - If you are a service provider press 2.
BG0503 - ..
BG0504 - There was no option to connect with Kitty C.
BG0506 - ..
BG0507 - Eventually an operator came on the line.
BG0509 - ..
BG0510 - After considerable discussion with the operator, she transferred the
BG0511 - call to...
BG0512 -
BG0513 - Kitty Cook
BG0514 -
BG0515 - ...left message asking if she is the Kitty C who was contacted by UCSF
BG0516 - and placed a call, per above, ref SDS 0 JW7M, and as set out in UCSF's
BG0517 - letter today. ref SDS 0 N87V
BG0518 -
BG0519 -
BG0520 -
BG0521 -
BG06 -
SUBJECTS
UCSF Claims Notice from Kaiser Patient Received Verbal Written Notic
CF03 -
CF0401 - ..
CF0402 - UCSF Received Verbal Written Assurance Patient Informed Coinsurance
CF0403 -
CF0404 - Follow up ref SDS 9 UM3V.
CF0405 -
CF0406 - UCSF letter from Bob Schwartz continues...
CF0407 -
CF0408 - 2. We have been informed by Kaiser that there is verbal & written
CF0409 - confirmation that Ms. Buck was informed that she would be
CF0410 - responsible for the coinsurance. ref DRT 1 PI6G
CF0411 -
CF0412 - [On 071010 Millie's letter to UCSF refutes allegations that
CF0413 - Kaiser disclosed coinsurance charges prior to making
CF0414 - referral for Millie's care at UCSF. ref SDS 13 HZ9P
CF0416 - ..
CF0417 - This part of the UCSF letter seems to address, though obliquely, the
CF0418 - question in the letter to UCSF on 070924 asking about the basis for
CF0419 - coinsurance charges on chemotherapy and related expenses in UCSF
CF0420 - invoices, which were originally represented to be paid by the clinical
CF0421 - trial. ref SDS 9 UM3V
CF0423 - ..
CF0424 - UCSF letter today citing coinsurance, ref SDS 0 N88P, may also address
CF0425 - the record on 071006 submitted to UCSF with the copy of the letter to
CF0426 - Kaiser on 071007, relating progress on solving Kaiser's problems
CF0427 - getting payment to UCSF. ref SDS 12 IE3R The basis for Kaiser's work
CF0428 - to pay UCSF rests on being responsible for any costs not paid by the
CF0429 - clinical trial, noted on 071006. ref SDS 11 TL98 At that time, Kaiser
CF0430 - requested background on their duty to pay for the referral work for
CF0431 - Millie at UCSF. ref SDS 11 Q969
CF0433 - ..
CF0434 - UCSF should submit information from Kaiser showing alleged notice to
CF0435 - patient responsibility for coinsurance, so this can be investigated
CF0436 - and corrected. Nameless representations are not constructive and only
CF0437 - delay solution by giving people false hope that an incorrect position
CF0438 - has support in the record. UCSF was notified on 070830 that Kaiser
CF0439 - made the referral for Millie's care at UCSF, and there is no basis for
CF0440 - coinsurance. ref SDS 4 ZS6M This is supported by correspondence
CF0441 - between Kaiser and UCSF listed on 070830. ref SDS 4 T247
CF0443 - ..
CF0444 - At that time on 070830 Bob examined the letter from Kaiser showing
CF0445 - Kaiser's agreement with UCSF to pay for any costs not covered by the
CF0446 - clinical trial, and noted there was no requirement for the patient to
CF0447 - pay coinsurance. ref SDS 4 T14K
CF0448 -
CF0449 - [On 071010 Millie's letter to UCSF refutes allegations that
CF0450 - Kaiser disclosed coinsurance charges prior to making
CF0451 - referral for Millie's care at UCSF. ref SDS 13 HZ9P
CF0453 - ..
CF0454 - It is unclear why employees at UCSF would spend so much time and
CF0455 - emotional capital trying to extract payment from a sick patient who
CF0456 - owes UCSF nothing, while making no attempt to collect from Kaiser who
CF0457 - owes payment to UCSF for referral work, shown in Kaiser's letter on
CF0458 - 061230, ref SDS 2 3X6K, and confirmed by UCSF correspondence on 070906
CF0459 - saying Kaiser made the referral. ref SDS 5 UK5M
CF0460 -
CF0461 -
CF0462 -
CF0463 -
CF05 -
SUBJECTS
Charity Referral Loan Home Equity Collection Billings Erroneous Char
DA03 -
DA0401 - ..
DA0402 - UCSF Offers Payment Assistance to Patient Rather than Kaiser
DA0403 -
DA0404 - Follow up ref SDS 4 9K7G
DA0405 -
DA0406 - UCSF letter continues...
DA0407 -
DA0408 - 3. As I mentioned earlier to Rod, we can arrange for interest free
DA0409 - payment plans for Ms Buck if she so requests. We also have a
DA0410 - Charity Care program, to assist patients with low income.
DA0411 - ref DRT 1 9J6L
DA0413 - ..
DA0414 - On 070830 UCSF proposals for payment assistance and charity for Millie
DA0415 - were misdirected, since there is no evidence the patient owes UCSF
DA0416 - money, and evidence shows Kaiser is liable for costs of care for
DA0417 - Millie contracted on referral to UCSF, and therefore collection
DA0418 - efforts should be applied to assist Kaiser in making timely payment to
DA0419 - UCSF. ref SDS 4 9K8Q
DA0421 - ..
DA0422 - UCSF letter continues...
DA0423 -
DA0424 - 4. Here is a listing of the accounts with current patient
DA0425 - responsibility. There are other accounts not listed here that
DA0426 - we are awaiting insurance payment. ref DRT 1 SK7G
DA0428 - ..
DA0429 - 12593370 O BUCK ,MILDRED 03/01/07 01/21/1936 $ 202.65
DA0430 - 12763636 O BUCK ,MILDRED 04/05/07 01/21/1936 $ 162.12
DA0431 - 12764302 O BUCK ,MILDRED 05/03/07 01/21/1936 $ 283.96
DA0432 - 12997805 O BUCK ,MILDRED 07/19/07 01/21/1936 $ 27.88
DA0433 - 12997886 O BUCK ,MILDRED 06/07/07 01/21/1936 $ 162.12
DA0434 - 12997900 O BUCK ,MILDRED 07/05/07 01/21/1936 $ 173.39
DA0436 - ..
DA0437 - This follows up Bob's last submission dated 070912, and received on
DA0438 - 070917. ref SDS 7 WP5I Review on 071006 shows pending issues of
DA0439 - justification have not been answered by UCSF. ref SDS 11 454M
DA0441 - ..
DA0442 - On 071006 Millie received additional billings that appear to duplicate
DA0443 - prior charges shown in the listing today. ref SDS 11 PRWW
DA0444 -
DA0445 - [On 071010 Millie proposed making interim payment,
DA0446 - ref SDS 13 UW5J, and requested that UCSF submit
DA0447 - explanations showing the basis of billings, and the total
DA0448 - amount owed todate. ref SDS 13 HZ9X
DA0449 -
DA0472 -
DA0473 -
DA0474 -
DA0475 -
DA0476 -
DA0477 -
DA0478 -
DA0479 -
DA0480 -
DA0481 -
DA0482 -
DA0483 -
DA0484 -
DA0485 -
DA05 -